One in every four citizens will suffer a mental health illness in their lifetime. And of those afflicted with a mental disease, only one quarter are currently diagnosed and receive adequate treatment.
The worrying statistics were revealed yesterday as the T&T Medical Association hosted its 24th annual medical research conference at the University Inn in St Augustine.
Speaking at the event, Health Minister Terrance Deyalsingh acknowledged the statistics as he proposed urgent reform of the country’s mental health policy.
“We have failed spectacularly to address mental health in T&T. Now we have a vision based on evidence,” Deyalsingh said as he noted he is planning to seek Cabinet approval of a new policy in January next year.
The policy includes the revision of the Mental Health Act.
“What we need is not evolution but rather a revolution in the way we treat with mental health,” Deyalsingh said.
According to Deyealsingh, the policy mainly seeks to shift focus away from institutionalised mental health care to community centres. He said they had already started implementing it in west Trinidad, where four new dedicated centres have been established.
“In the past you had specific days for clinics, but if you had a crisis after that day you had to wait seven days. Mental health cannot be treated by appointment, it has to be delivered on demand,” Deyalsingh said.
He noted that the shift would allow patients to live with their families and lead normal lives as opposed to the stigmatised existence they currently endure.
Deyalsingh was especially critical of the overreliance on the St Ann’s Psychiatric Hospital for treatment.
“What we did in T&T is take our biggest hospital in terms of beds and turned that over the decades into a warehouse. You put people on a bed and keep them there for a generation,” Deyalsingh said.
In addition to improving mental health diagnosis and treatment, the policy also seeks to address substance abuse. He said he proposes that a new Director of Mental Health and Substance Abuse be appointed to supervise the implementation of the policy.
Deyalsingh also questioned why medical students were not required to do more in-depth studies in mental health.
“They are good students but when they come out are they equipped to deal with the reality in the frontlines?” Deyalsingh asked.
In his address earlier, Dean of the University of the West Indies’s Faculty of Medical Sciences, Professor Terence Seemungal, admitted they were working with regional health authorities to give doctors seeking to specialise more time to complete research into mental health. He also admitted that medical students had a higher probability of suffering mental illness during their studies than in other fields.
“We have taken a position to move away from just monitoring mental illness in students and have moved to implement school-based solutions,” Seemungal said, as he noted its new academic advisory programme had been adopted in other faculties.
While Seemungal said diagnosis and treatment are important for mental illness, he called for more advocacy on preventing it.
“It is well advertised that a low sodium diet could control hypertension but no one says what we can do to control mental health problems,” he said.
Also addressing the gathering, former president Anthony Carmona called for citizens to be more open on the topic.
“It is passingly strange that we haven’t copied the American way, where there is almost a competition among neighbours and friends of whose clinical psychologist is better. There is a sense of pride in the discussion. That is the kind of clinical maturity we need in our Caribbean society,” he said.
Like Deyalsingh, Carmona admitted that from his past experience as a High Court Judge in the Criminal Division, he knows that staff at the facility in St Ann’s are overwhelmed and overburdened.
