Mon | Jul 23, 2018

Letter of the Day: Mental-health illness retards economic growth

Published:Wednesday | April 20, 2016 | 12:00 AM


How easy it is for us to get marooned on this little island of ours, I thought, as I sat in the Preston Auditorium of the World Bank Main Complex on Wednesday, March 13, 2016, and listened to World Bank President Jim Kim and World Health Organization Director General Margaret Chan, among other distinguished speakers, place mental health as a world financial priority for 2016.

They identified the world prevalence of anxiety and depression at 20 per cent, and that mental-health budgets worldwide range from five per cent of national health budgets in developed countries to one per cent or less in developing countries. They exhorted world governments to emphasise the urgent investments needed in mental-health services worldwide to halt the morbidity of these two mental-health conditions, highlighting the diminished national productivity caused by these conditions, and the fourfold increased financial return if they are effectively treated.

The Jamaican mental-health budget is about 1.5 per cent of the national health budget, with more than 80 per cent of that being allocated to the maintenance of the obsolete Bellevue Mental Hospital that treats fewer than 10 per cent of persons with mental illness in our country.

The paradox of that budgetary conundrum is that patients with anxiety and depression are never admitted to Bellevue Hospital, and are treated entirely in the private and public primary-care systems that limp along on a shoestring budget.

The paradox is compounded by the fact that the prevalence figure of 20 per cent quoted by the director of the World Bank does not include personality disorder, psychosis, dementia or childhood psychiatric illness. Were these conditions to be included in the Jamaican context, the prevalence of mental illness in our little island would exceed 70 per cent.

There is little wonder at the appalling lack of economic growth or financial productivity in or beloved island since Independence in 1962. It is our collective mental-health problem that account for our abysmal lack of growth and economic prosperity during this period.




Our world-leading homicide rate, our spiralling road traffic accident rate, our rampant transgressive and criminal behaviour and hypersexuality can all be accounted for by the largely unrecognised and untreated mental illness in our country. These problems cannot be solved by the police force only, but will require a significant investment in curative and preventative psychological treatments, and institutional psychotherapeutic development.

The fact that nearly 80 per cent of all psychiatric admissions are made to general hospitals islandwide, and that more than 55,000 patients with severe enduring mental illness are treated efficiently in 125 heath clinics around the country by a handful of dedicated mental-health professionals, and an unmeasured thousands of persons with anxiety and depression are treated privately by general practitioners, it is a miracle that the nation's health workers have been able to contain the ever-increasing burden of mental disorder in Jamaica.

I hope that our leaders will listen to, and heed, the call of Mr Kim and Ms Chan of the central importance of mental health as both a health and development priority and the need for collective, intersectoral action.


Professor Emeritus of Psychiatry