Editorial | JAMAL-ise mental health interventions

Last week, the health minister, Christopher Tufton, unveiled his ministry’s latest programme to help Jamaicans cope with the mental stresses that are part of their lives.

Initiatives of the kind are needed by all Jamaicans, but especially young people. For although it might be hard to admit, Jamaica can be a difficult and stressful place to live.

Last year, for instance, the island recorded 1,498 murders, for a homicide rate of 55 per 100,000. Only a handful of countries are worse. The problem is decades-old.

The vast majority of the victims, and perpetrators, of these killings are young people – mostly males under the age of 30. They are often members of gangs. In addition to the people who die, scores more are injured in gun violence.

The anxieties caused by Jamaica’s crisis of crime – which is estimated to rob the economy of five per cent of GDP annually – has been exacerbated in recent years by the COVID-19 pandemic, which kept children out of school for two years and pushed many families further into the economic margins.

The anecdotal evidence suggests that in the post-pandemic classroom, old problems with discipline have worsened, and that students are more apt to attempt to settle disputes with violence.

As many people find it increasingly difficult to cope in what Dr Tufton labelled “a society in distress”, some appear willing to take extreme action of ending their lives. In 2022, for example, Jamaica recorded 1,498 homicides, an increase of 88 per cent on the previous year. Drug use by young people has also risen.

CRYING OUT FOR HELP

People, however, are also crying out for help. Dr Tufton reported that last year, a suicide prevention support helpline run by his ministry fielded nearly 2,200 calls – an increase of nearly a third, compared to 2021.

Notably, suicidal calls jumped 80 per cent, to 236 last year. Of the overall number of calls handled in 2022, seven percent were from people facing emotional distress. A similar amount was directly related to depression. While in 2021 only five persons in the schizophrenia category called the helpline, last year the number rocketed to 183.

“These numbers suggest very strongly that a number of Jamaicans are having a rough time and may not be managing their challenges as well as they could,” Dr Tufton said.

This is what the pilot initiative he launched last week – Problem Management Plus – is intended to help people to do.

As The Gleaner has proposed at the onset of the pandemic – when the deepening of mental health challenges of Jamaicans was becoming apparent – this scheme will, as Minister Tufton put it, “bring mental health support services to communities, meeting people where they are”. Indeed, even before the pandemic it was estimated that four in 10 Jamaicans would at some point in their lives face a mental health disorder.

Already, 125 people, including six master trainers, have been trained for the project. They have been deployed across 12 of the island’s 14 parishes to help Jamaicans deal with a wide range of trauma. But even with this and other projects to turn around the crisis of violence and related psychosocial problems, the intensity of the intervention is insufficient.

SEEMINGLY DISPARATE

The approach is seemingly disparate – often inchoate and incoherent. There is an apparent lack of coordination – an absence of joined-up government.

The health ministry has a programme for addressing mental health literacy, centred on reducing stigma relating to mental health conditions. It separately runs a mental health support helpline with the support of UNICEF, the United Nations’ children’s welfare agency. The justice ministry has its own programme for training people, including for teachers, in restorative justice mediation. Additionally, towards the end of January, the national security minister, Horace Chang, announced a programme to help residents and communities deal with trauma, sounding very like the one Dr Tufton launched last week. Except that the initiative unveiled by Dr Chang fell, it was reported, under his ministry’s citizen security plan. Perhaps they are the same project.

All of these interventions are obviously interconnected, or ought to be. They are working towards the same end.

There is an obvious need for far greater coordination of various initiatives ­– whether by the Government and NGOs – that attempt to address the behavioural/psychosocial issues that lead to antisocial behaviour, including criminal violence. That way, limited resources can be used more efficiently, leading to better results.

Very important, too, this project demands a level of mobilisation – in which the leader of the Government is very deeply invested – that Jamaica has not mustered in several decades. At least not since the Jamaica Movement for the Advancement of Literacy (JAMAL) when hundreds, perhaps thousands, of young, educated Jamaicans were energised to teach illiterate Jamaicans to read and write. That approach, a national sense of ownership of an idea and its execution, is needed even more in the current crisis than the 1970s assault on a literacy rate of 50 per cent.