Below is an address given my Minister of Health Julius Timothy to mark World Mental Health Day being observed today.
Today, October 10th, 2011, the Ministry of Health joins the rest of the world in observing World Mental Health Day. This year, we selected our own Campaign theme which best reflects our current position on Mental Health in Dominica. The theme “Mental Health: My Primary Health Care Responsibility” is a rallying call to all Dominicans. Our mental health is a most important treasure and we must do everything possible to protect it. The main goal of this campaign is to improve community services for all our clients. Therefore, the government’s focus is to empower the District Health Teams, who most often are the first responders to persons with mental health problems.
Evidence put forward by the World Health Organization demonstrates that the economic and social burden of mental disorders on national economies is worsening. It has recognized for a long time that Mental and Physical health problems are interrelated. It further warns countries that the treatment gap for mental disorders is too wide and that people living with mental health problems should have greater access to treatment. They further advised that providing primary care for mental health has many advantages for patients and the country on a whole. It Enhances access to a higher quality of service and Promotes respect for the human rights of persons suffering with mental health problems.
So my government supports the integration of mental health services into Primary care because it is affordable and cost effective. This new approach will definitely result in good health outcomes for the individuals affected, their families and society as a whole.
Let us look at some of the statistics available that advise our new position. Recent Caribbean and Latin American studies indicate that a high percentage of people who need mental health care, do not receive this care.
1. For instance, although 6% of the Caribbean population is diagnosed as either abusing or dependent on alcohol daily; over 70% of these persons do not receive mental health care.
2. Marijuana and crack use is rampant among the youth population. Yet care is not readily accessible.
3. Another example is anxiety disorder, in which only 2 in every 5 persons suffering with the disorder receive professional care.
4. Furthermore, although depression affects 6% of our population, as many as 3 in every 5 depressed persons never receive adequate mental health care.
5. Imagine that psychoses and schizophrenia, a group of mental illnesses that affects about 1% of all populations throughout the world leaves more than 1 in 3 of its victims without any care.
These persons are more likely left abandoned, homeless, and hungry and wander the streets, or harass visitors and locals. There is definitely a huge treatment gap. This year’s campaign theme seeks to address the need to bridge this gap and improve the quality of mental health care. It is expected that a new approach will result in all health care workers taking full responsibility for our brothers and sisters suffering with mental health problems. This new disposition will put an end to the tradition of stigmatized mental health care services for Dominicans.
It is widely accepted that the stigma of hospital care is a strong barrier and keeps sick people away from consulting mental health specialist at the Psychiatric Unit. The Ministry of Health accepts that mental health services in our country need further upgrading. Persons living with mental illnesses do not receive equitable care for their diseases. This is a public health problem and the Ministry must find an effective way to improve the quality of care to all Dominicans. Therefore, this year’s campaign aims to call on all concerned to make mental health care services available at the primary care level. This includes not only health centers but anywhere within the community such as community homes for children and adults, schools and other national institutions. We can protect people’s mental health by changing our own negative attitudes.
The Director General of the World Health Organization Dr. Margaret Chan stated:
“Primary care starts with people. And, integrating mental health services into primary care is the most viable way of ensuring that people have access to the mental health care they need. People can access mental health services closer to their homes, thus keeping families together and maintaining their daily activities.”
Dominica has a renowned Primary Health Care System. Each community has easy access to health centers and health professionals. This system of care has contributed more than any other system to elevate the standard of the national health system. Because of this reality, the Ministry has embarked on this campaign of integrating all stable psychiatric patients into the general health center clinics throughout the island. Persons with mental health problems will now be fully accommodated and treated by their District Medical Officers and the rest of the health team. This changed practice will allow time for the specialist team from the Acute Psychiatric Unit to pay greater attention to persons who are noncompliant with treatment.
In fact, this group of mentally unstable persons is partly responsible for the negative attitude of the public towards all persons with mental illnesses. The new approach of Assertive Community Therapy will definitely stabilize their lives and that of their communities.
The case for integrating mental health in primary care is essentially a call for District Health Teams to get more involved in the provision of mental health care. In this year’s campaign specialist team of mental health workers is travelling throughout the island conducting Case Management Workshop with the District Health Teams. The aim is to empower Primary Health Care Workers to recognize the risk factors for mental illnesses thereby enabling them to provide better treatment and support for the vulnerable patients.
It is important to stress that in Dominica we believe that there is no health without mental health and that mental health is more than the mere absence of a mental disorder. Therefore, mental health is the foundation for well-being and effective functioning for an individual and for a community. Mental health and by extension mental illness is determined by multiple and interacting social, psychological and biological factors.
The Ministry of Health recognizes that promoting the mental health of Dominicans is not the sole responsibility of the Ministry. In November 2011, the final draft of the national mental health policy will be presented at a second national consultation for stakeholders. The new national mental health policies and programs demonstrate that an integration of mental health in education, labor, housing, justice, community development and welfare as well as other health sectors is the only way forward.
The Community Mental Health Team encourages all citizens of Dominica to join in this campaign to increase awareness that persons suffering with mental health problems may have better outcomes if they seek early consultations with their primary health care providers.
The Ministry is pleased that the quality of mental health services is improving within the health system and recognizes the tremendous efforts of the Consultant Psychiatrist and other Medical Officers, the support services of the Clinical Counselor, the Social Worker, and the Occupational Therapist. Most significantly, two qualified Psychiatric Nurses recently returned from training overseas and have joined the team of dedicated nurses. The task of delivering optimum mental health care is not easy but the reward is evident throughout the society.
The activities planned for this years’ campaign includes; a National Consultation for Stakeholders, Case Management meetings with all District Health Teams throughout the Primary Health Care System, Fun & Sports day for Clients, and Media Presentations by mental health care providers.
We therefore urge our fellow citizens to remain supportive to persons suffering with mental disorders. In this way we can all help to create a healthy and productive Dominica.