"A positive mental health is conceived as an inner balance, ability to manage the everyday deals and to choose a correct solution of personal problems, as well as to adhere to the conventional behavioural standards." So says the World Health Organisation in its report on T&T's mental health (2007).
The document goes on to say that some psychiatric disorders such as mild or moderate depression or anxiety are not perceived as serious emotional problems, whilst the concept of "mental illness" is attributed to severe psychiatric disorders.
Unfortunately, it's an assessment common among the general populace but also widespread among those in mental health care in T&T as well as those privilege to enter the Parliament as lawmakers here. This accounts for the misguidance and acts as the greatest setback in the delivery of mental health care.
Most of the stigma accompanying persons living with mental illnesses (PMIs) and their families are based on the propaganda, fear, and historicity of "severe" mental illness. The implications are that people hide mental problems, even those that are of no threat to anyone but the individual themselves who ultimately avoid accessing care.
Stigma, prejudice and misinformation act so that the metal health prevalence statistics are skewed. Therefore, it's prudent that the assumption made by the WHO and adopted in many countries must be accepted and must motivate government into action, which is that 25 per cent of our population are PMIs.
Additionally, the mental health system–well, there really isn't a mental health system in T&T–but what obtains disappoints. With my 2015 political aspirations already rejected, I'm using this platform to lobby the aspirants for government to see the enormous role they have in ensuring everyone experiencing or living/thriving with a mental health problem gets both support and respect from government as from society.
Despite its prevalence many people are unaware of the importance of their own status and most have nowhere to turn for help if they become unwell. Despite the established extent of the burden of mental disorders, health services have little response capacity, and inadequate human, social, and funding resources.
The next government and the next health minister need to embrace the following.
1 Accession to outstanding international conventions that guides/govern member states conduct towards persons living with disabilities.
2 Revision of the Mental Health Act. The first piece of mental health legislation was revised in 1975. Currently, it's the only available legal act regulating mental health care provision. Consider how much has changed in 30 years and know that this must be archaic in its best format.
3 Establish properly composed and functioning Mental Health Council. An attempt at a council I'm advised did not enjoy the success it should and that arrangement has been inactive for over two years.
4 Development of a national mental health strategy that would set out realistic and attainable schedules to promote good mental health and improve mental health services. That strategy would identify focus areas such as child and adolescent mental health, dementia, alcohol and drug abuse, etc.
5 Fair funding for mental health–Mental health receives four per cent of the annual health budget of just over $100 million, which is mostly, dedicated to St Ann's Psychiatric Hospital. Most of that figure is spent on wages and salaries. A properly composed council and an accurate strategy would help the minister to better understand how we should allocate funding for the care of the mind of a population of 1.3 million people.
6 Better access to mental health services–Much of the allocated funds go to mental health crisis care located at St Ann's Hospital. That is in itself an indictment on the ignorance of and apathy towards the widespread issues of mental disorders and the imperative to preserve the minds/good mental health throughout T&T.
7 Child/adolescence mental health care–Invest in parenting programmes focused on children and ensuring all women have access to ante and postnatal mental health support. Raise awareness of mental health by integrating the subject into the school curriculum and training teachers and nurses.
8 Improve physical health care for people with mental health problems–Create a national target to stop people with mental illness dying early, due to preventable physical health problems. Ensure government targets for other health issues apply equally to targets for people with mental health problems.
9 Integrate mental health care with general practice–Offer integrated health care in all health facilities so that we do not discriminate or perpetuate discrimination against people with mental health conditions.
10 Create an ongoing/annual national public education and awareness campaign.
11 Create legislative and financial support for equality in employment, provision against discrimination at work, provision for housing, and provision against discrimination in housing for people with mental disorders.
12 Provide funding and government support for advocacy for faith-based, non-governmental, community-based organisations and the like.
�2 To be continued.