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The suicide rate is not what WHO says it is

Kaieteur News, Guyana (November 15): Recently The Caribbean Voice received the following message from Dr. Leslie Ramsammy, former PPP/C Minister of Health.

“When I was Minister of Health, I openly disagreed with them (WHO) on suicide…We have averaged between 140 and 170 deaths in my time as minister (2001 to 2011). The rate was between 18 and 25 per 100,000.

“I have argued that while Guyana has a troubling high rate, our rate is not nearly as high as what WHO used to say – 44 per 100,000. I used to challenge them to find the extra 100 to 150 deaths they were claiming. “Their justification is that they made adjustments to cater for the underreporting, which they could not verify.

“It is interesting that when our actual deaths in the 1980 were over 250 they were actually reporting less than 150.”

So The Caribbean Voice did some digging and this is what emerged:

Clearly the 2012 figure is an anomaly, especially given that the only adjustment actually made by the WHO is from crude rate to age-standardized suicide rate, to eliminate the effect of differences in population age structures when comparing crude rates for different periods of time, different geographic areas and/or different population sub-groups. Thus the 2015 crude rate of 29.0 was adjusted to 30.6.

Whatever led to this apparent anomaly, it presents a skewed picture that makes the work of suicide prevention NGOs and activists that much more difficult, besides seeming to imply that with such a significant rate reduction, the government does not need to ramp up resources to tackle suicide.

That PAHO rep Dr. Adu Krow was quoted a number of times in certain sections of the media as stating that the 2015 rate was 20.6 is even more puzzling and despite The Caribbean Voice’s suggestion that Dr. Adu Krow, may have been misquoted, he has not, to date, provided any public clarifying statement.

(https://www.kaieteurnewsonline.com/2017/11/15/the-suicide-rate-is-not-what-who-says-it-is/)

 

Families struggle in aftermath of suicide

T&T Newsday (November 6, 2017): Last week bore witness to another tragic death of a young woman who died by suicide. But unfortunately, in the midst of the sad news, both the traditional and social media were awash with servings of speculation, and uncivil negative commentary.

There is no denying that suicide is controversial, and there is nothing wrong with voicing an opinion, having a debate or discussion, because after all, trying to make sense of situations helps in formulating solutions. Indeed, it’s important that suicide is demystified, and spoken about more openly, so that understandings of circumstances, risks, causes, and effects can inform prevention and intervention strategies.

But what’s distressing is the ongoing commentary being focussed on sensationalising the alleged deceptions of Miss Teelucksingh –some of which have overstepped the mark of civil decency. It appears many have forgotten that she has left behind a family coming to terms with their grief, guilt and distress. So many families lament that when a loved one dies by suicide their grief is compounded by societal stigma.

‘Jane’ explained that the most distressing situation she had to endure was as a result of her husband’s suicide being reported on social media.

She continues to be treated for clinical depression which she attributes to the harmful intrusive comments of friends and strangers.

She explained how she was interrogated and pressured into finding a reason for his suicide, and that her feelings were ignored while others freely shared their unfounded theories on the matter. Some suggested that maybe he found out he had a terminal illness, or he had lost his job and was afraid to tell her – none of which was true. Despite her reassurances to the contrary, many insisted that her husband was a selfish man who didn’t think of his family. That upset Jane because she did not want the children who adored their father to suddenly have doubts about how much he loved and cared about them.

‘Jane’ found the comments about her husband to be “inappropriate, distressing, intolerable and humiliating”.

She explained that what she really wanted at the time was support, comfort and advice. According to her, what she needed was guidance on the procedure to claim the widow’s pension; to know what services were available for her children to get help to cope with the loss of their father; someone to cut the lawn; advice on repaying her husband’s car loan etcetera. In her own words, what she wanted was not to be on the receiving end of other people’s judgments, but practical help and a shoulder to cry on.

Jane’s experience highlights some of the reasons why the suicide discourse should be sensitive and responsible. But additionally, ill-considered reporting poses a danger of contagion – which is where suicide ideation and behaviours happen because of the suicide or attempted suicide of others. Suicide is indeed very complex with so many risk factors.

On an individual level, some of the risk factors are:

In communities and wider society they are:

(taken from The World Health Organization (WHO) Preventing Suicide – A Global Imperative Report).

Suicide is an emotive topic, and the way that people respond to it carries a lot of stigma. Which is why many families try to keep it a secret to the extent where some deaths are classified as something other than suicide. However, such secrecy skews statistics and impacts on the decisions taken in the development of evidence-based suicide prevention policy and strategies.

Suicide is not inevitable, it is preventable and communities can contribute by providing social and emotional support to those who are vulnerable, and not forget that families struggle in the aftermath of suicide. They also need support, comfort, compassion and empathy.

If you or anyone you know needs help please call - Suicide Help LifeLine 645-2800 of lifelinett (on Facebook) or ALIVE 688-8525, 650-5270

Dr Yansie Rolston FRSA is a UK-based disability and mental health specialist advisor. She is a social strategist and trainer who works internationally at various levels of government, business and civil society. Contact her at yr@efficacyeva.com

(http://newsday.co.tt/2017/11/06/families-struggle-aftermath-suicide/)

 

Costly losses — but no reliable sum has been placed on deaths due to suicide

By Tajeram Mohabir

(Guyana Chronicle, October 30, 2017) RAMESH (not his real name), a father of four of Black Bush Polder, Corentyne, Berbice, relaxes in his hammock tied under his house, taking in the cool  afternoon breeze  after a hard day’s work in the farm.

He appeared refreshed, in good spirit and full of life, but three Septembers ago, it was a different story, one which he would live to tell and discourage others from doing.

Ramesh declined to mention his real name, fearing prosecution, since attempting suicide in Guyana is an illegal act, a clause in the law the Pan American Health Organisation (PAHO) and several other organisations are working to reverse.

The young father related that some three years ago, he was faced with severe depression due to personal issues at home and after a bitter quarrel with his wife one afternoon, he went downstairs and attempted to take his own life.

But his children who were playing nearby saw him in an ‘epileptic’ state and raised an alarm, alerting family and neighbours who rushed him to the Skeldon Hospital.

“Me rememba when me catch meself, I was in hospital, me hand bore up and thing and tubes attach to me body. De nurse ask me wah happen and me tell she me want live and beg them to save me.”

Ramesh did manage to pull through, but his recovery was slow and during the time, he related that he “prayed and prayed” and asked the Almighty and his family to forgive him for his rash act committed under frustration.

“Me beg God to spare me life when me see me children,” he cried as he sat up in his hammock, and continued: “When me ben sick and cannot wuk, me wife really struggle and them children suffer. It really hurt me when me see dem situation,” he said, fighting back tears streaming down his cheeks.

Wiping away his tears, the young father told this publication that today he is a changed man and through counselling, he is now able to control his temper and drinking problem.

And with some remorse, he said, “Me sarry for wha me do and me thank God fuh sparing me life. Me nah know wah woulda happen to me family if me ben dead.”

While Ramesh has survived the terrible ordeal and returns to being a provider for his family, others have not been so lucky and their loss have put an economic and emotional strain on their families.

Annan Boodram, a social activist, educator and President of The Caribbean Voice, a New York-based, Caribbean diaspora non-profit organisation, said there appeared to be an absence of research estimating the costs of suicide deaths in Guyana.

“Such costs are usually referred to as direct costs – costs associated with suicide and its aftermath. There are also the indirect costs – costs associated with productivity or earnings lost or projected loss of earnings and intangible human costs – pain, grief, suffering, lost quality of life, lost opportunities and values associated with what life would have offered. Usually also there is a total financial cost computed by adding direct and indirect costs,” he told the Guyana Chronicle while pointing out that in the U.S., these costs have been estimated to be $1,061,170 per suicide.

Former Health Minister, Dr Leslie Ramsammy, had estimated that suicide had cost the then Ministry of Health — conservatively speaking — around $600 million to $900 million annually in 2002 in hospital, medical, autopsies and other costs.

MILLIONS OF DOLLARS

Notwithstanding the apparent absence of research in this area, if these factors are taken into consideration, and given that the Guyana dollar is traded at $209 per US$1, it will literally amount to millions of Guyana dollars, even though Guyana has managed to reduce suicide significantly in the past few years.

According to the World Health Organisation (WHO) 2014 report, with 44.2 suicides per 100, 000 persons, Guyana was ranked first in suicides per capita worldwide.

This translates to about 333 suicides in a population of less than 750,000.

The WHO as of March 2017 puts the national suicide rate at 30.6 per 100,000, a marked decline from the 44.2 per 100,000 in 2012, but The Caribbean Voice has contended that given that globally, an estimated 25 per cent of suicides go unreported, the actual figures would be about 320 suicides in Guyana or more if the unreported cases are higher than the global estimate.

“Also, at a globally estimated 25 attempts per suicide, Guyana would have almost 8,000 attempted suicides a year, even though it is estimated that suicide attempts in Guyana are higher as these too are significantly under-reported,” The Caribbean Voice noted.

Suicide is the leading cause of deaths among young people ages 15-24 and the third leading cause of death among persons ages 25-44, while in the 15-19 age group, it is the leading cause of death among females and the second leading cause of death among males.

Junior Health Minister, Dr Karen Cummings, has credited the reduction in the national suicide rate to the work of government and non-governmental organisations.

INTERVENTIONS

The government on its part has established a multi-disciplinary taskforce to tackle the problem by focusing on four strategic areas, namely risk reduction, health promotion and prevention; Reduction of access to means of suicide; health systems response to suicidal behaviour; and surveillance and research.

Doctors are also being trained to handle mental health issues, the Inter-agency Suicide Hotline is in operation and strong focus has been placed in problematic areas, notably Regions Two, Three and Six.

Boodram said The Caribbean Voice has also been at the forefront of the fight against suicide here and over the past three years has invested some $5.5 million in prevention and anti-abuse.

During this time, it has engaged in over 300 successful counselling cases, held over 200 workshops that trained over 2,000 people, attended over 25 different fora and widely disseminated information on its work in Guyana reaching an audience of millions, both in the diaspora and farther afield.

Indrawattie Rooplall, 36, also of Black Bush Polder, who attempted suicide twice in mid-2005, is a proud beneficiary of the work of The Caribbean Voice, which has imbued in her strength of character after she had lost her husband, son and brother last year.

Her husband Pawan Chandradeo, 37, called “Suresh” and “Jug Up”; her son Jaikarran Chandradeo, 16, called “Kevin”, and her brother Naresh Rooplall, 35, called “Teeka Bai” and “Mice” in July 2016 were shot at point blank range by bandits at kokerite Creek Savannah, about three miles from Mibicuri in Black Bush Polder during a fishing trip.

“In my life I have seen many ups and downs including domestic problems. When I attempted suicide, my father was an alcoholic and I had no sister to talk to. On both occasions I survived and after a period of counselling from professionals and members of the church, I turned my life to Christ. The loss of my husband, son and brother caused great depression to me, but by the grace of God I am still alive. I have my children to live and provide for,” said Rooplall, who works as a security guard to make ends meet for her family.

The young mother is urging all persons experiencing depression to speak out, pointing out that only by doing so they can get help, even as she grapples with her own struggles — the emotional and economic losses due to the death of her husband — to provide for her remaining three children.

(http://guyanachronicle.com/2017/10/30/costly-losses)

Government must give meaning to anti-domestic violence rhetoric

(Oct. 30, 2017) India’s Supreme Court earlier this month, struck down a legal clause that permits men to have sex with their underage wives. The judgment stated that girls under 18 would be able to charge their husbands with rape, as long as they complained within one year of being forced to have sexual relations. Should this not be an instructive case for nations like Guyana where the age of consent is still 16 but the age of adulthood is 18?

Actually, two years ago The Caribbean Voice launched an online petition for the age of consent to be raised to 18. Now we are rooting for the realization of the Director of the Childcare & Protection Agency, Ann Green’s plan to have such a registry in 2018. As well, we appeal to readers to please sign our petition and urge others to do so by clicking on the ‘Age of Consent’ link at the bottom of the index page on our website – www.caribvoice.org so that we can boost the registry’s chances.

Meanwhile, it goes without saying that with respect to issues like suicide and abuse, language is a critical factor. Thus when a government minister defends the use of the term “deflowering” to refer to the brutal act of rape, that is an insult to rape victims and a sanitization of the ultimate act of violence against females. Surely the Hon. Minister must be aware of the messages inherent in such language?

As well, we strongly urge that the language used to talk about abuse be reshaped to ensure that the focus is on the perpetrators and not the victims. Thus instead of how many women were raped we need to talk about how many rapes were committed against women by men. And instead of violence against women, we need to talk about perpetrators of gender-based violence.  The idea is to address the violence and its perpetrators while helping victims to heal and take control of their lives in a safe and empowered manner.

Then there is the issue of myths and misinformation. Recently, Public Security Minister Ramjattan, stated that his ministry is working towards implementing anger management programmes countrywide, to help address gender based violence. However, gender based abuse is not caused by anger, otherwise abusers would abuse everyone who make them “angry”. In fact, abusers are very much in control because they can/do usually stop when interrupted. So while we laud this plan, we hope the Minister will also address the real causes of gender-based abuse.

Other prevailing myths include:

➢ She can always leave: The most dangerous time for an abused woman is when she tries to leave, as that is when the abuser usually fatally injures her. Other factors preventing the abused from leaving include having no safe place to go, family and social pressure, shame, financial barriers, children, religious beliefs. Anti-violence activists also point out that putting the onus on the abused to leave is victim blaming.

➢ Abusers are under a lot of stress or unemployed: Since domestic violence cuts across socioeconomic lines, domestic abuse cannot be attributed to unemployment or poverty. Similarly, advocates note that if stress caused domestic violence, batterers would assault their bosses or co-workers rather than their intimate partners. Domestic violence flourishes because society condones partner abuse, and perpetrators learn that they can achieve what they want through the use of force, without facing serious consequences.

➢ Abuse takes place because of alcohol or drugs: Substance abuse does not cause domestic violence. However, drugs and alcohol do lower inhibitions while increasing violence to more dangerous levels.  But drugs and alcohol use/abuse is an issue that also needs to be addressed anyway.

➢ Domestic abuse is none of my business: Like suicide, all abuse is everybody’s business. We would like for others to help if someone close to us was the victim, so we must do the same for others. Besides, silence and passivity would send the message that abuse is ok.

Guyana’s women abuse rate is 57 per 100,000, but over 50% of cases go unreported each year, because women feel a sense of shame and prefer to suffer in silence, blame themselves (sometimes taking their own lives) or remain silent because of the high tolerance for violence. In 2015, the Americas Barometer survey, revealed that acceptance of domestic violence in Guyana is relatively high. The data showed that Guyana was ranked third globally among interviewed countries, with 35.6% of interviewees indicating acceptance/normalizing of domestic violence and reinforcing the view that Guyanese society is abusive. In fact, daily newspaper reports of fighting, injuries and even fatalities, is one manifestation of this. The ongoing spate of robbery with violence with families of perpetrators giving tactic support and benefitting from the ‘spoils’ is yet another manifestation. As well, studies have indicated that Guyanese many women equate a certain level of abuse with love.

Meanwhile 2017 has seen the continuation of another manifestation of an abusive society, the ‘massacre’ of our womenfolk. Here are but a few instances:

• Savitri Deolall, died from third degree burns that were inflicted by her reputed husband.

• A 39-year old policewoman was chopped to death by her alleged lover who eventually committed suicide.

• 37-year-old Lindener, Shenika London, was stabbed multiple times by her husband at her home.

• 26-year-old teacher, Tishaun Bess, was found hanging from the ceiling of her apartment. Relatives claimed that the relationship shared by the woman and her partner was an abusive one.

• Dhanwantie Ram, 29, who had to leave her marital home with her three children, a few days before, was found strangled on a sofa, with a bed sheet wrapped around her neck. Her abusive husband of 12 years was arrested for the crime.

In fact thirteen reported domestic violence related murders have been committed for 2017 thus far. As usual, calls for a national conversation and stakeholders collaboration continue to be trotted out. However, there has been a surfeit of talk shops, which eat up resources and produce nothing concrete. Even the recent three-day In-Service Violence Against Women’ training workshop was abstract talk shop oriented instead of hands-on approach applicable in real life situations with concrete positive impact.

On the other hand, stakeholders’ collaboration is just a catchphrase as successive governments reach out to a select few who display political loyalty and are seen as ‘our own’ by the authorities. This was once again evident at the recent three-day In-Service Violence Against Women’ training workshop at which many stakeholders that are active in the field, were not invited. That a nationally embracing policy to stoke stakeholders’ collaboration can make a critical difference goes without saying. Through ‘Voices Against Violence’, a loose umbrella of 60 plus entities, the National Anti-Violence Candlelight Vigil has been garnering momentum with 500 vigils held across Guyana over the past two years. Thus, a more structured network, supported by the government, can become both proactive and effective in tackling gender-based violence. Other needed measures, many of them mooted in the media quite often, include:

  A national safety net for abused persons, to include safe houses for women and children. In fact abused persons should have a mandated right to safe homes while investigations and cases are ongoing and even afterwards if deemed necessary.

  Special, mandatory court sittings across Guyana to ensure expedited handling of all cases with all police officers trained to display understanding, empathy and diligence and to be proactive rather than reactive in dealing with abuse. Investigations must be carried out in such a manner that even if the complainant withdraws the complaint or refuses to testify, the case can still proceed. If yet not in place, a legal mandate to this effect is needed.

  A mechanism in place to ensure that victims can access financial support for self and children so that financial dependency does not force them to withdraw complaints or refuse to testify. As well the Ministry of Social Protection/University of Guyana need to undertake a study to identify the range of reasons that lead to abused persons withdrawing their complaints or refusing to testify, so that appropriate measures are put in place to address these. No amount of rhetoric alone, will not address this issue.

  The Gatekeepers’ Program can also encompass abuse in all its forms. Inter ministerial cooperation is therefore urged to urgently bring back this program to ensure gatekeepers/lay counselors in communities across Guyana. In fact, The Caribbean Voice can access a lay counselor trainer for a year if the government is willing to partner with the providing organization.

  Inclusion of domestic violence in the Family Life and Health curriculum in schools nationally as was discussed in a recent meeting between the Ministry of Education and The Caribbean Voice,.

Last November, the Social Protection Ministry engaged in a tree wrapping exercise and a sensitization and awareness exhibition as violence prevention measures. Just how do these activities redress gender-based violence is anybody’s guess. Like suicide prevention, abuse prevention should cease to be a dog and pony show with scarce resources wasted on pageantry and photo ops. As well Georgetown and Region Four continue to be the center of the vast majority of activities even though issues like gender-based violence are national in nature.

The need therefore, is for a national program of evidence based, abuse prevention strategies interactively delivered, modeled, reinforced by simulations and role play. This is what TCV does through our various free workshops, all five of which include modules on all types of abuse.

Meanwhile we note that the Ministry of Social Protection’s Sexual Offences and Domestic Violence Policy Unit (MSSODVPU) offers a range of services: shelter and temporary accommodation, financial assistance, rehabilitation, skills training, counseling, social work services, legal aid... So why is it that many cases of gender-based abuse continue to fester often with fatal consequenses? For example, a mother of five has been enduring years of domestic abuse, threats to her life, and most recently rape and an acid attack by her 56-year-old ex-reputed husband in spite of repeatedly reaching out to the police. Even reactively this Unit should have been able to help this woman and prevent the recent acid attack and rapes.

Thus, The Caribbean Voice calls upon the Ministry of Social Protection to set up offices in all ten administrative regions and engage in widespread and ongoing promotion as well as collaboration with the police and community based organizations so that its work can become proactively encompassing across Guyana.

The Caribbean Voice can be reached at caribvoice@aol.com, or 718-542-4454 (North America) and 644 1152, 646 4649 or 697-9968 (Guyana). As well, log on to our website at www.caribvoice.org to access our many social media pages.

(https://www.stabroeknews.com/2017/features/in-the-diaspora/10/30/government-must-give-meaning-to-anti-domestic-violence-rhetoric/)

 

Tackling suicide prevention in Guyana

(Oct. 23, 2017) Recently The Caribbean Voice received the following message from Dr. Leslie Ramsammy, former PPP/C Minister of Health, “When I was Minister of Health, I openly disagreed with them (WHO) on suicide…We have averaged between 140 and 170 deaths in my time as minister (2001 to 2011). The rate was between 18 and 25 per 100,000. I have argued that while Guyana has a troubling high rate, our rate is not nearly as high as what WHO used to say – 44 per 100,000. I used to challenge them to find the extra 100 to 150 deaths they were claiming. Their justification is that they made adjustments to cater for the underreporting, which they could not verify. It is interesting that when our actual deaths in the 1980 were over 250 they were actually reporting less than 150.”

So The Caribbean Voice did some digging and this is what emerged:

Clearly the 2012 figure is an anomaly, especially given that the only adjustment actually made by the WHO is from crude rate to age-standardized suicide rate, to eliminate the effect of differences in population age structures when comparing crude rates for different periods of time, different geographic areas and/or different population sub-groups. Thus the 2015 crude rate of 29.0 was adjusted to 30.6.

Whatever led to this apparent anomaly, it presents a skewed picture that makes the work of suicide prevention NGOs and activists that much more difficult, besides seeming to imply that with such a significant rate reduction, the government does not need to amp up resources to tackle suicide. That PAHO rep Dr. Adu was quoted a number of times in certain sections of the media as stating that the 2015 rate was 20.6 is even more puzzling and despite The Caribbean Voice’s suggestion that Dr. Adu, may have been misquoted, he has not, to date, provided any public clarifying statement.

Thus it is important to factor out the underreporting (estimated as 25% by WHO). That leaves an actual rate of 32.15 per 100,000, which would then mean that the reduction from 2012 to 2015 was 2.07 per 100,00 and not 11.4 per 100,000.

Now regardless whether the 2012 anomaly had a political motive as implied in some quarters, TCV can testify to the fact that politics and ethnicity have been interwoven into officialdom’s response or lack thereof to our suicide prevention and anti-abuse campaign. Just after the National Stakeholders Conference on Suicide & Related Issues, in August 2015, a cabinet minister told us that President Granger was happy about our work in Guyana and that the Prime Minister and himself were tasked with providing TCV with all necessary support for our campaign.  Almost three years later we are still waiting for that support to kick in. However a rationale of sorts for that not happening emerged when we learnt through a number of very reliable sources that suicide was allegedly identified as a problem specific to one ethnic group and TCV as an NGO reflective of that same ethnic group. While both of these assertions are inaccurate, is the implication that there exists a policy of different treatment for different ethnic groups?

In 2015 the army approached us to help with suicide, which they indicated was a significant issue within its ranks.  Subsequent efforts to set up a planning meeting elicited no response. Then we learnt that another NGO, with political connections, had been contracted to provide assistance.  Also, in 2015 Minister Ramjattan set up a meeting between TCV and the Police Commissioner to explore collaboration. Subsequently, the meeting was postponed by the Commissioner’s Office and to date requests to reschedule that meeting have met with silence.

As well, we had a meeting with the General Manager (GM) of the Guyana Chronicle to discuss non-publication of our letters. The upshot was a promise made to ensure publication of our letters, as well as a weekly column by TCV. Subsequent efforts to realize these promises were unsuccessful in spite of numerous emails sent to the GM and the Editor. More recently, our request to use the government guesthouse during a two-day outreach in one of the regions was rejected by that region’s Chief Executive Officer who incorrectly claimed that TCV ‘is PPP’. So is it only pro-government organizations and personnel that are entitled to access to such state resources?

There are many more examples like these.  Yet, the reality is that TCV is neither politically affiliated nor ethnocentric. Our 70 plus volunteers and support specialists, with a range of skills and expertise, including psychologists, clinical counselors, researchers, pollsters, sociologists, medical personnel and social and community activists, reflect the ethno and political gamut of Guyana. And those who take our training, attend our workshops and outreaches, appeal for help or are proactively provided assistance, are not screened for ethnicity, political affiliation or anything else. In short no one has ever been, is ever or ever will be turned away by TCV, on the basis of age, ethnicity, political affiliation, gender, sexual orientation, status or any other indicator.

Furthermore, over the past three years, The Caribbean Voice has invested about five and half million dollars in suicide prevention and anti-abuse in Guyana. During this time we have engaged in over 300 successful counseling cases; held over 20 workshops that trained about 2,000 persons, including hundreds of students, and engaged in another 20 outreaches that networked with a few thousand persons. As well we held more than 50 meetings; attended over 25 different fora, widely disseminated information (articles, letters, interviews) across numerous media platforms, traditional (including international media such as New York City’s Daily News newspaper, the BBC, Vice News, ITV and Al Jazeera), and online posts (Facebook, Twitter, Instagram, Google, Linkedin, Pintserest, Tumblr, Youtube) reaching millions; engaged with other stakeholders, in lobbying for a range of measures, with the suicide helpline coming into being (promises to place counselors in schools and to develop a model to tackle pesticide suicide were made but not delivered); commissioned two surveys and held four press conferences. Also, we held the first and only truly National Stakeholders’ Conference on Suicide and Related Issues that was attended by over 70 stakeholders from across the nation, with transportation assistance provided where requested.

Additionally, TCV launched the Annual El Dorado Awards, which has, so far, honored 34 social activists and change agents – individuals and organizations - with another 18 to be honored this year. Among the 2017 honorees is an NGO working with children in the Amerindian community, an Amerindian artist who engages in tremendous social work, a few businesses that give back to the tune of millions of dollars, two community based organizations that do tremendous work within their communities, one youth activist and one youth organization that focuses on youth activism, a disability rights activist who is visually impaired, a women's empowerment activist, an organization that works with autistic children, and an organization that provides relief supplies to families who face disasters such as fire and flood. The names will be publicized closer to the awards.

Also, TCV partners in Voices Against Violence, which organizes the Annual Anti-Violence Candlelight Vigil that, in two, years saw 500 plus candle light vigils held across Guyana. This year 59 partners organized vigils from Corriverton to Mabaruma and Charity. Partners were drawn from all ten administrative regions and included NGOs, Faith Based Organizations, Community Based Organizations, special interests groups (including youth and women’s groups), Regional Democratic Councils, Neighborhood Democratic Councils, businesses, media, religious institutions and political parties. Thousands of person participated and many cultural programs were held. Collaboration underpinned almost all the vigils, community togetherness was reinforced and social activism given a boost.

This year, like last year, letters were sent out to various cabinet ministers as well as the President, the Prime Minister and the First Lady, seeking meetings to discuss collaboration with and support for the vigil, but none of the communication was even acknowledged. Both the PNC and the AFC were invited to partner in the vigil but neither responded. However the PPP and the URP did. Hopefully, next year would be different since not only is the vigil here to stay; it keeps gaining more momentum, participation and support. In fact an event like this should be supported, promoted and fostered by the Ministries of Social Cohesion, Communities and Indigenous Affairs as it fits into their respective agendas.

In effect, our work has a national reach and TCV have established regional sub groups in seven regions with the remaining three to be set up next year. In recognition of our work we were invited to make a presentation at a special session of Guyana’s parliament. Interestingly, the invitation came from the local UN office in Guyana rather than parliament itself or the government. As well our work has been featured in the newsletter of the International Association for Suicide Prevention.

Meanwhile, regardless of what kinds of labels are thrown at TCV will continue to educate, enlighten, advocate, lobby, train, counsel, network, engage in outreach, foster collaboration while debunking myths and misinformation, providing coping skills, developing self esteem, arming Guyanese with the wherewithal to face and overcome challenges/stress and to identify suicide and abuse warning signs and take action proactively, ensuring that all, who so request or are identified, do have access to counseling.

Meanwhile, we will continue to reach out to government at all levels with the hope that, among other things:

➢ The promise made by Ministry of Education officials to ensure that our Youth & Student Workshops are offered to public schools, will be kept;

➢ Our National Youth & Student Essay Contest will be facilitated in schools throughout the nation, having already been endorsed by the Ministry of Education;

➢ We will be allowed access to schools for our workshops and outreaches and access to state guest houses especially in the hinterland where we plan to soon extend our activism starting with Region One later this year;

➢ Both the Annual Anti-Violence Candlelight Vigil and El Dorado Awards will be endorsed and supported;

➢ Chronicle will keep its promise to publish our letters and the weekly column that was agreed on.

Suicide and abuse are national scourges affecting all segments of our population. Thus, suicide prevention and anti-abuse should be everybody’s business and government at any level should not display ethnic, political or any other bias towards those who give selflessly of their time, efforts and resources to save lives and empower people.

(https://www.stabroeknews.com/2017/features/in-the-diaspora/10/23/tackling-suicide-prevention-in-guyana/)

 

Employee Mental Health Critical

(Oct. 11, 2017) The Caribbean Voice (TCV) absolutely agrees with the Director of Mental Health, Dr. Util Richmond Thomas, that smart employers do foster their employees’ positive mental wellbeing. Such employers develop policies that support employees by 'normalizing' mental illnesses as health conditions that carry no shame; facilitate access to care and adopt effective work re-entry programs for individuals with mental health problems. Employers who want to maximize work productivity need to know that they will have greater success when they spend some time and resources on addressing mental health at the office.

The fact is that six in 10 people say poor mental health has impacted their concentration at work - meaning that they are physically present but seriously underperforming. And then there are millions of workdays that turn into sick days each year due to mental health problems - 70 million in the UK, 32 million in France, 18 million in Germany. One in ten employees have taken time off work for depression. One in five employees will have a mental health condition over the course of their careers that impacts performance and requires time away from work. And workers have partners, parents and children who also may have mental health conditions requiring extra attention at some point. Addressing employee mental health needs comes with a cost - but ignoring mental health in the workplace is not an option; the costs triple and quadruple when we turn a blind eye - which doesn't make any cents. The fact is that just $1 of investment in treatment for depression and anxiety leads to a return of $4 in better health and ability to work.

Stats are not available for Guyana but each year in the U.S., mental illness accounts for the loss of 217 million workdays and costs $193.2 billion in lost earnings.  And the World Economic Forum estimates that the cumulative global impact of mental disorders in terms of lost economic output will amount to $16.3 trillion between 2011 and 2030.

A 2008 World Health Organization report on Guyana stated that, “75,000 to 112,500 Guyanese suffer from mental disorders and require some level of mental health care services. Of these approximately 22,500 to 37,500 would be expected to suffer from severe mental illness. One can easily estimate the massive losses to employers and the economy because of this reality, especially since today, those figures would be significantly higher.

It is in recognition of these realities that TCV launched our Employees Mental Health Workshops last year, which like all out other workshops is offered for free to businesses.  Among the issues addressed in the workshop are depression and anxiety, self-esteem, coping strategies to handle stress and challenges, self/wellness care, abuse in all forms and suicide. The workshop is interactive and uses the facilitative delivery method and the KISS approach, that includes ice breakers; diagnostic and self knowledge questionnaires; use of fact sheets, posters and other ancillary materials; role play, simulations and games; Q&A; case studies and anecdotes; use of enabling technology such as power point slides, videos, virtual charts and graphs.

While we urge businesses to take advantage of our workshop we also once again call on the government to heed the WHO’s call for mental health care to be decentralized and integrated into primary health via a coherent and concerted national process. According to the WHO, “By making (all) health care workers sensitive to the presence of mental health problems and by equipping them with skills to deal with those problems, much wastage of efforts in general health care can be avoided and health care can be made more effective”.

In fact this approach has been highly successful in Zimbabwe and Uganda in particular, among many other nations. In Zimbabwe lay health workers screen for common mental disorders, including depression and anxiety. For those who screen positive, a lay health worker delivers problem-solving therapy with education and support. Those who receive the intervention improve and look better six months later, compared to usual outcomes.  As well, local community members without formal mental health education can be trained to deliver basic psychotherapy services as is happening in Uganda. One of the first randomized controlled trials for mental health in low and middle income countries was a landmark study of group interpersonal therapy in war-affected Uganda. The intervention led to large and significant reductions in depression for participants.

Also an innovative study in Chile demonstrated that stepped-care for depression in primary care works better than treatment as usual. The Chilean government translated the research into policy and depression is now a priority health condition, with depression treatment included in Chile's national insurance plan. In Guyana, depression and anxiety treatment should also be covered by the National Insurance Scheme.

As well, we urge the Ministry of Health to make sure that mental health professionals are available 24/7 at public hospitals, and where there are psych wards, mechanisms, including signage providing directions, must be put in place to make access to such wards easy and quick for anyone seeking help, given that delays and consequential frustration/anger can lead to loss of lives.

Also, the media recently reported the case of an individual with mental health issues sentenced to imprisonment in the court. This begs the question as to whether magistrates and judges should not first mandate psychiatric evaluation and treatment for such persons, if deemed necessary. Perhaps government should ensure such a mandate is in place.

Meanwhile TCV is thrilled that the Public Health Ministry has decided to offer counseling to family members of teenaged rape/murder victim Leonard Archibald. We also hope that this marks the beginning of a policy that would embrace all families of abuse - sexual, gender based, child, alcohol and drugs - as well as suicide survivors and that the offer of counseling would not be selectively offered. We also urge that all regions follow the example of Region Two, which, in collaboration with The Caribbean Voice, recently set up a committee to visit families of suicide and abuse victims in order to ensure that any necessary counseling be offered as needed. Towards this end the region also recently acquired the services of a psychologist.

Finally, we believe that Guyana should join other nations such as the US and UK and mandate counseling in all cases where mental health issues are identified especially at workplaces, schools and homes. This would ensure that employers, in both the private and public sectors, become responsible for the mental well being of their employees and consequently become the smart employers that Dr. Util Thomas referred to and that is desirable.

(http://guyanatimesgy.com/mechanisms-must-be-in-place-to-prevent-abuse/)

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