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Ministry trying to remove stigma that affects mental health patients

BY ALPHEA SAUNDERS
Senior staff reporter
saundersa@jamaicaobserver.com

Wednesday, September 12, 2018

ACTING Director of Mental Health and Drug Abuse in the Ministry of Health Dr Kevin Goulbourne says stigma still remains a significant part of the problems facing persons with mental illnesses.

He said, however, that persistent efforts are being made to reduce stigma and encourage families to seek help for their loved ones.

“One of the ways we have been trying to do that is to train persons who are not mental health professionals to be part of the team, because a lot of persons who have mental health issues actually approach their general practitioners first, so we are trying to equip the general practitioners and general nurses with the necessary skills to identify persons with mental illness, to start treatment and, where necessary, refer them to us. Usually, when persons are seen by a general practitioner first and they are seeing them for some time, they may get more comfortable, with the general practitioner's recommendation to seek psychiatric help,” he explained.

Dr Goulbourne was speaking about the role of depression and other mental illnesses which could lead to suicide in Jamaica. He was also among a panel of experts who outlined the extent of the problem at this week's Jamaica Observer Monday Exchange.

According to Dr Goulbourne, mental health authorities are not only seeking to educate the general public, but also health workers themselves, including doctors, who sometimes have negative attitudes towards psychiatric patients. “If the attitude is there, then the patients or relatives also will be kind of timid to approach psychiatric treatment for their relatives. But if doctors and other health-care workers are accepting that psychiatric illness is an illness which affects the body, in this case the brain, and they feel more comfortable in giving treatment, and when that the treatment does work they (patients) can improve and get back into mainstream society.

“If that acceptance is both on a health-care level and the general public, then persons will be more willing to accept persons who have mental illness,” the doctor explained.

Dr Goulbourne, meanwhile, noted that there is also the long-standing stigma attached to institutionalisation for psychiatric illnesses. He said a part of the thrust is to help persons who can to reintegrate into the society, and thereby assist with removing stigma. He said, too, that work would continue on plans for the deinstitutionalisation of patients at the island's only psychiatric hospital — Bellevue.

“When persons become mentally ill, we say they belong at Bellevue… we are moving away from that idea that persons have to be treated for mental illness within an institution. We are moving toward where persons can be treated in the community, and hopefully we will have persons being treated at home,” Dr Goulbourne said.

Classification of patients at Bellevue Hospital has already been undertaken and a Cabinet submission is being prepared, seeking authorisation for separation and changes in staffing arrangements, said the medical doctor.

The plan for Bellevue, said Dr Goulbourne, is multi-pronged, as mental health services have to be readily available within the communities to absorb these persons. He added that the initial phase of the plan is not mainly focused on getting the patients out of the hospital, as in some instances persons have been there for decades and it is difficult to locate their families.

“The initial step we want to do is separate persons who are there more for social reasons – meaning their mental illness is relatively stable, they can function somewhat but they don't have anywhere to go. [We want] to have those persons treated within a different location within a hospital and have fewer professional persons looking after them. So you won't have to have doctors and nurses seeing them as regularly, and have those persons who are acute being treated by nurses and doctors instead,” he outlined.

Mental health services are available across the ministry's four health regions, administered by psychiatrists, and mental health officers, assisted by psychiatric aides.

Dr Goulbourne said services can be accessed at community health centres, hospitals and there are also 24-hour emergency services, including response to calls for assistance.