Dear Editor,
Today I wish to initiate a national debate on mental health. Guyana is one of the leading countries in the world as it pertains to mental health issues and the associated suicide and parasuicide.
I recently learnt of a former medical colleague who is battling mental illness. A gifted doctor who is now a vagrant on the streets, with no support either from healthcare professionals or the Medical Council of Guyana.
Whatever happened to duty of care? In St. Lucia, where I worked, a young gifted colleague committed suicide because of mental illness and lack of support. Another, also in St. Lucia, has also taken to living on the street.
I saw a video of a young lady experiencing a mental health crisis at UG and some folks on social media found it funny. These are just a few unfortunate examples. The evidence is that doctors are at higher risk of mental illness and suicide because of the nature of our jobs.
I’m not at liberty to divulge the mental illness of any of my colleagues, but I do wish to share my own battles. I wish to educate the public about the relationship between childhood psychology trauma and mental illness. I also wish to highlight the deep seated ignorance of mental illness in Guyana, the prejudice and stigma we experience, hence the main reason why many patients keep their diagnosis private.
What I am going to write is no easy task. I wrote several letters to the editor with a view of sharing my mental health battles, only to email the editor to request it should not be published. Today, I have taken the painful decision to be open about it because I feel I owe it to my fellow patients to be their advocate.
I suffered from mental illness since I was a teenager. The tragic death of my mother when I was too young to understand the finality of death is a major factor. Abandoned by a useless father further compounded this childhood mental trauma. My aunt did a great job bringing up five orphans, but at the tender age of 22 years, she was not equipped to deal with that massive responsibility. I applaud her for her efforts and owe her a great debt of gratitude.
As a teenager, I had to be hospitalised for one week for attempted suicide. I’m not sure what transpired during my in-patient stay, but I was referred to a psychiatrist. I went to my appointment and became scared with what I saw; a crowded clinic with patients in varying states of mental distress. I exited the clinic and vowed never to return.
I migrated and my symptoms of highs and lows continued. Insomnia, paranoia and the associated irritability was a pattern of behaviour. One of my consultants within a year of me migrating to the UK, recognised that I needed help. I was forced to seek help and was diagnosed with bipolar affective disorder, which I likely had since I was a teenager. I was ashamed of my diagnosis and would never discuss it. The negatives are many but I’d rather focus on the few positives, namely, increased creativity and higher than average intelligence by many who have it. Many past and present brilliant scientists have it. Many great writers have it. Many Grammy and Oscar winning artists and actors have it. Some psychiatrists argue it is the price that humans had to pay for higher intelligence, when compared to our primitive ancestors.
In 2015, I once again attempted suicide. I drove my Audi TT Quadro sports car into a parking lot of cars. Anyone who knows about Audi sports cars would tell you they have powerful engines. My car was written off. Four other cars were written off in the process. I was stopped by hitting into a wall. I immediately regretted it but lied it was an accident. Clearly it was not. At that time, I was off sick for 11 months, as the medical council investigated my mental health. No clinical concerns were ever raised, it was always my pendulum of moods.
Today, thankfully, I am better on medication and I do receive the support from my employer, medical council and my psychiatrist (medical supervisor), who all recognised me as an exceptional doctor that needed help. The support was instigated in 2016 by the medical council in the form of legal undertakings, since despite the investigations, I continued to refuse the necessary support because like most mental health patients, I refused to accept my diagnosis.
In retrospect, this was the best thing to have happened and started as the impetus for me to be open about my diagnosis with those close to me.
With the help of my employers and the medical council, I became the first from my batch to pass the MRCP (UK) in record time. The first from my batch to become a consultant in the UK. The first from my batch to become a specialist in the UK. The first from my batch to become a fellow of a royal college (FRCP Edin). The first and only MRCP PACES examiner from Guyana and possibly the Caribbean. I was recently nominated for the FRCP (UK) fellowship.
My point is that with the right support, mental health patients in Guyana can live productive lives. The Government should urgently develop policies to address this very serious national issue. The public needs to be educated. The public needs to understand that mental illness is not dissimilar to physical illness. Laws should be passed to protect mental health patients from discrimination. It should be mandatory that employers have systems in place to support mental health employees.
Yours faithfully,
Dr. Mark Devonish MBBS MSc
MRCP (UK) FRCP (Edin)
Consultant Acute Medicine
Nottingham University Hospital
