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Editorial: Change the discourse on mental health

Published:Friday | April 22, 2016 | 12:00 AM

The inference is that a young man who was shot dead on Wednesday after reportedly snatching a policeman's rifle, suffered from mental illness and may not, therefore, have been consciously responsible for his actions. Investigators suggest that Odane Bennett, 23, was recently in hospital for psychiatric problems.

If that turns out to be the case, it would not, on the basis of the anecdotal evidence, be an unusual event in Jamaica of violence by, or against, people with mental illness. We know well that jarring attempt at euphemism, referring to someone of "unsound mind", who is reported to have committed, or has been victim of, some act of violence

It is noteworthy, and of significant coincidence, though, that the Odane Bennett incident occurred the same day as a letter in this newspaper by Fred Hickling, a professor emeritus in psychiatry at the University of the West Indies (UWI), Mona, highlighting the prevalence of mental illness in Jamaica and the weak policy response to the issue.

Professor Hickling drew attention to estimates that up to 20 per cent of the world's population suffer from anxiety and depression and the move by the World Bank to place mental health as a global economic and financial priority. For mental-health problems, like other health issues, affect domestic and global productivity and ought to be approached in a fashion similar to other health conditions.

As Professor Hickling pointed out, it is estimated that there would be a fourfold return on expenditure if anxiety and depression were effectively treated in global economies.

Professor Hickling, however, sees a greater problem in Jamaica. He argues that if issues such as personality disorder, psychosis, dementia, and other conditions were taken into account, "the prevalence of mental illness in our little island would exceed 70 per cent". In other words, Jamaica faces a mental-health epidemic.

It is not the first time that he is making these seemingly alarming assertions. Five years ago, for instance, in a study with clinical psychologist Vanessa Paisley, he concluded that 40 per cent of Jamaicans suffer from personality disorders, between three and six times the ratio of other countries.

"There is little wonder at (Jamaica's) appalling lack of economic growth or financial productivity" over the past half-century," he said in Wednesday's Letter of the Day. Mental illness was also a significant contributor to the country's high crime rate and other forms of social dysfunction.




Yet, Professor Hickling pointed out, only 1.5 per cent of Jamaica's health budget is spent on mental illness, and 80 per cent of that is for the "maintenance of the obsolete Bellevue Mental Hospital that treats fewer than 10 per cent of the persons with mental illness".

Many people will be inclined to deem Professor Hickling hyperbolic and alarmist. For we tend to stigmatise mental illness and are uncomfortable discussing the subject. But even if the numbers are not as bad as has been posited, it is clearly an issue that ought to be on the national agenda - as it is being placed on the global one.

It is time for a new and frank conversation on the matter and for creative approaches to tackling the problem. It might provide a new context within which to tackle Jamaica's underachievement in economic development and overperformance in crime and social dysfunction. It is an issue that the new health minister, Christopher Tufton, should place among his priorities.