Panel Discussion on the Caribbean Secondary School Exam

The scheduling of the Caribbean Secondary School Exam has created some controversy in various Caribbean nations as teachers and their unions along with parents are up in arms, citing safety concerns, lack of student preparedness and related mental health issues. To address these issues and to explore possibly synergies, The Caribbean Voice in collaboration with Caribbean Education Project has organized a panel discussion on Wednesday 17th June from 7 to 8PM, New York City time.

The panelists include:

  • Dawn Lovell (Barbados) – writer, motivator, social activist;
  • Pandit Deodat Persaud (Guyana) – youth, community and social activist;
  • Everton Hannam (Jamaica) – Past President of the Jamaica National PTA and SG of UNESCO (Jamaica);
  • Mark Lyte – President, Guyana Teachers’ Union;
  • Margaret Nakhid-Chatoor (Trinidad & Tobago) – psychologist;
  • Alia Hutton, Michael Fein and Shawn Shivdat (US) – the Caribbean Education Project;
  • Nicole Manning, the Director of Operations and Mr. Shawn McBean, a Measurement & Evaluation Manager, CXC;
  • Trinidad & Tobago United Teachers Association;
  • Laura George, Amerindian People’s Association, Guyana;
  • Antonia Tekah-De Freitas – President, Trinidad & Tobago Unified Teachers Association.

he panel discussion will be on Facebook live will be accessed on The Caribbean Voice Media page at CaribbeanVoiceMedia/?modal=admin_todo_tour. For further details please call or What’s App Annan Boodram at + 1646-461-0574 or Shawn Shivdat at +14044069638. Both persons can also be contacted via FB Messenger.

The Caribbean Voice is a not for profit, volunteer driven NGO engaged in social activism and advocacy, especially abuse and suicide prevention, in various Caribbean nations. The Caribbean Education Project comprises a group of US based college students who have created an online platform with free resources for students preparing for the Secondary School Exam. The resources can be accessed at


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Mental health is a critical needs sector

By Annan Boodram – The Caribbean Voice (TCV)

Mental healthcare is a critical needs sector that has been glaringly brought home during this coronavirus pandemic. Nations across the Caribbean and elsewhere are struggling to provide minimal mental healthcare because the requisite infrastructure, skills, and resources are not in place. And so, in the new normal, post-pandemic, mental healthcare must also not be the same as it was pre-pandemic.

The World Health Organization (WHO) has long stressed the need for mental healthcare to be decentralized and integrated into the primary healthcare system with the necessary tasks carried out, as far as possible, by general healthcare workers rather than by specialists in mental health. This is especially critical in developing nations like Guyana where mental health specialists are in very short supply, but the need for the delivery of mental healthcare is acute. According to the WHO, “by making care workers sensitive to the presence of mental health problems and by equipping them with skills to deal with those problems, much wastage of efforts in general health care can be avoided and health care can be made more effective.

Furthermore, “research has shown that emotional and psychological distress may be an early manifestation of physical disease processes or may itself cause such diseases (the mind/body connection).” Thus, “an important concept in primary health care is that health activities should develop horizontally to involve other sectors working within the community … intersectoral collaboration, involving governmental and non-governmental organizations is important in all areas of health.”

The second component of viable healthcare delivery is social collaboration, which is the pragmatic avenue through which good mental (and overall) health can be effectively achieved, despite the constraints of resources and facilities. This collaboration must include the private and public sector, governmental and non-governmental organizations, mass-based organizations and special interest groups. This combination of intersectoral and social collaboration will then embrace all possible stakeholders and ensure good mental health across any nation. Gregory Popcak, author, pastor, counsellor, and psychologist, has identified nine components of good mental health, among them:

  • Attuned Communication — The ability to pick up on the meaning of subtle, non-verbal, physical cues (facial expressions, tones of voice, posture) that indicate another person’s emotional states and degree of well-being.
  • Emotional Balance — The ability to maintain optimal emotional functioning; to be emotionally stimulated enough to be aware and engaged in impacting circumstances and relationships but not so emotionally stimulated to be regularly flooded by one’s feelings and be carried away by them.
  • Response Flexibility — The ability to pause before acting on impulses and to wilfully change the direction of one’s actions if doing so is better than the dictates of one’s initial impulses.
  • Fear Modulation — Reducing fear. People with anxiety and panic disorders, especially, have a difficult time modulating the brain’s fear responses. They become easily flooded with anxiety where others might just experience nervousness or even excitement.
  • Insight — The ability to reflect on one’s life experiences in a way that links one’s past, present, and future in a coherent, cohesive, compassionate manner. Insight helps one to make sense of both the things that have happened in the past and the things that are happening now.
  • Empathy — Essentially, empathy is the ability to have insight (as defined above) into other people. Empathy is the ability to imagine what it is like to be another person and to reflect on their experiences in a way that links their past, present, and future in a coherent, cohesive, compassionate manner. Empathy helps one to make sense of other people’s lives, the way they think, and their feelings.
  • Morality — The ability to imagine, reason, and behave from the perspective of the greater good. This includes the ability to delay gratification and find ways to get one’s needs met while understanding and accommodating the needs of others.

These aspects of good mental health can go a long way in positively impacting a range of issues that are mental health-related including suicide, gender-based violence, child abuse, alcoholism, violent crimes, and sexual crimes which are all significant issues.

In this approach VIPs, celebrities, sports and entertainment stars, influencers, and shapers of society must step up for advocacy and information dissemination for various issues relating to mental health. We have seen this stepping up to some extent during this pandemic but many more need to be involved and such involvement must be ongoing. This, along with a sustained effort by the government health sector and other stakeholders, is necessary to delink mental health issues from the existing stigma, prejudices, and biases, including benevolent ones.

This collaboration does not have to be a process of reinventing the wheel. Globally many mechanisms have been reaping significant benefits. One such mechanism is the Friendship Bench in Zimbabwe whereby grandmothers are trained in evidence-based talk therapy, which they offer on public benches across communities. Another is the lay counsellor program employed in many nations, whereby selected individuals are trained within communities, to identify warning signs for suicide and various forms of abuse and to take proactive steps to get help for those in need.

It is generally accepted that a correlation exists between a nation’s mental health (as a component of overall health) and its economic growth. According to the WHO, the positive impact that health has on growth and poverty reduction occurs through several mechanisms, such as a reduction of production losses due to fewer worker illnesses, the increased productivity of adults as a result of better nutrition, lower absenteeism rates, and improved learning among school children. This relationship also allows for the use of resources that had been totally or partially inaccessible due to illnesses. Finally, it allows for alternative use of financial resources that might normally be destined for the treatment of ill health.

In effect, it is so important that the collaborative approach to mental health care, be regularized across the Caribbean and the developing world, instead of being applied in a piecemeal, random manner. “The collaborative care model is an evidence-based approach for integrating physical and behavioral health services within a primary care-based model and other settings”. (Unützer, Harbin & Schoenbaum; 2013)

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Free Online Resources for students preparing for the Secondary School Entrance in the Caribbean.

Please spread the word! The Guyana Education Project, led by a group of college students and professors from the United States, have partnered with The Caribbean Voice and other organizations in Guyana and the Caribbean to distribute high-quality educational materials catered specifically for students planning to take the National Grade Six Assessment. The website linked below offers free resources to help children in Guyana and across the Caribbean study and prepare for this exam. Please spread the word! With thousands of students in lockdown due to COVID-19 measures, we want to ensure as many as possible can get the resources they need to pass this exam! Keep this spreading!

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Suicide and the young

By Annan Boodram – The Caribbean Voice (TCV)

Suicide is the second leading cause of death among 15-29-year olds globally. Moreover, it is estimated by the World Health Organisation (WHO) that at least 25 attempts are made for every completed teen suicide.

Teenage years or adolescence in itself has been identified as a crucial period, considering the rapid changes as a part of the developmental phases itself, coupled with dealing with the transition from childhood into the next developmental phase of life, bringing with it inherent anxieties, and confusions regarding the formation of identities, dealing with relationships and their self-concepts. Within such a context, it is not surprising to understand the susceptibility of the youth towards experiencing high-stress levels.

Warning signs

Suicide among teens often happens after a stressful life event, such as problems at school, a breakup with a boyfriend or girlfriend, the death of a loved one, a divorce, or a major family conflict. Adolescence is also a time of sexual identity and relationships and a need for independence that often conflicts with the rules and expectations set by others.

Young people with mental health problems such as anxiety, depression, bipolar disorder, or insomnia are at higher risk for suicidal thoughts. Teens going through major life changes (parents’ divorce, moving, a parent leaving home due to military service or parental separation, financial changes) and those who are victims of bullying are at greater risk of suicidal thoughts.

The following are warning signs of adolescents who may try to kill themselves:

  • Change in eating and sleeping habits;
  • Withdrawal from friends, family, and regular activities: violent actions, rebellious behavior, or running away drug and alcohol use;
  • Marked personality changes, including  neglect of personal appearance;
  • Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork;
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Not tolerating praise or rewards;
  • Talking about suicide or death in general including giving hints that they might not be around anymore;
  • Talking about feeling hopeless or feeling guilty;
  • Writing songs, poems, or letters about death, separation, and loss;
  • Giving away treasured possessions to siblings or friends
  • Engaging in risk-taking behaviors;
  • Having signs of psychosis (hallucinations or bizarre thoughts)
  • Refusal to talk;
  • Difficulty coping with stress or grief;
  • Self-mutilation through cutting, burning, and so on.

Role of family in preventing suicide

Some years ago a young man died in the streets. A sibling disclosed in the wake that the brother would occasionally spend time by her home as he was living in the streets. On that night the young man called his sister around two or three in the morning requesting to drop by her. She told him that it was very late and she needed to sleep, so he could drop by in the morning, as he knew where the spare key was kept. The next morning they learned of the suicide of the young man but told the public that he died by a drug overdose. That young man, who came from an affluent family and whose father was well known in the community, was in the streets because of differences with a parent.

Also, some years ago, a young lady, again from an affluent family, died by suicide.  Both her parents were highly qualified professionals whose college student daughter had apparently failed to maintain her straight A’s during the semester prior to her death. This apparently angered her parents who let their daughter know how they felt. This exchange was the trigger for suicide.

These two incidents highlight the fact that families often drive teens to suicide. Yet, given that that youngsters spend more time at home than anywhere else, families are in the best position to identify warning signs and seek help for at-risk members. In effect, parents must always be alert to what’s happening in the lives of their teenagers; they should always find out how their teenagers are doing and if anything’s bothering them.

Some adults feel that kids who say they are going to hurt or kill themselves are “just doing it for attention.” It’s important to realize that if teens are ignored when seeking attention, that may increase the chances of them harming themselves. Thus it’s important to see warning signs as serious, not as “attention-seeking” to be ignored. And in addressing any problems parents must not use language that would alienate their teenagers, make them feel unloved and unwanted, make them act in anger and/or haste, or make them feel, alone and lonely.

It’s important to try to keep the lines of communication open and express your concern, support, and love. If your teen confides in you, show that you take those concerns seriously. A fight with a friend might not seem like a big deal to you in the larger scheme of things, but for a teen, it can feel immense and consuming. It’s important not to minimize or discount what your teen is going through, as this can increase his or her sense of hopelessness.

If your teen doesn’t feel comfortable talking with you, suggest a more neutral person, such as another relative, a clergy member, a coach, a school counselor, or your child’s doctor.

Some parents are reluctant to ask teens if they have been thinking about suicide or hurting themselves. Some wrongly fear that by asking, they will plant the idea of suicide in their teen’s head. It’s always a good idea to ask, even though doing so can be difficult. Sometimes it helps to explain why you’re asking. For instance, you might say: “I’ve noticed that you’ve been talking a lot about wanting to be dead. Have you been having thoughts about trying to kill yourself?”

As well parents should not impose their views about how things should be on their teenagers since the issues parents faced when they were growing up and the environment of those times are not quite the same as what exists today. Among other things, parents have to work towards the following:

  • Cutting down, if not eliminating nagging and lecturing which generally causes children to stop listening to what is being said and to become resentful as well. Keep conversations brief, don’t repeat things too often and if necessary, develop a set of consequences with children so they take ownership for their behavior and actions and embrace the consequences;
  • Desist from interrupting when children are expressing themselves so they feel what they have to say is given value;
  • Do not be directly critical of children. If necessary enter into a discussion about behavior and/or actions and work with children to understand where they may have been wrong and what would be better options;
  • Do not keep dwelling on the past, as children need to know that they can start over with a clean slate. If a pattern develops then maybe have a supportive and caring family intervention;
  • Desist from trying to control children through guilt because this is a sure way to negatively affect relationships and children’s self-esteem as well;
  • Do not use sarcasm as this can have negative effects on children in many ways;
  • Work with children to help them solve their problems, instead of imposing solutions as this can lead to resentment. Offer guidance and scope for them to find solutions as children need to learn by themselves and know that they are capable and trusted;
  • Never put down children, even as a joke. This can lead to children feeling rejected, unloved and inadequate;
  • Never use threats as these can lead to children feeling powerless and resentful.

Seek  help

Concerning relationships, especially if pregnancy is involved parents must reach out for assistance to ensure that their teenagers are safe. Remember that ongoing conflicts between a parent and child can fuel the fire for a teen, who is feeling isolated, misunderstood, devalued, or suicidal. Get help to air family problems and resolve them in a constructive way. Also let the mental health professional know if there is a history of depression, substance abuse, family violence, or other stresses at home, such as an ongoing environment of criticism.

If your teen refuses to go to the appointment, discuss this with the mental health professional — and consider attending the session and working with the clinician to make sure your teen has access to the help needed. The clinician also might be able to help you devise strategies so that your teen will want to get help.

Remember also to never make excuses or pass the buck by blaming others – friends, girlfriends or boyfriends, other families and so on. Regardless of what they may or may not have done getting help for your child should be the focus, first, last and always.

The Caribbean Voice offers free counseling. Please email us at or; WhatsApp 646-461-0574 or 592-621-6111. Also, check out our website at

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Free Virtual Concert by The Caribbean Voice

Regional non-governmental organization (NGO), The Caribbean Voice (TVC), will host a concert aimed at lifting the spirits of persons in lockdown and quarantine and those struggling to cope with the COVID-19 pandemic.

Under the theme ‘Saving Lives, Empowering People’ the concert will be streamed via Facebook Live on May 23, 2020 from 6-9PM on FB page ‘Concert For Hope’ at

The concert features a cross section of music genres, including reggae, reggae fusion, soca, chutney, chutney soca and R&B and comprises singing, dancing, drumming, comedy and spoken word.

According to a TCV spokesperson, “This Concert for Hope’ is aimed at lifting up the spirits of those locked down at home, in quarantine or struggling with the coronavirus restrictions. As well, in true TCV fashion, this concert will showcase the ethnic and cultural diversity of the Caribbean world, and connect the Caribbean region with its Diaspora.”

The star-studded line up for the concert includes: Guyana’s current chutney monarch, Bunty Singh; upcoming Jamaican reggae artiste, Garfield Maclean aka GMac; Trinidad & Tobago’s cultural crossover singer, Anthony Batson; Philadelphia based Jamaican reggae fusion performer Lushy Banton (US).

West Indies cricketer turned music star and motivator, Omari Banks from Anguilla; versatile Guyanese American, Rickford Dalgetty and Friends; the inimitable Roger Hinds, former Guyana chutney monarch and soca/calypso star; Guyana’s singing sensation, Charmaine Blackman; Florida based Chutney singers , Satish Udairam and Natty Ramotar (US).

Mc Drew P. Canada based chutney star and radio personality; New York City based reggae artiste Pablo G; Reggae group Votsee featuring Jah Dover, out of California (US); Golden Om Dharmic Youth Dancers (Guyana); Teenaged author and poet from New York City, Anaya Willabus (US).

Buxton Fusion School of Music from Guyana; the Tarana Dance Troup from New York City (US); US based Barbadian star, Toni Norville (US); Barbadian singing star Sherridean Skeete; US based Guyanese singing star, Terry Gajraj aka Guyana Baboo; Barbadian born, New York City based seasoned comedian, Robert  Sinckler and Chanique Rogers, US based Vincentia singer/songwriter and model.

Hosts for this concert are Imran Ahmad, Aubrey Campbell, Narine Dat Sookram and Dimple Willabus all highly experienced, broadcasters and emcees.

Imran has been on radio and TV for over a decade with his very popular and highly accolade radio and TV show ‘West Indian Today’. Narine Sookram is also a seasoned multi platform broadcaster out of Canada, who has initiated a number of different radio and TV programs that have won many awards.

Jamaican, Aubrey Campbell has been making his mark on the journalism and broadcasting landscape for decades while Dimple Willabus is a household name, as host and CEO of Rhythm Nation Entertainment.

For further information, to be considered for participation or to support this unique event, please contact 592-621-6111, 646-461-0574, 868-364-6177, 772-7123-8308.

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Editorial blames abused victims for their plight

Annan Boodram

By Annan Boodram – The Caribbean Voice (TCV)

“It’s a skewed, cockeyed construct,” the reaction of UK based psychologist and mental health expert, Dev Daniel Ramdass, a member of The Caribbean Voice’s (TCV) technical team. He was referring to a recent editorial in the Guyana Chronicle newspaper, which made several ghastly, grossly incorrect, and astounding claims about gender-based violence.

According to the editorial: “The line of reasoning is clear, a person must respect himself or, in this particular case, herself, first. The result will be that respect will be earned from others. If that course of action is not taken, the inevitable outcome is disrespect, dysfunctional relationships, and, probably, domestic abuse including the possibility of violence.”

Responded TCV’s Ramdass, “Domestic violence is all about power and control in a relationship; the responsibility lies with the perpetrator, not the victim. The editorial is clearly blaming women for their treatment because in the eyes of abusive men women deserve it. A lack of personal self-respect, low self-esteem cannot be a prerequisite for being beaten up and killed.”

Indeed what is generally accepted and proven by mountains of research as well as abounding literature is that gender-based abuse is about power and control on the part of the abuser and has nothing to do with women disrespecting themselves.

In fact, in 2016, Laura Niemi, a then postdoctoral associate in psychology at Harvard University, and Liane Young, a professor of psychology at Boston College, noted that moral values play a large role in determining the likelihood that someone will engage in victim-blaming behaviors. “The derogation of the victim comes as a defensive reaction against [one’s] personal worldview unraveling,” and that the process is typically implicit.

“There’s just this really powerful urge for people to want to think good things happen to good people and where the misperception comes in is that there’s this implied opposite: if something bad has happened to you, you must have done something bad to deserve that bad thing,” says Sherry Hamby, a professor of psychology at Sewanee University as quoted in the UK Guardian in 2018.

First formulated by Melvin Lerner in the early 1960s, the just-world bias can be seen in any situation in which victims are blamed for their misfortune, whether it be abuse, sexual assault, crime, or poverty.

As journalist and editor, Kaleigh Roberts stated in The Atlantic, in an article entitled The Psychology of Victim-Blaming, victim-blaming is a natural psychological reaction to crime, “At its core, victim-blaming could stem from a combination of failure to empathize with victims and a fear reaction triggered by the human drive for self-preservation. That fear reaction, in particular, can be a difficult one for some people to control. Retraining this instinct is possible—it just isn’t easy”. In these instances empathy training is critical. So too is the openness to seeing (or at least trying to see) the world from perspectives other than one’s own.”

The Chronicle editorial added: “It is generally accepted by experts that gender-based abuse—most frequently directed against women — originates with disrespect for the female gender.” In support of that assertion, the editorial quoted ‘American researcher’, Dr Justin Coulson, who “posits that there is a direct relationship between disrespect for women, which often begins in youth, and violence.”

Not true; experts certainly do not generally accept any such assertion; no study supports it. Dr Coulson, who is not American, is neither a researcher nor an authority on domestic violence. His ‘theory’ is certainly not cited in the literature on domestic violence and what he posits is not based on any peer-reviewed research. In fact, domestic violence itself is not his field at all.

While disrespect for women will make it easier for a perpetrator to be violent towards women, that violence will be manifest because the perpetrator wants to exhibit his/her power and demands absolute control over the victim. In any case, this lack of respect for women is not a problem for the victim but the perpetrator and is generally a learned behavior that starts in the home. And it must be noted that the perpetrator’s lack of respect for women does not result in violence against his mother, sisters, aunts, female cousins, and other females in his life; generally, it’s only the partner who is abused.

The editorial added: “Two thinkers expressed it as follows:

  • Confucius said: “Respect yourself and others will respect you.”
  • Dostoevsky said, ‘If you want to be respected by others, the great thing is to respect yourself. Only by that, only by self-respect will you compel others to respect you’.”

How the editorial made any connection between these quotes and domestic violence is a mystery since neither quote was made in the context of domestic violence per se. Besides, as TCV’s Ramdass pointed out, “quoting a 17th-century philosopher (or an ancient one for that matter) to formulate an argument in the contemporary world ignores current research and evidence”.

The editorial also quotes ‘relationships researcher, Laura Forting’ on respect. There is no such person. The actual person is Laura Catherine Schlessinger aka Dr Laura, a radio talk show host on relationship; someone considered a ‘pop psychologist’. No connection between the quote and domestic violence was ever made by Dr Laura.

  1. Laura has absolutely no credentials in psychology or relationships and is not considered or recognized as an authority or researcher on domestic violence.

Concerning the editorial’s mention of music and lyrics, we again quote psychologist, Ramdass: “Of course, music, lyrics are influences in today’s society but not a key driver.” While there are a few studies that suggest a link between some form of music and alcohol abuse and violent behavior, there is nobody of conclusive evidence to support this. More importantly, no study or research draws a direct link between any form of music and domestic abuse, although hip-hop and some other genres have been accused of glorifying relationship violence.

On the other hand, there are also many singers in these same genres, who, “promote healthy relationship boundaries through music and other initiatives” ( It is also well known that music does indeed serve as therapy for abused victims and those suffering from several other mental health issues.

The bottom line, however, is that the media has a critical responsibility to be accurate and factual in its reporting. And concerning social issues such as gender-based violence, that responsibility is compounded by the fact that the media is one of the stakeholders in the prevention campaign and should never put itself in a position where it becomes a vehicle for the fostering of myths, misinformation, and attitudes that would seek to blame victims and/or justify the pathology.

The Caribbean Voice offers free counseling. Please email us at or; Whatsapp 646-461-0574 or 592-621-6111. Also, check out our website at

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Mental health parity critical

By Annan Boodram – The Caribbean Voice

The coronavirus pandemic has placed mental health front and center like never before. Advocates, activists, and experts are already pointing to an upsurge in the need for mental health care post-COVID-19.

However, given that mental health care globally, but more particularly in developing nations, has been lagging far behind physical health care, the upsurge could be another pandemic according to many specialists and experts such as New York City-based psychiatrist, educator, and writer, Robert T. London and Mark Henick, a Canadian mental health strategist and speaker.

According to an April 27 column by Benjamin F. Miller in USA Today,  “Mental illness is epidemic within the coronavirus pandemic”. As well an April 10 report in JAMA Internal Medicine says to expect an “overflow of mental illness that will inevitably emerge from this pandemic,” and that the surge will itself be a pandemic.” China already has a mental health crisis resulting from the pandemic. In developing nations where mental healthcare is either an afterthought or non-existent, the situation would be much direr. Thus the need for mental health parity will be even more urgent.

Mental health parity refers to the equal treatment of mental health conditions and substance use disorders in insurance plans and health care services. When a plan has parity, it means that if you are provided unlimited doctor visits for a chronic condition like diabetes then you must also be offered unlimited visits for a mental health condition such as depression or schizophrenia.

Parity would also ensure that all health care institutions must not only have medical personnel trained to diagnose mental health issues, but also to follow up with requisite treatment. In effect, mental healthcare must be as normal as care for physical illnesses and must, therefore, include the presence of clinical counselors, psychiatrists, psychologists, traumatises, and other mental health experts at all health care institutions.

Of course, establishing a mental health care system parallel to the physical healthcare system would not be economically feasible for developing nations, especially those with very small economies and populations like Caribbean countries. Thus the World Health Organization (WHO) has been touting an integrated healthcare system whereby mental healthcare can piggyback onto the existing physical healthcare system. Nurses and doctors can be provided with a certain degree of mental health training such as WHO’s Mental Health Gap Action Program (mhGAP), which is already been implemented in nations such as Guyana and “aims at scaling up services for mental, neurological and substance use disorders for countries especially with low- and middle-income”.

The WHO offers training for trainers who can then turnkey the training throughout the healthcare system. As well, there are other training programs available via various bilateral and multilateral efforts as well as online, that can lessen the work of psychologists and clinical counselors – cognitive behavior therapy, lay counselor training, the Friendship Bench (in Zimbabwe where grandmothers to develop their existing skills so that they could give problem-solving talking therapy to people with anxiety, depression and other mental health problems) that can be offered to stakeholders outside of the immediate health care system, including NGOs for example.

However, the process of parity must begin with updated and expanded mental health legislation that takes into consideration all developments in mental health care and current mental health-related laws must be revised to update and maximize provisions for mental health care. In Guyana, for example, the Mental Health Ordinance has not been updated since the 1930s, St Kitts and Nevis since 1956, and Antigua and Barbuda since 1957. A few have mental health plans or policies that have been approved with only Jamaica, Suriname, and Belize having both.

As well, the average percentage of the health budget dedicated to mental health in the Caribbean is 4.33 percent. Four countries receive more than five percent of the health budget and seven countries receive less than three percent. Parity would mean a greater percentage of the overall health budget dedicated to mental health.

Mental health parity also means that insurance – private of government must cover mental healthcare, in the same manner, they cover physical healthcare. For without this coverage an integrated healthcare system will still not be able to provide parity. And because globally mental health is still highly stigmatized, parity would necessitate ongoing sensitization and information dissemination on various mental health issues in the same manner as happens concerning various physical ailments.

A 2018 Lancet Commission report on mental health stated that mental disorders are on the rise in every country in the world and will cost the global economy $16 trillion by 2030. The economic cost is primarily due to the early onset of mental illness and lost productivity, with an estimated 12 billion working days lost due to mental illness every year. Then there are healthcare costs, crime costs, welfare costs, social costs, the costs to families, and the added burden to both cost and standards of living.

On the other hand, if mentally ill people receive treatment so that they have the same employment rate as the rest of the population, total employment would be four percent higher, adding significantly to national output. As well, psychological treatment can reduce a person’s annual physical health care costs by 20 percent. Consider other savings relating to crime, social life, welfare, families and it becomes certain that mental health parity would make a significant positive difference overall.

As young people face the brunt of the global burden of mental illnesses, the Lancet report places great emphasis on experiences in childhood and adolescence, which shape life-long mental health. Lancet report co-author Dr Janice Cooper, stated, “…we need to begin with young people and train teachers to identify and refer students for help.” Naturally, school systems must be manned by clinical counselors to offer help to students as obtains in developed nations, and a few developing nations – Trinidad and Tobago and Jamaica for example.

Now with the coronavirus pandemic, mental health issues are already beginning to significantly increase, especially, sexual abuse, gender-based, and (child) suicide, depression, stress, and anxiety. It must be noted that both anxiety and depression lead to suicide. As well, the pandemic is also creating additional issues for those with current mental health issues, especially addictions (drugs, alcohol) and behavioral issues such as bipolar disorder, post-traumatic stress, Attention Deficit Disorder (ADD) and Attention Hyper Deficit Disorder (AHDD), autism, dementia, and eating disorders.

With healthcare systems globally overwhelmed with COVID-19, these issues will snowball and become a Himalayan demand on the health care system, post-COVID-19. However, with the economic fallout from COVID-19, developing nations will struggle to provide physical healthcare for quite a while, and it’s almost certain that mental healthcare will be neglected, if not abandoned. Thus, it is important that as nations strive to rebuild their healthcare system they focus on parity via integration of physical healthcare with mental health care.

In the context of the Caribbean, only Guyana would be in a position to access the financial resources necessary for overall economic development because of the oil wealth. *Even with the global contraction of economies, Guyana’s economic growth increased from 4.4 percent in 2019 and anticipates over 50 percent in 2020 (downgraded from over 80 percent because of the pandemic).

However, considering that when mental healthcare lags, it acts as a drag on all other sectors of the economy and quality of life; developing nations must, of necessity, ensure that parity underpins the development of healthcare systems post-COVID-19. And, one thing this coronavirus pandemic has taught is that it cannot be business as usual anymore, healthcare included.

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Elder abuse prevention

Elderly individuals are often more vulnerable to various forms of abuse because they tend to have assets that they have accumulated through their lives and because they may also experience mental or physical limitations. In many cases, older persons will refuse to seek assistance because they may be in denial, feel ashamed about needing help or worried about losing their independence. Some fear retaliation from abusers.

When the caregivers are their children, elders may feel ashamed that their children are inflicting harm on them or they just may not want their children to get into trouble. As well, during this COVID-19 pandemic, they will have nowhere to go and no one to turn to if they are being abused in a context where most of the world is either under shutdown or stay at home mandates.

Elder self-neglect is defined as the “inability, due to physical or mental impairment or diminished capacity, to perform essential self-care.” This includes an inability to maintain basic daily necessities such as food, clothing, shelter, or medical care, or to manage financial affairs. Neglect is when caregivers (official or unofficial) do not ensure such care or do so in a manner that leaves much to be desired.

Elder neglect or self-neglect warning signs may include unusual weight loss, malnutrition, dehydration; untreated physical problems, such as bed sores; unsanitary living conditions such as dirt, bugs, soiled bedding, and clothes; not taking or being given regular baths or regular change of clothes; not wearing appropriate clothes for the weather and unsafe living conditions such as no running water or lack of food supply.

To prevent elder self-neglect, call (and visit during normal times) as often as possible to check upon them. Monitor their medications to ensure the right amounts are taken at the right times. Make sure the supports they need are in place so they can be able to better take care of themselves. As well, put in place mechanisms for them to quickly and easily access help if needed. This can be done in many ways, such as, for example, enrolling them in a medical alert program.

Abandonment is when the seniors are put out of homes and/or living in the streets. There was one case of a daughter-in-law seeking a restraining order against her father-in-law, thereby resulting in the senior being unable to live in the home. Yet a simple intervention by family and/or friends could have resolved the situation. There was another case of an elder being placed in a basement with no air conditioning in summer and no heat in winter. Meanwhile, the son and daughter-in-law seized all the financial aid the old man obtained, as soon as he accessed them. Concerned neighbors who eventually learned of the situation obtained help for the senior citizen.

Financial abuse includes significant withdrawals from the elder’s accounts; sudden changes in the elder’s financial condition; items or cash missing from the senior’s household; suspicious changes in wills, power of attorney, titles, and policies; addition of names to the senior’s signature card; financial activity the senior couldn’t have undertaken, such as an ATM withdrawal when the account holder is bedridden. To prevent financial abuse, check the elders’ bank accounts and credit card statements for unauthorized transactions and always be aware of all activities relating to their financial matters.

In addition to inflicting physical hurt, physical abuse includes putting the elder to do tasks for which he/she is incapable. In one case an elderly mother in law sent was sent by the daughter-in-law to do grocery. The elder struggled to push the cart to and from the grocery store and on one or more occasions fell on the pavement. Yet, she was in such fear of her daughter-in-law that she begged others not to report. There are also cases of the elderly forced to do household chores or babysit when they are not fully physically and/or mentally capable of doing so.

Physical abuse warning signs include unexplained signs of injury, such as bruises, welts, or scars, especially if they appear symmetrically on two sides of the body; broken bones, sprains, or dislocations; broken eyeglasses or frames; signs of being restrained, such as rope marks on wrists and ankle or caregiver’s reluctant for you to visit the elderly alone.

Emotional abuse warning signs include being subjected to threats, belittlement, humiliation, ridicule, habitual blaming, menace, and terror and being ignored or isolated from friends and family. Sexual abuse warning signs include bruises around breasts or genitals, unexplained vaginal or anal bleeding and torn, stained, or bloody underwear.

If you are an elder who is being abused, tell at least one person – doctor, a friend, or a family member whom you trust. Or call a helpline if you know of one. If you see an older adult being abused or neglected, don’t hesitate to report the situation. In the case of an elder experiencing abuse by a primary caregiver, such as an adult child, do not confront the abuser yourself. This action may put the older person in more danger. Instead, identify the warning signs of abuse or neglect and report them without delay.

If you suspect that the elder is in potentially life-threatening danger call the police or relevant government agencies or departments. We should all become mandatory reporters of elder abuse.

As well, if you have an elder living with you but find it difficult to manage you do have options. If they are physically and mentally able, enroll them in a senior citizen center or daycare. Otherwise, get aides and home visits by nurses through the insurance agencies and doctors’ recommendations, access assisted living for them if they still want and can manage a certain level of independence or place them in nursing homes if they need round the clock care.

However, if you do place your elder in a nursing home please make sure you do your research first to ensure the home does not have a bad reputation As well, speak with home administration so your concerns are addressed. Regularly, make unannounced visits so you can ensure the right care is being given and abuse or neglect does not take place. Always speak in private with your elder to find out of she’s happy and all is well. And, if you feel the need to, ask to be allowed to place a camera in the room of your elder.

In the Caribbean, most of these options may not be available but one option that may work is to have the elder spend time with each adult child during the year so each adult child gets a respite. Also, it is important to understand that at their age it’s rather difficult for seniors to change their behavior, therefore, some tolerance must be displayed.

Another option if there are children at home is that the children can help the elderly grandparent to better manage behavior as the bonds between grandchildren and grandparents are much more emotional as grandchildren usually have a greater tolerance for their grandparents. As well, this relationship can be a learning experience for the children, as grandparents will have a wealth of stories and lessons to share. Elders may be one of the best means to keep children occupied, as they would be more tolerant than parents and more open to engaging with the children.

The vast majority of those dying from COVID-19 are aged 80 or older, but advocates say the pandemic also puts them at risk of elder abuse.

In fact, globally, elder abuse is on the rise at this time. Scammers are already trying to capitalize on the pandemic by offering “miracle cures” and fake tests, misinformation abounds and all sorts of stratagems are being employed. With more seniors at home alone, they may be looking to the internet to get information, and this is where they may fall prey to these scammers and fraudsters.

So staying connected with the elderly (phone, social media, Skype and the like) and ensuring that they are protected from scammers is especially critical. If possible, also occasionally check upon them as they may be struggling but not wanting to burden their loved ones.

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Use of technology to improve mental health care

By Annan Boodram – The Caribbean Voice

Mental health has galloped to the fore during this coronavirus pandemic. According to the World Health Organization (WHO), one in four people in the world will be affected by mental or neurological disorders at some point in their lives. Nearly two billion people suffer from mental illnesses every year. Furthermore, those who live with severe mental illness are more likely to face chronic medical conditions and die around 25 years earlier as well as routinely suffer gross human rights violations.

While nations struggle to diagnose and service their increasing mentally ill populations, technology is gradually moving front and center in that process. In fact, one way in which mental health care is more easily and extensively accessed is through apps. But are phone users willing to use apps to help themselves and others deal with mental health issues? A survey conducted by the Journal of Medical Internet Research found that 76 percent of people would be interested in free apps, which aim to improve mental health or assist with mental health self-monitoring.

Simply searching a relevant term such as “depression”, on the App Store, produces a wide range of results. The list of such apps is far too extensive to present here, but below are a few of the more popular ones:

Calm: Appropriate for ages 4 and up, Calm is an app that focuses on meditation, sleep, relaxation techniques, and stress reduction. Its overarching goal is to lower stress levels and promote balance, self-awareness and better sleeping habits.

Moodkit: Is a mood-tracking app intended for individuals, aged 12 and up. The app is centered around the design of Cognitive-Behavioral Therapy methods and provides a space for users to journal their daily moods, emotions, and thoughts. The app allows you to monitor your mental state and subsequently avoid negative thought patterns. It also provides a platform for users to increase self-awareness and develop healthier ways to think by providing activities, guidance, and space for journaling.

Smiling mind: A mindfulness-centered app, appropriate for ages 4 and up. The app was developed by psychologists and educators, with the goal of promoting mindfulness, compassion, happiness, and balance within all age groups. It allows you to check in about your mood, meditate, and has various programs designed to target different populations. Some of these programs include sessions for adults and children, sessions focused on mindfulness in the classroom or workplace, and sport programs.

BREATHE2RELAX: Appropriate for ages 4 and up. Created by the Center for Telehealth and Technology, this app is intended to reduce stress by introducing and encouraging ways to manage stress and worry. Breathe2Relax focuses largely on guided breathing techniques to promote mental stability, but also has features which encourage you to rate your emotions or mood, and provides useful facts about the effects stress has on the mind and body.

WHATSAPP is focused primarily on helping users cope with depression by offering the basis of cognitive behavioural therapy, alongside breathing techniques and a journal to monitor thoughts and moods. The app also includes exercises to help reduce anxiety and aids in providing alternative coping mechanisms for users.

Moodpath is your pocket-sized mental health companion. Moodpath asks daily questions in order to assess your wellbeing and screen for symptoms of depression. The screening progress aims to increase your awareness of your thoughts, emotions, and feelings. After a period of two weeks, the app generates an electronic document that you can discuss with a healthcare professional. More than 150 videos and psychological exercises are available to help you understand your mood and strengthen your mental health.

PACIFICA is an app with anxiety and stress in mind. It provides a toolbox to deal with daily anxiety and stress, along with a highly supportive community of like-minded individuals. Pacifica helps you to break cycles of unhelpful thoughts, feelings, and behaviors through methods such as CBT, mindfulness meditation, mood tracking, and relaxation. The app houses audio lessons and activities that help you to cope with stress and depression, and it sets daily challenges to help you tackle anxiety one day at a time and reach your long-term goals.

SUPERBETTER is a game focusing on increasing resilience and the ability to remain strong, optimistic, and motivated when presented with challenging obstacles in life. A study by the University of Pennsylvania in Philadelphia found that when people played SuperBetter for 30 days, their mood improved, symptoms of anxiety and depression decreased, and self-belief to achieve goals increased. The app will help you to adopt new habits, improve your skills, strengthen relationships, complete meaningful projects, and achieve lifelong dreams. SuperBetter also has the potential to help you beat depression and anxiety, cope with chronic illness, and recover from post-traumatic stress (PTSD).

7 CUPS: If you are feeling lonely, sad, stressed, or worried, 7 Cups could be the perfect app for you. It provides online therapy and emotional support for anxiety and depression. There are more than 160,000 trained listeners and licensed therapists who are available to anonymously speak with 24/7. These listeners can be searched for based on their experience or their specialties, such as bullying, panic attacks, eating disorders, relationship breakups, and many more. Affordable therapy with an online therapist can commence one-to-one in a confidential setting.

Apps are not the only form of technology used to foster mental health care. Tech interventions include:

  • The use of mobile and smartphones,
  • Internet-delivered programmes such as webinars, videos, related programs, blogs, interactive tools,
  • Telepsychiatry – using online videoconferencing for allowing psychiatrists to provide direct clinical consultations for diagnosis or follow-up care to patients as is being done in countries such as Somaliland, South Africa, and India,
  • Text-messaging,
  • Remote sensing – obtaining information about objects or areas from a distance, typically from aircraft or satellites,
  • Wearable devices such as smartwatches with apps and sensors, wristbands with sensors and wireless devices worn on wrists or carried in pockets,
  • Closed-circuit TV.

Technology is beginning to play an important role by shifting tasks performed by specialist medical providers into the hands of non-medical health workers. For example, web-based screening tools designed to be delivered on mobile phones by non-medical health workers were effective for diagnosing depression or common psychiatric disorders in clinical settings in India. As well TCV has been able to identify needs and engage in successful counseling (and direct referrals for help) to hundreds of clients through various social media, FB Messenger, what’s app. texting, emails and direct phone calls.

Another example of technology intervention is Facebook, which, in 2016, extended its suite of anti-suicide tools to users worldwide, simplifying the process for worried users to flag postings by friends who may be considering harming themselves. The mechanism allows users to flag postings by others that could hint at suicidal thoughts or plans to self-harm. Facebook’s dedicated teams will then assess the risk level indicated by the post, intervening accordingly.

As well, given the dynamic relationship between violence and mental health, in Jamaica, closed-circuit television (CCTV) cameras and a public address (PA) system have made it much easier to monitor activities and spot altercations, which can then be nipped in the bud. Mounted in the office of one principal are two large screens displaying live footage of the activities of students and staff around the compound. Several schools have installed their surveillance systems in a bid to increase safety and security. It is a move supported by Jamaica’s education ministry.

In Guyana, we have welcomed the initiative by Digicel to send out the suicide helpline contact info to all their mobile phone subscribers and we are hoping that GT&T will follow suit. We are also hoping that both carriers would start sending out awareness and prevention messages for suicide and all forms of abuse. As well we urge electronic billboards advertisers to do the same. Also, for years we have been lobbying for the government to establish a registry of sex offenders as one measure to tackle sexual abuse and we hope the government that takes power after the March elections will place this registry on its list of priorities.

In fact, at some point in the middle of this decade, the number of active cellphone subscriptions grew larger than the number of actual people on this planet, according to data from the UN’s International Telecommunications Union (ITU), the World Bank, and the UN itself. And by 2025 almost three quarters (72.6 percent) of Internet users will access the web solely via their smartphones according to a report published by the World Advertising Research Center (WARC), using data from mobile trade body the Global System for Mobile Communication (GSMA). In effect, the global population is an increasingly mobile phone user population, ideally suited to access and use apps and other related technology.

Mental health includes emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. A 2018 Lancet Commission report on mental health stated that mental disorders will cost the global economy $16 trillion by 2030. The economic cost is primarily due to the early onset of mental illness and lost productivity, with an estimated 12 billion working days lost due to mental illness every year. The report also found that young people face the brunt of the global burden of mental illnesses.

Thus nations, especially developing ones, can ill afford to continue to neglect and sideline mental health, especially in an age when easy to use and relatively inexpensive technology is more and more embraced by the global population. And so TCV urges the government to budget resources for the creation of a mental health app that would provide quick and easy access to those seeking help – counseling, legal and material such as housing, financial support, job training and enable quick, easy follow up through available platforms such as email, phone, texting and messaging.

Such access would include, police, all government resources, NGOs, faith, and community-based organizations and media. Guyana has a number of talented young tech experts who can get this done and The Caribbean Voice would be willing to collaborate on this process.

In the current pandemic technology is quite possibly the only means of addressing mental health issues right now.

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PAHO engaging in misinformation?

By Annan Boodram

The majority of coronavirus patients were infected by someone who wasn’t showing any symptoms of the deadly virus (asymptomatic persons) a new study of cases in China found. Researchers from the Shanghai Jiao Tong University School of Medicine estimated how long it was taking for someone to become infected with COVID-19.  Using mathematical modelling, the team found that 79.7 per cent of people with the deadly virus caught it from someone not showing any symptoms.

According to the UK’ Daily Mail, the findings of the Chinese study mirror already available data on viral shedding studies in close contact areas – particularly from confirmed cases.

These findings seem to contradict PAHO’s position as published in the Guyana media, which quoted PAHO/WHO country representative, Dr William Adu-Krow as saying that the “risk of contracting the novel coronavirus disease (COVID-19) from an asymptomatic host is relatively low”.

Another point to note is that stats from New York State, released on April 7th, 2020, revealed that the majority of coronavirus deaths (61%) were among men, 63% of the deaths were among those age 70 and older, and 86% of all deaths were among people who had underlying illnesses, such as hypertension and diabetes, new state data shows.

Findings included:

  • The leading underlying illness was hypertension, which showed up in 55% of the deaths.
  • Next was diabetes, which was diagnosed in about 37% of the cases.
  • Other top illnesses found in those who died from coronavirus were hyperlipidemiacoronary artery diseaserenal disease and dementia.

It is also to be noted that early treatment does lead to greater chances of recovery. Thus as soon as someone suspects that he/she is having symptoms quarantine (in a separate, well ventilated, room, if possible), should go into effect, sanitizing should be the order of the day, focus should be on foods and beverages that help boost immunity especially ones containing vitamins C and D such as citrus fruits, garlic, papaw, crabs, gooseberry, watermelon, sweet potato, eddo/taro, carrot, broccoli and ginger.

In fact every one should be using foods to boost the immune system at this time and everyone should wear masks and gloves once outside the home. No one is immune to this disease, no matter how young, strong and/or healthy one is!

As well, foods, beverages and herbs that contain anti-viral properties should be used – aloevera, sage, basil, garlic, peppermint, oregano, ginseng, rosemary, bell/table peppers, pomegrante, coconut, green tea, cabbage, onions, tomatoes, walnuts and lemon balm.

Other steps including

  • wearing a mask all the time, essential for the protection of others in the home as well, including pets;
  • using only Tylenol or acetaminophen; while there is no evidence to show that ibuprofin or aspirin can create problems there is not enough evidence to show that they are absolutely safe either. Use as often as recommend by doctor or about 6 hours intervals as it helps with fever and pain management. If fever gets to above 104 degrees F go to a hospital;
  • sponge baths with slightly warm water instead of shower and change of clothing at least once a day;
  • stay hydrated all the time with tepid liquids (ginger or green/black tea for example) or citrus fruit juices – lemon, orange/lime/tangerine;
  • lozenges, cough drops, halls, ginger tea, mint tea for the cough as well as a cough suppressant such as Ferrol Compound;
  • if the body pain is continual a vigorous body rub down, maybe once a day will helps;
  • chills is also a symptom associated with COVID 19 so make sure you are able to keep warm if that becomes necessary;
  • eating regular meals; you may not have an appetite and you may find that your taste buds are not operating so it is recommended that you eat small portions often – chicken soup is highly recommended;
  • adequate rest, especially since the symptoms can interfere with a patient’s rest;
  • If symptoms worsen please see your doctor or go to a hospital to get tested firstly and then be advised accordingly;

The WHO also recommends that:

  • bathrooms and kitchens should be well ventilated;
  • one member of the household, who is in good health with no underlying chronic medical conditions, should take on the role of caregiver – no one else should visit the patients until they are symptom-free ( both patient and caregiver must wear masks);
  • caregivers should wash their hands after every contact with the patient, as well as before and after preparing food, before eating, after using the toilet, and whenever hands look dirty;
  • after washing hands with soap and water it is preferable to use disposable paper towels to dry them. If these are not available, use clean cloth towels and replace them frequently;
  • the sick person should use separate cups, dishes, utensils, towels and bed linen to the rest of the household. And all these items should be washed separately using soap and water;
  • any surfaces and objects that have been touched by the sick person should be cleaned and disinfected at least daily.

Finally the fact that at least two COVID 19 deaths could have been avoided in Guyana, had the hotline responded in a timely manner leaves much to be desired. A hotline must be manned 24/7 and a rapid response team be in place in the event that patients are struggling, especially with breathing.

Remember safety, protection and knowing that help is immediately available, if needed, contribute to easing stress, anxiety, panic and tensions, factors that will certainly compound the condition of anyone suffering from COVID 19.

The Caribbean Voice offers free counseling. Please email us at or; What’s App 646-461-0574 or 592-621-6111. Also check out our website at for more informatio

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