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Enhancing the provision of community mental health care

CHRISTOPHER TUFTON

Sunday, October 13, 2019

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World Mental Health Day 2019, celebrated on October 10, was a special day for the Ministry of Health and Wellness and, more importantly, for the people of Jamaica whom we serve.

It is the day we announced the Mental Health and Suicide Prevention Helpline 888 NEW LIFE (635-5433); revealed our fleet of new buses to support the delivery of community mental health services and launched the public awareness campaign on mental health 'Speak Up, Speak Now'.

The helpline affords persons in need a reliable access point for initial counselling by psychologists and appropriate referrals for follow-up psychological and social support, and for intervention to address mental health crises, including suicidal intent or attempts.

It is against this background that we are enhancing the provision of community mental health service delivery and response, including the addition of 14 new buses to provide mental health services at the community level. Last year, of the more than 4,500 mental health crisis calls received islandwide, the community mental health team provided face-to-face response to some 2,500.

Our efforts to improve service offerings are also evidenced by ongoing measures to increase the staff complement in the regions by training different categories of staff for mental health teams.

Five psychiatrists should be graduating next year to enhance the complement in the public system. There are also efforts to increase the cadre of psychiatric nurses, who are mental health officers or mental health nurse practitioners.

Of the 170 applications for the psychiatric nursing aides course, 108 were eligible to be sitting pre-entrance tests and be subject to psychometric testing by the end of this month. The entire process should be completed and the training of 35 persons to become psychiatric nursing aides begins next February.

The objective is to have 108 psychiatric nursing aides for the south-east health region, 44 for the west and 44 for the southern region. In the next year, it is projected that at least 70 psychiatric nursing aides will be trained.

The deployment of more buses, together with the staff increase, should improve community mental health services even as we put a spotlight on mental health with the campaign.

Among other things, the campaign provides a platform from which people can share their story of mental illness, since, as we say on the new mental health web page of the ministry ( https://www.moh.gov.jm/mental-health), “every story of mental illness, whether of struggle or of triumph, is one more that can inspire”.

We want Jamaicans to be unafraid and unapologetic about talking about mental illness. It is one of the first steps to ending mental illness stigma.

Meanwhile, teamwork has never been more important than in the effort to safeguard mental health and prevent suicide, which affects so many of our people and, in particular, our youth.

Some one million people globally die each year due to suicide. In Jamaica, the suicide rate is approximately 2.1 / 100,000 with reported statistics from the Jamaica Constabulary Force showing between 47 and 56 deaths per year due to suicide over the last three years.

The Global School-based Survey conducted in Jamaica in 2017 examined children 13 to 17 years old and found that in the previous 12 months, 25 per cent of youngsters had seriously considered suicide and 18 per cent had attempted suicide.

Research has shown that among the risk factors for suicide are family disruption, relationship problems, social isolation, and economic problems. We need families and communities, schools and places of work, the private and public sectors, together with civil society working as a team to address these psychosocial risk factors.

Another important approach to preventing suicide and promoting mental health is encouraging healthy lifestyle choices. A healthy lifestyle is about doing regular exercise, getting adequate sleep, having a balanced diet and promoting healthy relationships all of which foster mental, social and physical well-being.

Health systems and society as a whole also present risk factors for suicide. They include barriers to accessing health care, inappropriate media reporting on cases of suicide, access to means of committing suicide, and stigma associated with help-seeking behaviour.

The ministry is intent on addressing those risks through a range of initiatives, including the implementation of the Primary Care Renewal Model, which has as its main objective to improve access to comprehensive and timely health care services, including mental health services.

There is ongoing training of primary health care workers to provide initial care and referral of persons with mental health and substance use disorders, which are risk factors for suicide. This training is pivotal as primary health care staff forms the first point of contact within the health system and is a vital link between the community and the health care system.

We, however, need the public's support if our success is to be assured. Let us work together to prioritise mental health and in the public health interest.

Dr Christopher Tufton is the minister of health and wellness


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