Tackling mental health in the Caribbean
Mental health illnesses are reaching unprecedented levels globally. According to estimates by the World Health Organisation (WHO), they account for 30 per cent of nonfatal disease burden worldwide and 10 per cent of overall disease burden including death and disability.
In 2013, the WHO published their Mental Health Action Plan 2013-2020 with the goal of identifying global improvements in the types of treatments and interventions aiming for a reduction in “mortality, morbidity and disability for persons with mental disorders”. Many health institutions have also put pressure on governments across the world, identifying the gaps in mental healthcare not only in developed countries, but also in developing ones. In 2010, the global cost of mental health illness was estimated at $2.5 trillion, but by 2030 this is expected to rise by 240 per cent to $6 trillion, according to the World Economic Forum.
The challenge of tackling mental health globally is that it requires new approaches which go beyond the technical aspects - encompassing social, political, technological, economic, environmental and cultural awareness - it needs innovation.
The Caribbean complication
There is a combination of cultural, economic, social and political reasons which explain why mental health has long been neglected in the Caribbean region. The socio-economic situation has allowed for poverty, income inequality and unemployment to become deeply rooted in degrading mental health. On average a country from the Caribbean spends only 4.3 per cent of its healthcare budget on mental health. This is unsurprising as the economies are structured around two to three key industries, which means mental health is left underdeveloped.
This is further complicated by the different and diverse groups that exist in the Caribbean - those of African, Indian and Chinese descent amongst others. These groups are vulnerable to mental health issues regardless of gender, age, sex, race, ethnicity or religion, as they share similarities, but also differences in cultural norms and values. Some consider themselves to be modern and others keep in tradition, which is where the social complexity of mental health lies. Social stigma and taboo are still big issues surrounding mental health in the Caribbean and to overcome this, cultural change has to occur, but this can be a long and arduous process.
On the ground in the Caribbean
It has been suggested that Caribbean countries need to reform their mental health policies and practices. In many instances, governments leave a huge gap in supporting the needs of these countries and many grassroots and community-led organisations have to assume responsibility as key actors in providing mental health care, support, treatment and intervention.
This is evident in Suriname and Guyana, two countries with the highest rates of suicide in the world. Suicide and mental health are indirectly linked through disorders such as depression, schizophrenia and bipolar disorder, as suicide can become the reactionary response to these issues. Grassroot community organisations and local NGOs such as the Guyana Foundation and Swarnapath fill this void, and despite their informality, the results are impressive and display the power of community cohesion and resilience.
The trouble is that these organisations are small and lack the resources to accelerate their aims on a grand scale.
Innovation can help in different ways from developing a platform of advice for patients to integrating the mental health care and support from smaller organisations into the primary health system.
Future innovation for mental healthcare
There is scope to deploy new systems and technologies which could drastically improve the mental health of citizens. Different types of innovations already exist for this purpose:
- Kurdiji 1.0 is a suicide prevention app for the Walpiri Aboriginal group in Australia
- SCARF tele-psychiatry connects citizens to psychiatry treatments in India
- Ginger is an app that supports people suffering from anxiety, depression and stress through trained experts
- CAMH in Haiti created a culturally adapted cognitive behavioural therapy program which was specific to the socio-cultural environment.
These innovations identify and treat mental health problems, but also raise awareness and reduce social stigma - a critical reason for the persistence of mental health issues. But we must not only be reactive in our approach in responding to mental health, we need to be preventative as well.
The reality is that practical and preventative action by all actors involved is necessary to make an impact or change the effects that mental health has on the region.
Many people in the Caribbean have access to technology such as smartphones, but innovation and apps will not solve the mental health crisis in the Caribbean. They should be used as tools to aid the issue. Instead, governments must seek the help of mental health innovators for ideas and solutions, while also working with local NGOs and grassroots organisations in better understanding the situation that exists to best serve their citizens.