Mental health and the poor and downtrodden

The recent death by suicide of American celebrity chef, television personality, travel documentarian and author, CNN’s Anthony Bourdain, has placed the spotlight once more on the issue of mental health awareness and treatment. Bourdain was widely acclaimed and his television series, “Parts Unknown,” won him Primetime Emmy Awards each year from 2013 to 2016 for “Outstanding Informational Series or Special,” and at the time of his death, he was estimated to have a net worth of US$16 million (which translates into a little over 3.2 billion Guyana dollars).

The picture of success painted of Bourdain contrasts sharply with his unfortunate demise at his own hands, and shock and sadness was felt around the world by those who knew him personally, or through the realms of television, magazines and books. The stereotypical image of a person suffering from mental illness teetering incoherently on the verge of madness was also given a sharp blow, with the realisation that normal looking and normally functioning persons can be suffering silently from the maladies that are grouped and more euphemistically referred to as “mental health issues.”

Mental health issues include depression, anxiety and panic disorders, bipolar disorders and eating disorders, substance abuse and addictions, antisocial personality disorders, and paranoid personality disorders among others. In Guyana and around the world, many persons suffering from these disorders go undiagnosed and untreated even when violent incidents occur as a consequence of the person suffering from mental health issues. Indeed, it is believed that there are many persons serving prison sentences actually suffering from various mental health disorders, but who neither receive diagnosis nor treatment while serving their sentences.

A mental health treatment advocacy body, appropriately named the Treatment Advocacy Center, operating out of Arlington, Virginia in the US, stated on its website that, “Serious mental illness has become so prevalent in the US corrections system that jails and prisons are now commonly called: the new asylums.” The Treatment Advocacy Center which boasts a wide array of professionals on its staff and Board of Directors, as well as having a string of doctors on its Psychiatric Advisory Board, estimates that prisons in America contain ten times the number of mentally ill persons than actual mental patients remaining in the nation’s state hospitals. This is a gloomy picture indeed of the situation facing mentally ill persons in one of the world’s foremost democracies.

But when the findings of the Treatment Advocacy Center is juxtaposed with the public outpourings of sympathy and grief at the Anthony Bourdain tragedy an obvious contradiction emerges in the way people who are suffering from mental health issues are viewed and treated. Many persons of lesser means and leading much more innocuous lives, knowingly and unknowingly suffering from mental health illnesses are thrust into the criminal justice system without regard to a medical diagnosis and without hope for treatment.

When we consider the level of violence meted out by a wide cross-section of Guyanese particularly against their spouses and other close family members, the question of the mental health status of these perpetrators should be raised in the process of them being passed through the criminal justice system. However, more often than not the need to punish seems to override any attempt at remedial treatment of the perpetrators of violence on others (not including criminal violence from robbery and other forms of banditry). Persons suffering from the various mental health disorders, some of which are mentioned earlier in this editorial, can become prone to violent reaction to perceived problems and thus wind up on the wrong side of the law.

Without question even Anthony Bourdain reacted with violence to his mental health issues – violence he directed at himself primarily, yes indeed, but violence nonetheless, even if suicide might seem more “socially acceptable” to unwarranted excessive physical violence directed at someone else. But the lesson for us here in Guyana, where the likelihood of violent confrontation between friends or relatives and violence as a remedy for even the most basic disagreements have perhaps reached the epidemic stage, should not be lost on those in authority.

Recently, a serving member of our Military was allowed to undergo psychiatric evaluation after killing a close family member and turning himself over to the police. There have been many such killings of female spouses over the years whereby the perpetrators have done little or nothing to conceal their hand in the heinous act, and this perhaps points to a serious need for the psychiatric evaluation of such persons if the authorities are ever going to get a handle on this pervasive spirit of violence in all its forms that currently seems to have many persons in Guyana in its vice-like grip.

Suicide is also a form of violence, but much like is happening with Bourdain’s death, it is usually heavily romanticised and not considered in a practical, nuts-and-bolts manner. Guyana is one of the countries considered a “ suicide capital of the world” and this points to a serious mental health endemic affecting our populace.

If the high-profile death by suicide of one of the world’s most acclaimed and beloved television personalities only draws attention to mental health issues of the rich and famous while similar or worse issues affect the poor and downtrodden who are simply gathered up and placed in “the new asylums,” that is, prisons, then an incredibly teachable moment would have been lost.

When a Diamond man on trial for attempted murder was remanded to prison on Wednesday last, he went berserk, snapping his handcuffs before assaulting a police officer and yelling at the Court, “I want dead! Y’all gah kill me!” it was perhaps another teachable moment for those in authority in Guyana to recognise the burgeoning mental health precipice that we are teetering on.

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