Reduction in suicide rate is not due to the work of government but of NGOs

Dear Editor,

 

The Caribbean Voice notes an article in a section of the local media in which PAHO’s Dr Adu-Krow, is quoted as saying that the suicide rate in Guyana has  “plummeted to 20.6 per 100,000 people.” Actually WHO figures indicate a rate of 30.6 and a global ranking of number two. Perhaps Dr Adu-Krow was misquoted. Not that we’re not thrilled by the significant reduction from 44.2 in 2012 and a global ranking of number one, but we are bemused by the implication that this reduction is due to the work of the Government of Guyana (GOG). Actually, this reduction is due much more to the work of NGOs like The Caribbean Voice (TCV) and very little to GOG efforts.

In fact TCV has an ongoing campaign organized and run by almost 70 volunteers in and out of Guyana, built on five pillars ‒ training, information dissemination and awareness building, lobbying and advocacy, counselling interventions (over 300 cases in three years) and building stakeholders collaborations (such as with Annual National Anti-Violence Candlelight Vigil to mark World Suicide Prevention Day, Sept 10) – and includes five different workshops: youth & students, teachers, community outreach, train the trainer and  employee.  Seven dedicated sub groups in six regions (with plans to set up same in the other four regions) managed by a passionate leadership committee, ensures that our work is continual, ongoing, holistic, collaborative, and comprehensive. For example, two mental health outreaches and three workshops in three regions in August partly typify what we do on a monthly basis.

Meanwhile, we commend doctors being trained in WHO’s Mental Health Gap Action Programme (mhGAP), but WHO has actually strongly advocated integration of mental health care into the current primary health care system as being critical to address mental health issues, including suicide. The training of doctors is just the start of such a process, and by itself has a negligible impact. As WHO itself pointed out, “Successful scaling up is the joint responsibility of governments, health professionals, civil society, communities, and families, with support from the international community. The essence of mhGAP is building partnerships for collective action”;  in other words, an integrated health care system and concerted collaboration, by all stakeholders.

The article goes on to talk about vaguely defined ‘suicide deterrent’ measures that we have heard about before. However, given that the government rejected something as fundamental as decriminalizing attempted suicide because supporting the bill would have meant that the opposition would get credit, explains quite clearly that government actions are premised on gaining political mileage rather than genuinely addressing suicide and mental health in general.

So we wonder whether that is why the Suicide Prevention and mental health plans drafted under the previous government and subsequently fine-tuned by officials of the Ministry of Health, have been shelved by the current government. In any case, the Caribbean Voice has continually pointed to the following as a basket of measures for effective implementation:

Counsellors in schools, which must be taken off the back burner and urgently acted on. Our suggestion is that the Diploma in Counselling should be reintroduced by UG (both campuses) and offered weekends to teaching staff and full time to retired teachers, who can then be placed in schools after completing the training.

Psychologists at all public health care institutions, which would necessarily have to be incremental.

The Gatekeepers’ Programme, also be taken off the backburner, to enhance community health care and ensure proactive first responders to save lives and tackle abuse.

A programme modelled after Sri Lanka’s highly successful Hazard Reduction Model to tackle pesticide suicide, instead of a piecemeal, ad hoc approach.

Urgent renovation of the National Psychiatric Institution and establishment of psych wards at all health care institutions to ensure in-patient services.

Wide and continuous promotion of the suicide helpline and inclusion of priests from the major religions to talk to callers.

Meanwhile we applaud efforts to incorporate important mental health topics into the Health and Family Life Education syllabus in secondary schools but we wonder whether teachers would be trained to not only deliver the content but also identify mental health issues and provide access/help. Otherwise, merely providing the information to students becomes an exercise in futility.

We must point out that at a meeting with Ministry of Education (MOE) officials last year, our Youth & Student Workshop was endorsed and we were told that it would be included in the Health and Family Life Education syllabus and facilitated by MOE. Our repeated attempts for follow up meeting to formalize this have elicited no responses. This workshop (also endorsed by the Child care Protection Agency which has also offered support) has already been offered to numerous private schools and a number of youth groups and has been very well received as (like all our workshops) it not only offers information, but is interactive, user friendly and easily understandable, eminently functional, and provides strategies that can be immediately used.

A similar workshop for teachers offers them the tools to follow up on content delivery. As well our ‘Classroom Management Without Corporal Punishment’ workshop for teachers offered to the government, pro bono, has not, to date been accepted. This workshop follows up on the Teachers’ Workshop.

Yours faithfully,

Annan Boodram

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