Mentally ill persons are often misunderstood. Some are feared, others scorned, some laughed at and others not taken seriously.
We may see a socially displaced person on the street and forget they once belonged to a family.
A failed relationship or failed school examination can trigger a mental illness, traumatic events, life changes, substance abuse, family disputes and genetic influences that can predispose persons.
All ages can be affected, from the hyperactive child with ADHD to the elderly confused with dementia. Some relatives are often unable to understand that depression is real and one cannot just snap out of it. Some still see psychosis as a spiritual problem. Some are ashamed of having a mentally ill relative and either lock them away or abandon them.
We have even changed the names of our clinics to stress clinics or mental health and wellness clinics instead of psychiatric out-patient clinics, to be more welcoming to persons who feel the stigma of attending ‘the mad clinic.’
Mental illnesses are increasing globally and depression is now the leading cause of morbidity.
We are seeing a vicious cycle, the decrease in petrodollars bringing in social hardship which triggers an increase in depression with it’s economic burden further draining our economy.
This is worsened by the economic and emotional fallout caused by the COVID 19 pandemic.
Even among those who survived the COVID infection, one in three people will be diagnosed with a neurological or psychiatric condition within six months of being infected. We have to observe these individuals as well, as a factor in the cost of treatment.
Mental health issues now present a pandemic within a pandemic.
Her Excellency President Paula-Mae Weekes, on World Mental Health Day, gave a precise understanding of the mental effects of the COVID-19 pandemic, “Job and income loss, interruption to education and academic goals, social isolation, fear of contracting the virus, bereavement and the overall uncertainty surrounding the pandemic have caused many people to experience stress, anxiety and depression. To make matters worse, the provision of services to those in treatment for mental health conditions has also experienced disruption due to COVID-19 restrictions. There remains an undeniable and yawning gap between demand for mental health services and their supply, due largely to underinvestment in mental health infrastructure,” the President said.
I hope her observation on the treatment gap and underinvestment is heeded by our Minister of Health. Patients, relatives and mental health workers are extremely thankful for her call.
“Moreover, many people who need mental health care do not seek or receive it because of biases and misunderstandings about what care entails and, as a result, their mental health problems go undiagnosed and untreated. It is high time that we have the difficult but important conversations that will demystify and destigmatise mental health and allow people to seek help or offer their support to others in need of treatment,’ Weekes said.
WHO indicates mental disorders will affect one in four people. I always joke if you have 41 members of parliament in the lower house, at least 10 may have some issues. The public can play psychiatrist and make their judgment.
Abraham Lincoln was described as suffering from melancholy throughout his life, triggered by the death of his first love and later a cancelled engagement to another. Winston Churchill suffered from manic depression, having periods where he would stay in bed with little energy, no interests, no appetite and difficulty concentrating, which would alternate with periods of high energy and creativity.
In the book ‘Eric Williams: The Myth and the Man’, Professor Selwyn noted that there is a great deal of evidence by those who worked closely with Williams that he was prone to mood swings and exhibited a work style that suggested he suffered from “bipolar disorder,” along with examples of paranoia and other forms of irrational behaviour. This invoked a lot of anger by some members of the PNM who took this as an attack on Williams.
This shows some are not able to accept mental illness as they would accept his diabetic diagnosis. The fact remains diabetes or other medical conditions can be a comorbid contributor to depression, it was mentioned his mother was a patient of St Ann’s Hospital so we have a genetic link and all would agree he had a most stressful job of both leading the country and his fallout with his previous employers. The only living psychiatrist who can give us a correct historical perspective is Dr Iqbal Ghany.
I use this as a positive influence to belabour the point that despite suffering from bipolar, he was able to lead T&T and produce brilliant publications.
According to the President, this is a ‘golden opportunity to rethink mental health, address harmful misconceptions and stigmas and commit to the enhancement and development of mental health systems and services for all.’