Letter: Govt suicide prevention operating at the level of rhetoric

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Dear Editor,

While The Caribbean Voice awaits suicide figures for 2017 we must point out that even though such figures may well indicate a decline over the previous year because of the work of all stakeholders, they would invariably be rather conservative.

This is because as the World Health Organization has pointed out, 25% or more of suicides are generally unreported and because, in the case of Guyana, reportage is also affected by the still strongly held taboo (family dishonor) and attempts that ensure that many suicides are reported as otherwise.

That being said The Caribbean Voice notes the Ministry of Health’s ‘suicide deterrent measures’ with a certain degree of skepticism. For one, efforts to ensure that existing laws and regulations regarding pesticide sale, use and storage, are being enforced, will have no impact unless these attempts are part of a concerted pesticide suicide prevention strategy, such as the Sri Lankan Hazard Reduction Model, which has been lobbied for by The Caribbean Voice since 2015, and which is, by far, the most successful pesticide suicide reduction plan ever. We strongly believe that should Guyana approach the World Health Organization, a similar level of assistance may be offered as was available to Sri Lanka.

With respect to moves to be made to train at least 50 percent of Primary Health Care doctors in the WHO recommended mhGAP-Intervention Guide, we have pointed out that the WHO also recommends that the best way of approaching mental health care for small economies like Guyana is to integrate mental health care into the current physical health care system, an approach that would ensure that mental health care (including suicide pevention) is cost-effectively accessed nationally in the same manner as physical health care.

While we applaud plans to increase the number of beds added to the inpatient service offered at the Georgetown Public Hospital Corporation’s psychiatry ward, may we point out that Georgetown is not Guyana and such a service must be offered at every public hospital in Guyana at the minimum to have any kind of impact, especially since the much touted plan to rebuild the National Psychiatric Hospital in Berbice, seems to have fallen off the radar screen.

Meanwhile we commend plans to incorporate important mental health topics into the Health and Family Life Education syllabus in secondary schools, a call that was mooted by The Caribbean Voice almost two years ago.

However, we hope this plan will not follow the fate of counselors in schools, which was top priority when the government got into power, only to be subsequently relegated to ‘a few years down the road’. The fact is that The Caribbean Voice and other non-governmental stakeholders have been continually working with schools and students and everywhere the appeal is the same – ‘our students need so much help, please come back as often as possible’. In fact one school we visited recently asked us to go back weekly as well as to devise and implement training for teachers.

In effect, at the government level, suicide prevention continues to operate at the level of rhetoric with intermittent, isolated, one off, piecemeal action, here and there, and all the talk about stakeholders collaboration is just that, as most of the stakeholders – entity and individuals – that actually are doing consistent, collaborative work are being ignored or sidelined.

For example, over the past two years, The Caribbean Voice, a totally voluntary NGO, funded by members and supporters, has undertaken more than 150 successful and free counseling interventions in Guyana, most of them based either on direct appeals or referrals.

Our information dissemination campaign has probably been more extensive that that of the government with respect to all media – print, broadcast and social media. Our community outreach and youth and student workshops are gaining traction to the extent that we receive more requests that we can handle. And in February we will be launching our Train the Trainer Program to get gatekeepers into every community as quickly as possible since promises to bring back this program have ended the way of all other promises.

Yet, The Caribbean Voice continues to be blanked by the Ministry of Education (among other government entities) in our attempts to obtain permission to visit schools as requests are made, to launch a national essay contest for youth and students and to train teachers in classroom management without corporal punishment.

Meanwhile the government’s suicide hotline seems to have been relegated to the back burner and to date, no official statistics indicating its extensive and successful use have been released; most public hospitals are still to be serviced by psychologists or clinical counselors; the National Suicide Plan is still awaiting daylight, the Gatekeepers Program seems a lost cause and while Trinidad & Tobago recently took the lead in raising the age of consent to 18, Guyana continues to be mired in the past.

What about a registry of sex offenders? Peer counselors in schools? A national parenting program to instill empathetic communication and parenting skills to combat the high level of dysfunction that contributes to suicide and violence on the whole? Trained domestic violence/suicide prevention personnel, or personnel with basic training in mental health or social work, at every police station?  And so on….?

Yours truly,
The Caribbean Voice

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