Mental illness a developing story

From its high rate of suicide, Trinidad & Tobago seems to have an above-average level of depression—one in eight adults is likely to be depressed, according to a study published in 2007 by RG Maharaj in the journal BMC Family Practice. (However, in May this year, then-acting Minister of Health Tim Gopeesingh put the national rate at between six and eight per cent.) Another study—which did not include Trinidad and Tobago—put the rate of depression in poor countries at around 11 per cent, and wealthier countries at around 15 per cent. I don’t know whether we count as rich or poor, since, as I’ve said before, our GDP per capita bears no relationship to the daily lives of many citizens, but it is certain that we have many of the stressors of rich countries without the infrastructure to treat with the attendant problems they give rise to. Despite the best efforts of some stalwarts of the medical community, mental illness remains poorly understood in our neighbourhoods and communities, and those suffering with depression might go for a long time before they are diagnosed and treated.

 

Because of our religious bend as a nation, we tend to want to seek solutions for mental illness in faith rather than in medicine. In truth, mental illness is a developing story even to researchers, and therefore I wouldn’t say its treatment or cure should be found only in medical resources. The brain is physical but the mind is not; one’s mental state is as much the product of one’s brain chemistry as one’s thoughts, and for some it would be useless to say, “Take two Xanax and call me in the morning.” Equally, however, we cannot afford to ignore the developments of modern medicine and leave our mentally ill to the bosom of religion. This is one instance when one hand will definitely not clap. I’m thinking about these things partly because I’ve heard a couple of sermons in recent weeks talking about depression. The congregations were urged to pray for those who were anxious and depressed, and I surely do. However, prayer can’t be the only recourse to those who are ill. (Consider the fact that prayer won’t kill the pathogens in raw milk and so we all drink pasteurised milk; think of a mental-health doctor as pasteurisation for the mind.) Those of us who pray should and must pray for those who suffer mental illness, but we also have a civic duty to support them in seeking medical treatment.

 

It is also important to take seriously the need for more community mental-health interventions, more public clinics in neighbourhoods and more easily accessible and affordable psychiatric outpatient care. We also urgently need a national campaign to destigmatise mental illness in all its manifestations. Faith might believe in demon possession, but medical science recognises other causes for depression; again, think of pasteurisation rather than allowing the population to drink raw milk. Depression is not a condition to be taken lightly. In some cases it passes without medical intervention, it is true, but in many other cases it can spiral into a life-threatening condition. Health experts in this country must be well aware that our suicide rate is the second highest in the region, as Dr Edison Haqq was quoted as saying in the Guardian last October. 

 

In the same article, Health Minister Dr Fuad Khan promised an updated Mental Health Act would be laid in Parliament early this year. To my knowledge, nothing has been done in this regard, and the issue of our outdated and inadequate mental healthcare system only got attention when it became politicised in the Cheryl Miller incident.  Meanwhile, the pie lady shakes her head because her best friend’s child was shot, and her own child only escaped being shot because she sent him abroad. Gridlocked traffic jams trap us for hours every day. The cost of living rises and our salaries can’t keep up, so we buy the cheapest, not the most nutritious food we can get.

We work so hard (we who can get work, that is) that we don’t have enough time to see our loved ones. Families disintegrate, marriages fall apart. The stressors keep piling up. Yet we remain too afraid or ashamed to seek help for the real medical condition that is depression. Indeed, someone should pray for us.