MENTAL HEALTH will be high on the Government's agenda in 2003 as the Ministry of Health moves ahead with proposals to reform the delivery of medical care and support services to people with mental health problems.
Shortly, Dr. Earl Wright, Director of Community Mental Health in the Ministry, will answer questions put by the Parliamentary Committee on Human Resources and Social Development. In February, the Ministry of Health will begin a public education campaign to heighten understanding of what is meant by mental health and to help change attitudes to those individuals with mental health problems.
One of the main concerns that needs to be addressed is how to rescue a society that is so prone to violence. This may not necessarily be seen as a mental health problem, but Dr. Wright wants people, particularly parents, to understand that the emotional development of children from a very early age provides them with the skills to deal with situations appropriately throughout their lives. "Unless a child has learnt to manage his or her emotions before the age of 10 they will find it very difficult not to use aggression and violence to solve their problems," he says.
This is a worrying statement for parents to hear, but there is a lot that they can do to provide their children with emotional intelligence that will help them to face life's stresses in a non-violent manner. Through good parenting and early childhood education, children can learn the five main points for achieving emotional intelligence. These are: recognising their own and other people's feelings; managing their feelings and impulses; empathising with others to understand what they are feeling; developing goals and being motivated to achieve those goals; and learning social skills such as compromise and negotiation.
"We know that Jamaica has a high bias towards aggression. Therefore, we have to address the problem at the root," says Dr. Wright.
"You are handicapped for life if you can only react aggressively. Everyone has to learn how to manage his or her emotions. Without these skills, values and attitudes, a person cannot feel good about him or herself," he continues. Managing emotions is the main element to maintaining good mental health for an individual and the wider community, as one person's actions will have an effect on others.
The Ministry of Health is working with the Coalition for Better Parenting to ensure that all the agencies working with parents and children can play a part in instilling these fundamental life skills.
Another issue that is of particular concern to the Government is how street people with mental health problems are being treated. About half of the persons living on the streets have some form of mental illness. Many of them are schizophrenic, and many are also drug users. Treating mentally ill street people is difficult because they are obviously on the move and it may be difficult to keep track of them. Also, there are not enough shelters or feeding programmes in existence to assist with their care.
There are already teams of mental health officers who work on the ground to treat and evaluate people living on the streets. The reform programme for mental health services includes increasing the numbers of these professionals in all regions of the island so they can be more effective and reach larger numbers. There are also plans to provide more drop-in centres where sufferers can access care. It is important to reach people where they are so that their mental health can be appropriately managed according to their circumstances.
The changes to health provisions for people with schizophrenia stresses community treatment rather than hospitalisation, except in severe cases. As Dr. Wright explains: "Often it is not possible to hospitalise persons against their will if they are not a danger to themselves or to others. Preserving an individual's civil rights is important, regardless of their state of health. In any case, long periods of hospitalisation mean that a person is more likely to lose connections with their family," says Dr. Wright.
This point should not be ignored because support from family members is often vital for helping a person to maintain good mental health. Relatives can ensure that the person is keeping well and help them to manage the illness, encourage them to take their medication regularly, and give practical and emotional support and comfort when needed.
Looking after someone with a mental health problem, whether they live on the street or not is really about understanding the illness and being prepared to cope with it. "A mental illness is no different from any other chronic illness, for which a person may need to take medication for the rest of their lives," says Dr. Wright. "Mental illness must be viewed in the same way as high blood pressure or diabetes - a condition that needs constant management, not something to fear".
As the year moves on, Dr. Wright and others at the Ministry of Health hope that people will come to have a greater understanding of mental health and will view maintaining good mental health, and treating poor mental health, as something to be discussed openly for the good of everyone in the society.
