Mental health dilemma
Severe shortage of psychiatric clinicians to treat children, adolescentsThursday, June 10, 2021
BY ALICIA DUNKLEY-WILLIS
ONLY eight per cent of Jamaican children are having their mental-health needs met because of the inability to attract professionals to care for them due to low wages and poor working conditions, according to the findings of a Caribbean Policy Research Institute (CAPRI) study.
CAPRI, in the study titled: Mind the Gap – The Inadequacy of Mental Health Services for Children, released Tuesday, said, “There is only 30 per cent of the requisite clinical staff complement of the principal child mental-health service provider, the Child Guidance Clinics, to meet current demand.”
“Given the easy mobility of medical professionals, as long as remuneration for mental-health practitioners in Jamaica remains far below the rest of the region and North America, the staffing needs of Jamaica's mental-health system will likely never be met,” said the report.
The Ministry of Health and Wellness is the state entity with oversight in this area. However, according to CAPRI, their stated policies and programmes “are predominantly hampered by staff shortages given the limited number of mental health-care providers, specifically those with child and adolescent training”.
According to the data, there are approximately 94 practising psychologists and counsellors in Jamaica and 28 psychiatrists. Of this number, only 12 clinicians provide services predominantly for children, while, nationally, the ratio of psychiatrists to population is 1:1,582, and the ratio of community mental-health officers/nurses to population is 1:306, compared with international standards of 1:150 and 1:50, respectively.
At present, there are only three psychiatric clinicians who are formally trained to work extensively with children and adolescents across the entire island. “In per capita terms, this means there is only one psychiatrist available for every 267,000 children,” the CAPRI report stated.
“There are three general psychiatrists who have received additional training in child and adolescent psychiatry [done through a fellowship and supervision with a qualified child and adolescent specialist], but who have not completed the years of schooling nor have they received the certification to be formally classified as child and adolescent psychiatrists,” CAPRI said further.
“This study has established that the demand for children's mental-health services in Jamaica outweighs the existing provision of those services,” it stated, adding that “a substantial number of the nation's children are suffering or may suffer from mental and emotional disorders, and lack the appropriate support to resolve their issues”.
According to CAPRI, “Very often these children go through different development stages undiagnosed, and are thrust into environments with children suffering from similar afflictions, heightening their proclivity to fall into criminality.
“Childhood trauma and ill, mental and psychosocial, health persists into adulthood and impacts on outlook, relationships, and productivity. This can potentially lead to or worsen what is already a cyclical crisis of violence and underperformance for Jamaica,” it stated.
CAPRI said if the deficit in child mental-health services is to be resolved, the issue of the lack of resource investment in the sector, low pay, and poor working conditions must be addressed.
“The unmet demand for children's mental-health services, in the form of more child guidance clinics, more mental health professionals in the correctional services system, more psychologists working with children in state care, and more and better trained school guidance counsellors will not be resolved unless these change,” it pointed out.
Said CAPRI: “More resources to the sector would substantially rectify both of these problems. Recommendations such as more child mental-health clinics — several of which are clearly necessary — are moot while the shortage of professionals persists, as it will, unless remuneration is significantly increased.”
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