Mental health sector unhealthiness

Dear Editor,
He posted a heartwrenching appeal, sometime after midnight, a few days ago on the Facebook page of The Caribbean Voice (www.caribvoice.org), asking for help because he was having familiar feelings of the kind that had driven him to attempt suicide once before. Immediately, some members of the group sprang into action. As we engaged him in chat, someone from the Mental Health Unit of the Health Ministry joined in and quickly phone-messaged a counsellor. It took a while, but eventually the doctor called and set up an appointment for him at the Georgetown Public Hospital, at eight am. We continued to engage him until he went to bed sometime after two that same morning, promising that he would do nothing foolish, but instead would keep the appointment the following day.
As daylight chased away darkness, he informed us that he was keeping his appointment, thankful that he was getting professional help. But his arrival at the hospital created confusion and frustration as no one could direct him to the doctor he was seeking. Frustration was turning to resignation as he texted that he was leaving and going to the seawall to end it all. As one member of The Caribbean Voice (TCV) kept him engaged, the same personnel from the Mental Health Unit, who had put him in connection with the doctor, hurried to the hospital, some two hours plus after the 19-year-old had arrived. Yet it took that person almost another hour before she could connect him with the help he needed.
The young man was given attention, but refused to stay over for observation, as he was under the popular misconception that only ‘mad’ people are held back at the psych ward and he most definitely was not mad. And while he initially agreed to keep the subsequent appointment some three days later, he later changed his mind. So, The Caribbean Voice continues to engage him, as we usually do with regards to all our cases, hoping that we can still persuade him to take the additional counselling.
This experience begs the following questions:
1. Why was it impossible for hospital staff to direct the young man to the psych ward? Surely this information should be available at reception desks and known by all staff?
2. Why was there no mental health professional to meet with the young man until close to 11:00h even though he had an appointment? Surely, the staff at the Mental Health Unit knows that delays and consequent frustration can concretise the final act of suicide?
This particular case also brings to the fore the suicide hotline. Empirical and anecdotal evidence indicates that Guyanese are hardly utilising the hotline and we do recall that an appeal last year for figures to be released was met with deafening silence in spite of claims of its success. It is critical that the Ministries of Public Security and Health embark on an ongoing, national campaign to make the suicide hotline a household item and to encourage citizens to make use of it with the promise of absolute confidentiality every time. As well, statistical and related evidence proving its extensive use and success ought to be made public, as this will bolster widespread confidence in its effectiveness. After all, it would have been quicker for the young man to call the hotline and get help than to reach out to TCV via Facebook.
On the issue of confidentiality, TCV has also found that too many Guyanese are still sceptical of counsellors and counselling because of claims that confidentiality is not often kept. And perhaps that is why, far too often, those seeking help emphatically refuse counselling in Guyana and/or by Guyanese, when we place that on the table for them.
Also, this case and many others that TCV has handled over the last two years make it clear that mental healthcare has to be national in scope and easy to access. Thus TCV reiterates its call for mental health care to be integrated into the physical healthcare system, per the recommendation of the World Health Organisation, for nations like Guyana. And we urge that a look be taken at the Sri Lankan Model in this respect, as that nation has very successfully implemented this integration.

Sincerely,
The Caribbean Voice