Mental health treatment in Guyana is being practiced by non-professionals and this is very dangerous, according to Ingrid Goodman, who has worked in the area in various countries.
Goodman continues to accuse the government of not engaging her, even though she has a lot to offer, inclusive of a Women’s Refuge Home to rehabilitate mothers accused of abusing their children. “My observation has been that the new administration’s modus operandi is that they have the solution to every problem, and they are paying lip service to partnership,” Goodman told the Sunday Stabroek in an interview.
She has had some head-butting with persons in high office, inclusive of Director of the Child Care & Protection Agency (CC&PA) Ann Greene and former Minister of Social Services Volda Lawrence. Last year, she had revealed that a mental assessment conducted on staff at three state-run child care facilities—the Mahaica Children’s Home, Sophia Care Centre and the Drop-In Centre—found troubling issues, including the inability of more than half of the caregivers to define the term abuse and the use of lashes as the main form of punishment.
She had accused Minister Lawrence and Greene of showing disinterest in her findings, while incompetency persisted in the care of institutionalised children. They both had denied this charge.
In an extensive interview with the Sunday Stabroek, Goodman pointed out that mental health is like Information Technology or Chemistry, it is a discipline. “People go to the university for many years to get trained, they do not get it in three-day workshops; those workshops are for people who are trained already,” she said.
According to Goodman, efforts are being made to remedy the situation through a partnership with York University to have social workers trained but she warned that those trainees would not be ready until another ten years.
Goodman, who returned to Guyana eight years ago after living in several countries, has a BSc in Economics and Business Administration, an MA in Social Work and Community Organisation and a post-graduate degree in Behavioural Analysis. She also described herself as a social entrepreneur, who is in the business of marketing social and intervention programmes.
The woman, who said that since she returned she has been attempting to represent the poor and downtrodden, believes she is being discriminated against by some in authority.
She gave the example of being contracted by PAHO in November, 2016, and before the assignment started it was withdrawn by the Ministry of Public Health without any explanation. “My experience is with serving the poor, who on many occasions have to go the state because of poverty,” Goodman said before adding that whenever she represents clients, they are often punished and for some the services that were being offered are withdrawn. “I was warned and questioned why I was going to the media and not collaborating,” Goodman, who has written several letters highlighting various issues, said. “And when they do that it is poor and the oppressed who are further punished,” she added, before revealing that the Guyana Police Force has been more cooperative than those in government.
Meanwhile, talking about the training she conducted at the three homes at the request of Greene, Goodman said she conducted two sets of training and Greene called her back in 2014 to conduct a third training session since, according to her, the personnel were not getting it and there was no improvement.
“… I asked permission to do something different, to allow me to assess them, individually and in groups,” she said. This assessment found that the basic reading and comprehension skills of the participants were lacking. She said 94% said they understood the CC&PA policy on discipline.
However, it was found that 66% of those interviewed were “unable to define abuse.” She also found that 59.1% of those interviewed only had a primary-level education, while 34.2% had a secondary-level education. The 5.5% who had tertiary education were all based at the Mahaica facility.
After the assessment, Goodman said, there was a breakdown, which became visible when the new administration took office.
“We are dealing with a… malfunctioning work force,” Goodman stressed, while adding that when she presented the findings it was “the beginning of the end.” This issue was raised with Greene by this newspaper when Goodman first publicly raised it and she had denied her claims.
She had said Goodman did indeed present the information “to us in a presentation format and she was to give the final copy.” She had said too that she was not sure if that was ever done. “We have looked at the information and in fact it has informed us and it has helped,” she added.
Goodman said there has been no further progress on the matter.
Under the new administration, she was given one contract in 2016 by Minister Lawrence at the Palms and she conducted an assessment and presented a report. She was not engaged again but later saw a newspaper report, which stated that the recommendations she submitted were being implemented by the ministry.
‘Accepted norm’
For Goodman, one of the difficulties upon her return was understanding the culture and she found a lot that was disturbing.
“Sexual abuse of children is a culturally accepted norm in Guyana,” Goodman charged, before adding that she believes that the change agents need to ask the question ‘How do we change cultural norms?’ She believes that the root is economics as there is a dependency syndrome, where women go from generation to generation depending on men.
“There is also a cultural norm of abandonment, there is abandonment of children and the elderly and this a cultural norm,” she said.
Further, she said, Guyanese do not know their rights and she pointed out that in other countries no matter how poor persons are, they know their rights. “…It is not so in Guyana. Even the educated don’t know their rights and if people don’t know their rights, it is easier for governments to further oppress them,” she added.
There is a need, Goodman said, for social programmes to be recognised as entrepreneurship but instead the state operates as if they are the sole agents of social programmes, which they purchase from foreigners and which many times are not applicable to Guyanese society.
Goodman revealed that she designed a mental health programme, which she taught at the Institute for Distance and Continuing Education from 2011 to 2013, and which focused on preparing the work force to identify the early signs of mental disorders.
A similar programme was done at Critchlow Labour College back in 2014, but following the proroguing of the National Assembly in that same year, it was derailed. She believes that she is well grounded with the people in the communities but she said while people are calling for services and screenings are done, when they hear they have to pay clients do not return.
Refuge Centre
Since her return Goodman has opened a refuge centre at Melanie, East Coast Demerara, where she offers a psychosocial treatment programme for women who have mental health issues, are abusers of their children and who may have been abused themselves as children.
It was launched in 2014 and it was envisioned that it would have worked in collaboration with the state, since the state has access to the perpetrators.
The centre has ten available beds and is marketed as an emergency crisis centre which treats people who are displaying symptoms of psychotic and disrupted behaviours that lead to mental disorders.
But the beds remain empty as those who need the service are unable to pay for same and the state seems least interested, according to Goodman. Only two women took up residence in the centre since it opened.
“People who need the service, they can’t afford the service,” she noted, revealing that the treatment regimen costs $87,000 for boarding, food, assessment and intervention.
The centre also offers counselling sessions, which cost $5,000 for every hour. It is staffed by four persons.
“People would come for two, three weeks, once a week, and then they stop because of the payment,” Goodman said, while adding that persons in crisis may need first to be stabilised and have two or three sessions a week before the sessions are reduced to once a week.
The centre does pro bono work and Goodman said that in those cases persons do not miss sessions and this also involves making home visits and visiting the schools of affected children. Goodman and her team also go into the communities and hold self-esteem sessions, which are held for ten weeks free of cost and they have found that people turn up to the sessions. In 2016 alone, some nine communities on the East Coast were covered.
“People do not value therapy…they would love to have it if they did not have to pay. But it is not a service they attach monetary value to. When they have to take action to correct a behaviour and take ownership, they rather walk away from the treatment. It is more painful to correct it and becomes easier to live with,” Goodman shared.
The refuge centre can be contacted on 273-5391.
