Fewer than 10 percent of people diagnosed with depression in countries such as Guyana are treated. This is according to Dr. Util Richmond-Thomas, Director of the Mental Health Unit of the Ministry of Public Health.
Dr. Util Richmond-Thomas said that although there are known effective treatments for depression, fewer than half of those affected in the world are diagnosed and treated.
She has revealed that approximately 50 percent of persons who commit suicide are depressed and approximately 15 percent of depressed patients kill themselves.
Depression is the most common mental illness and accounts for 4.3 percent of the global burden of disease said Dr. Util Richmond-Thomas who noted that by 2030 it is forecast to be the second largest single cause of disability worldwide using the World Health Organisation’s measure DALY (Disability Adjusted Life Year).
In recognizing the high prevalence of depression and the debilitating effects on ones quality of life, the Mental Health Unit of the Ministry is aiming to hit depression forcefully. The mental health specialist said that an upcoming anti-depression campaign will soon kick into high gear and it is hoped it will result in major positive changes in the lives of Guyanese.
Barriers to the treatment of depression, she noted, include lack of resources, lack of trained health care providers and social stigma associated with mental disorders. However, other barriers, according to Dr. Richmond-Thomas, are inaccurate assessments, misdiagnosis and incorrect treatments.
“The pattern is the same for all mental disorders. Almost half of the world’s population lives in countries where on average one psychiatrist serves 200,000 or more people,” Dr. Util Richmond-Thomas related.
However, other mental health providers who are trained in the use of psychosocial interventions are even scarcer, she admitted. “Here in Guyana there are approximately six psychiatrists for our population of approximately 750,000.”
Currently there are three psychiatrists at the Georgetown Public Hospital Corporation, one at the National Psychiatric hospital, one at the Linden Hospital Complex and one in the private sector. This according to Dr. Richmond-Thomas translates to approximately one for every 150,000 persons.
But according to her, a major answer of the Ministry of Public Health to the existing mental health maladies is Community Mental Health. She noted that the majority of mental, neurological and substance use disorders can be managed by non-specialist health care providers.
She insisted, “It is a myth that improvements in mental health need expensive technologies and large numbers of highly specialized staff.”
But according to Dr. Richmond-Thomas, the Public Health Ministry will soon embark on training non-specialist doctors, nurses and social workers throughout the 10 regions of Guyana. The trainers were trained by the Pan American Health Organization (PAHO) last August and according to Dr. Util Richmond-Thomas, professional staff of the Mental Health Unit have also been trained.
“They are ready, willing, eager and able.”
These trained health care providers, she noted, will treat the common mental health disorders including depression, self-harm/suicide, psychosis, bipolar disorder, epilepsy/seizures, developmental and behavioral disorders and substance abuse disorders. They will also be trained in the appropriate pharmacological and psychosocial interventions for these disorders, Dr. Richmond-Thomas said.
“Of course there will always be need for specialists. However, the vision is that with so many watchdogs of the nation’s mental health, there will be a drastic reduction in mental, neurological and substance abuse disorders and a corresponding increase in quality of life,” Dr. Richmond-Thomas added.
She noted that persons needing mental health care will no longer have to leave their communities and travel long and expensive distances to the GPHC and the National Psychiatric Hospital.
“They will be able to access that care at the health centres in their community or at their regional or district hospital. Like pregnancy, diabetes mellitus and hypertensive persons will be able to access effective care everywhere, including the health centres from competent health care providers,” said Richmond-Thomas as she added, “also like pregnancy, diabetes mellitus and hypertension they will be referred for specialist care when necessary.”
But according to Dr. Richmond-Thomas, unknown to many in the public, the Government of Guyana through the Ministry has long been working feverishly to turn the tides of mental health in Guyana. She noted that very few know about the strong collaboration between the Ministry and the Pan American Health Organization to bring Community Mental Health to Guyana and improve the quality of life and health of all Guyanese.
“Like the slogan ‘No health without mental health,” Dr. Richmond-Thomas said that the ministry recognizes the importance of good mental health in enabling persons to realize their potential, cope with the stresses of life, work productively and contribute to the community.
But according to her, Guyana has not been suffering alone.
“All over the world there is a large gap between the need for treatment and the actual provision of it. Between 76 percent – 85 percent of people with severe mental disorders receive no treatment for their disorder in low-income and middle-income countries. In high income countries that figure is 35 percent – 50 percent and, according to Dr. Richmond-Thomas, “Suicide in Guyana is a reflection of this problem.”
Through various programmes and sustained collaboration with NGO’s and other stakeholders, Dr. Richmond-Thomas said that the suicide rate is expected to drop significantly by 2018. “There are many planned programmes that are going to unfold,” added Dr. Richmond-Thomas, as noted that “Guyana has been through rough days in terms of mental health but as in the poem of Artur Clough “Say not the struggle naught availeth” Let us not faint because the results may not be immediately apparent.”
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