The Jamaican Approach to Mental Health

Wednesday, March 8, 2023

By Courtney Wise

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Despite limited resources, Jamaica pioneers a different approach to mental health

In 1962, when it acheived independence, Jamaica didn’t just move to decolonize itself. It also became one of the first countries in the world to deinstitutionalize its mental health system, according to a report in The Guardian. Under British rule, Bellevue Hospital in Kingston provided virtually the only mental health treatment in the country. It had been built as a lunatic asylum and was infamous for abusive and repressive treatment. After independence, the late Frederick Hickling became Bellevue’s senior medical director. He worked to end the custodial treatment practices of the British, in which mentally ill patients were held in hospitals against their will. 

“Post independence, we had limited financial resources and a population traumatized by colonialism and the legacy of slavery,” said Geoffrey Walcott of the Caribbean Institute of Mental Health and Substance Abuse. Hickling’s worked to treat patients outside of Bellevue, diminish the stigma of mental illness, reduce involuntary treatment, and make care accessible to the large rural population. “If patients are part of the decision-making process and accept treatment, they are more likely to recover and remain well over a long-term period,” Walcott said. 

Today, thanks to those efforts, most Jamaicans with chronic mental illness are no longer hospitalized, but receive treatment in local clinics or at home, from teams of psychiatrists and nurses deployed in the field. But even with these innovations, Jamaica, as a developing nation, continues to lack the resources that would allow it to adequately serve those in need. 

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San Diego street medicine team brings mental health supports to those in need

Two years ago, love and commitment led Scott Vicki to San Diego. He traveled there from Virginia to scatter his wife’s ashes along Ocean Beach, one of her favorite places, but PTSD kept him there. Today, he still lives along the San Diego waterfront, bringing joy and smiles to passersby as “Chicken Man,” though his audience is unaware of the pain that drives his performance. While anxiety kept him from seeking help, he told the San Diego Union-Tribune, mental health treatment eventually came to him, in the form of Father Joe’s Villages street medicine program.

The nonprofit’s mission is to end homelessness, while also providing care to people while they’re unhoused. Late last year, they added psychiatric mental health nurse Michelle Padilla to their street medicine program. “Being homeless is traumatic,” Padilla said. “Having to sleep with one eye open at all times. You don’t know if your stuff is going to be stolen, if you’re going to be stabbed in the middle of the night. Now they’re not sleeping, and it can lead to hopelessness and depression.”

A month and a half into weekly sessions with Padilla, Vicki says his mental health is improving. He not only gets medication, he feels cared for. “I have less night terrors. PTSD is down, the bipolar is more level,” he says. Plus, he says, he has “somebody else who cares about me, who comes out once a week.” 

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Rather than disband tent camps, some cities fund them instead

While many American cities are banning and demolishing homeless camps, others, like Athens, Georgia, have authorized space for them, the Christian Science Monitor reported. An Athens encampment called First Step opened last spring as a fenced-in site with security, bathrooms, food, recreational activities and 55 tents that provide temporary homes. The National Coalition for the Homeless opposes the sanctioned encampment model, arguing that it allows local governments to criminalize unsanctioned camps and to avoid creating affordable housing.

Athens Mayor Kelly Girtz sees it differently. “The point was to move people from unstructured camping to a more structured, clean, stable, and healthy environment,” he said. Trash, sanitation, and substance use problems associated with “Cooterville,” a previous, unsanctioned tent city, is not an issue at First Step. Athens-Clarke County is putting $5 million into the effort, which includes additional crisis beds at a local mental health clinic, as part of a $60 million grant it received from the Biden administration’s American Rescue Plan. 

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In other news…

Looking for your next read? The New Yorker’s Lily Meyer suggests The Absent Moon: A Memoir of a Short Childhood and a Long Depression by Brazilian author Luiz Schwarcz. Meyer writes: “It is restrained and full of explicit omissions, and yet it offers astounding emotional clarity. Schwarcz evidently sees his project – or his responsibility – as a double one: to share but not interpret the profound suffering he’s faced in his lifetime with depression and bipolar disorder; and to tell, again without interpretation, what he can of the family story that underlies both his struggles with mental illness and his instinct, or compulsion, toward silence.”

Minnesota lawmakers are considering a bill to make the state a “safe haven” for children and teens in search of gender-affirming health care. Minnesota Public Radio journalists examined what such a law would do in practice. Here’s a link to the transcript and the nine-minute listen.

Does personality affect employee fitness for remote work? Gleb Tsipursky considers the question in a column for Psychology Today.

A team of scientists at Michigan State University is exploring how virtual reality can support the mental health of in-home caregivers. The hypothesis is that the technology may offer caregivers a momentary escape. “They’re taking a vacation, a little mini, short vacation, in the home, in a safe space, seated comfortably in their chair. And they’re able to put on these goggles for ten minutes or so, and actually have a completely new experience,” lead researcher Rebecca Lehto told WILX. Virtual excursions include a walk on the beach, a float through space, or a break in a springtime forest. Lehto and her team are looking for caregivers to participate. Interested parties can email lehtor@msu.edu.

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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