On Tuesday, the Ministry of Health announced that Dr Timothy Morgan, former coordinator of its Mental Health Unit, had replaced Dr Util Thomas as its head, following an evaluation of the unit’s work. The explanation given by Minister of Health Dr Frank Anthony was that Dr Morgan had more knowledge of the discipline than his former superior, with the inference being that he would do a better job than she has done over the last four-odd years.
Evidently, the evaluation of the Mental Health Unit must have found Dr Thomas wanting in a very major way. So much so that as a woman who reportedly has some two decades of experience in treating mental health issues, Dr Thomas was fired from the unit on January 27 this year. However, she was informed last week by way of a letter from Permanent Secretary of the Ministry of Health Malcolm Watkins that she was being rehired. “Please be informed that after further deliberation on the matter, a decision has been taken to rescind your termination and for you to be re-designated as Government Medical Officer with effect from 2022-03-22, inclusive,” the letter from Mr Watkins read. “A decision has also been taken for you to be assigned duties at the Enterprise Health Centre, East Coast Demerara to function as the doctor in charge of that facility.” If she accepts the position, Dr Thomas will be practising general medicine since the Enterprise facility is not a mental health clinic.
It is therefore now pellucid that the Ministry of Health wants Dr Thomas as far away from its mental health programme as possible. Since there was no correlating disaster in mental health in Guyana prior to her removal, at least none that was made public, the decisions described above are open to conjecture. One reckons that no one fires a doctor with decades of experience in a specialised field for no reason. Therefore, the issue that caused Dr Thomas to be sacked must be one of egregious proportions. However, she has been offered a job heading a health clinic so that removes the spectre of malpractice.
The very next extrapolation is dangerous given the current temperature of our society and though it is yet unproven, in the face of no evidence to the contrary, it is the logical hypothesis that even the most casual observer will be forced to make. The facts are thus: Dr Thomas returned to this country from St Lucia in 2017, where, reportedly, she had worked in the field of mental health for 15 years. Her appointment to head the local Mental Health Unit was made during the tenure of the APNU+AFC administration. Nothing else needs to be said here, except that an evaluation of the Mental Health Unit, as the reason offered by Dr Anthony for Dr Thomas’s relegation to the Enterprise Heath Centre, is hopelessly vague. It begs the question as to why her services were terminated in the first place if, as he was quoted as saying, this reassignment will allow her to better utilise her skills.
In using innuendo when nothing but clear speech and straightforward explanations are required, Dr Anthony does the Guyanese public a disservice. Is one to presume then that Dr Thomas’s skillset is not in the field of mental health? If that is the case, then how was it that she managed the Mental Health Unit from 2017 until January this year? If that is not the case, is the minister simply casting aspersions on the professional character of Dr Thomas? As someone who claims to care about mental health in Guyana surely Dr Anthony owes the public more than the litany of obfuscation he has so far uttered.
Mental illness is among the most undiagnosed and untreated diseases in Guyana; it is also still highly stigmatised. Suicide, as is well known, is linked to mental health and the rate per 100,000 population at which people ended their own lives in this country had at one time earned it the unsavoury moniker of ‘suicide capital of the world’. According to a 2012 World Health Organisation report, Guyana’s suicide rate of 44.2 per 100,000 people was the highest in the world. In its ‘Suicide Worldwide in 2019’ publication WHO pegged Guyana’s suicide rate at 40.3 per 100,000 people, an improvement on its former status. What this should be saying to all of us is that the measures put in place so far appear to be working, but much more needs to be done. Dr Anthony appeared to be well aware of this as he referred to certain regions in Guyana, where he said suicide was a huge problem, as requiring adequate focus on mental health. What was a bit surprising was that he failed to mention or even hint at other mental health conditions, including bipolar disorder, obsessive-compulsive disorder, psychosis, and schizophrenia, which exist in Guyana and manifest in various ways among people who suffer from them.
If anything, Guyana has a shortage of qualified mental health personnel. Over at least the last four administrations, those in authority have been touting the need for more psychiatrists and mental health therapists. While health brigades from China and Cuba possibly included specialists in this field, the language barrier would have prevented them from making much of a difference. It is important to remember that a therapist needs to establish a relationship of trust with a patient. The inability to comfortably converse in the same language would render this impossible.
Furthermore, the strictures on our lives suddenly imposed in order to curb the spread of the COVID-19 have led to more people needing and seeking mental health services. That being the case, this is hardly the time for there to be any doubt or confusion over what is occurring in the Mental Health Unit. The government and Dr Anthony need to shoot straight on what the situation is. The people of Guyana deserve no less.
