Mental Health Unit making strides in care delivery

…40 additional doctors trained

By Lakhram Bhagirat

Although just a little over one year old, the Public Health Ministry’s Mental Health Unit has been making great strides in the delivery of adequate mental health services throughout the country. However, it has not been without its challenges.
The Unit is equipped with six trained psychiatrists, four psychologists, and six social workers. However, in a population of over 750,000, it means that one psychiatrist would have to service at least 100,000 persons. In a country known for its high suicide rate, that is just not enough to combat the range of mental issues among Guyanese.

To address this, Director of the Mental Health Unit, Dr Util Thomas says that the department in collaboration with the World Health Organisation (WHO) developed a training manual to train doctors in the general principles of mental health care.
“We have trained 40 doctors from Regions Two, Three, Four, Five and Six. The training programme is four days, because they are licensed doctors; [it] is just to train them in the (mhGAP Intervention Guide) manual,” she said.
She added that the doctors were being trained about the general principles of mental health and effective communication.
“But the real hardcore mental health stuff is the depression, psychosis, epilepsy, child and adolescent mental and behavioural disorders, dementia, substance use, self-harm/suicide and this is a manual prepared by the World Health Organisation specifically to train non-specialist doctors to treat these conditions,” she added.

Mental Health Action Plan
The National Mental Health Action Plan 2015-2020 seeks to decentralise mental health care delivery and bring it to the grass-roots level. As a requirement, the Unit is mandated to train 80 per cent of the doctors in the mhGAP programme by the year 2020. However, Dr Thomas said that they were going one step further and would be training all registered doctors to provide mental health care.
“This is going to be an ongoing training. We are being provided with all the materials by the WHO; they are strongly backing us. Every health centre will have doctors trained to deliver mental health services. If it is a case which that doctor can’t handle it, then they will refer to a specialist, but if they are handling it, then they keep and treat,” Dr Thomas said.
“We want anybody who has a mental health condition to be able to walk off the road into the Health Centre and get their mental health condition treated and that is why we are taking it to a community level and working very hard to ensure this works,” she added.
The Mental Health Action Plan seeks to reduce the role of the National Psychiatric Hospital (NPH), in Berbice, reducing the number of beds after deinstitutionalising psychiatric care and to transform the NPH into a rehabilitation centre. The NPH rehab centre would specialise in psychosocial and drug abuse rehabilitative care.
The estimated cost to implement the plan is some $2.34 billion over the five-year period.

Challenges
Sourcing human resources is one of the major challenges of the Unit, but steps are being taken to remedy that, according to Dr Thomas.
“We don’t have enough specialists, so what we have to do is train people to deliver the service in the community. In July 12-21, we have a training for non-specialists in psychology. It is another WHO training for persons who are not psychologists to offer low-level interventions. When we receive that training, we will train persons to have counselling facilities; we will make sure that there are counselling facilities in every health centre offering low-level counselling services,” she revealed.
Dr Thomas said the training programme would focus specifically on nurses so that they can be placed at various health centres to deliver counselling services to persons suffering from depression and other mental illnesses.
“The Unit is a young unit and we are going about as fast as we can to educate people about mental illness that is not necessarily a mad man eating out the bin, but it can be somebody you see well-dressed who was having and going to work and everything, and he is having some difficulty,” Dr Thomas informed.
Persons desirous of accessing mental health services can visit the various satellite clinics throughout the country.