Editorial | End stigma in mental illness

Writing in The Gleaner on Thursday, Monique Lynch, the programme coordinator at the School of Nursing at the University of the West Indies, Mona, called for the integration of mental health into the wellness initiatives at Jamaica’s workplaces.

Ms Lynch offered an unimpeachable reason for her suggestion: if employees feel comfortable discussing their mental health issues at work, without fear of retribution or stigma, the likelihood is that it will result in better mental health and less burnout among staff.

Although Ms Lynch didn’t explicitly say so, that’s good for companies’ bottom lines. And, would add to the national economy.

Put another way, the problem of mental health is not only an emerging workplace crisis. It is a national one, which this newspaper believes Jamaica should seek to confront not in isolation, but as a common challenge in partnership with other members of the Caribbean Community (CARICOM).

In that regard, we suggest to the health minister, Christopher Tufton – who has made sporadic attempts at bringing mental health into the broader discourse on healthcare – that he urges his boss, Prime Minister Andrew Holness, to endorse this newspaper’s call for a special CARICOM initiative on mental health. Mr Holness should propose an extraordinary summit of CARICOM leaders to launch the project.

As we previously proposed, this programme should be called the Patsy Richards Mental Health Initiative, named for the mother of the Antigua and Barbuda prime minister, Gaston Browne.

The Gleaner suggests that name so as to give a specific face and personality to a condition that affects hundreds of millions of people globally – many of them in this region – but which, too often, remains hidden – locked away because people fear the discrimination and stigma that comes with mental illness. This, as Ms Lynch suggested, includes in Jamaica’s workplaces.

PULLED SCREEN BACK

In July, Prime Minister Browne courageously pulled that screen back, opening a window into his family’s encounter with mental illness. In a tender eulogy, he gave eloquent testimony about his mother’s struggles with a mental disorder, including her stays at Jamaica’s psychiatric hospital (popularly referred at the time as the Crazy House), the stigma and poverty and sexual predation her illness induced, and yet, Ms Richards’ made all efforts to hold her family together.

While it may not be usual for this issue to be so personally, or openly, engaged, especially by someone in such a high office as Gaston Brown, this story isn’t unique. It is far more prevalent than most people are aware.

Indeed, the World Health Organization (WHO), which will mark World Mental Health Day on October 10, estimates that in 2019 over 970 million people, or 13 per cent of the world’s population, suffered from a mental health disorder.

In Jamaica, the official estimate is 20 per cent. However, Professor Fred Hickling, the late psychiatrist and pioneer of community-based approach to treating mental disorders, suggested that the figure could be twice the official number.

Of the WHO’s six regions, the Americas, including the Caribbean, had the highest prevalence of mental disorders – 15.6 per cent of its population.

A decade-and-half ago, it was estimated that mental illness cost the global economy about US$2.5 trillion for the treatment of its various conditions and in lost productivity. That cost is projected to rise to US$6 trillion by 2030.

This year’s focus of World Mental Health Day is mental health at the workplace. According to the WHO, 15 per cent of the world’s working age population suffers from a mental disorder. An estimated 20 billion working days are lost annually because of workers’ depression and anxiety. The cost in lost productivity is US$1 trillion.

GO UNDIAGNOSED

Many of these relatively easily treatable disorders go undiagnosed and therefore untreated, in large part because sufferers fear stigmatisation and discrimination.

This newspaper is not aware of recent studies in Jamaica, or in CARICOM as a region, that disaggregate mental illness by type, cost to economies, and, very critically, the impact of mental disorders on the well-being of individuals, their families and communities. Recently, CARICOM announced a study, in conjunction with UNICEF, the United Nations children’s organisation, on the state of mental health of the region’s youth, but that project, on its face, doesn’t appear to be sufficiently broad or deep to address the issues at hand.

Mental health, we believe, ought to be subjected to the depth of analysis and attention that CARICOM has placed on non-communicable diseases, like obesity, hypertension, and diabetes, and the campaign against stigma and discrimination that has been directed against HIV/AIDS.

Such interventions, clearly, are most successful when anchored in broad coalitions – government, the private sector, civil society and communities.

Indeed, the private sector, as the data suggest, has a great stake in being involved. The loss of talent, and time away from work by staff who are too fearful to talk about their depression and anxieties, costs money, negatively impacting the profits of firms.

Regarding Jamaica taking a regional lead on the mental health issue, Prime Minister Browne, given his personal involvement in the issue, might be disinclined to promote the initiative. However, part of Minister Tufton’s response to Jamaica’s NCDs crisis is his Jamaica Moves initiative – the campaign to get Jamaicans to exercise more and eat healthier. He has proudly sought to take his Jamaica Moves campaign to the rest of the region.

Moreover, Dr Tufton has declared a key element of his health strategy is the promotion of wellness in its broadest sense. He should accelerate this effort in mental health. And bring Prime Minister Holness along with him.