What constitutes an anti-suicide campaign?


Minister Broomes on ‘anti-suicide’ campaign at Linden schools” screamed the headline in a local newspaper. But then the article proceeded to wax on the minister’s talk to the students. So The Caribbean Voice checked and found out that Minister Broomes is not a psychologist or counselor or suicide prevention advocate or activist. But as a minister surely she would have been advised as to what suicide prevention entails?

In fact, TCV expected to read that the Minister has provided at least one clinically trained counselor to each school and that staff would be trained to identify suicide-warning signs so they can quickly refer at risk students to the counselors. We also expected to read that the Minister is planning workshops for teachers to strengthen them mentally and emotionally and to address their psychosocial needs.

Furthermore, we expected to read that the Minister is planning suicide prevention workshops in Linden schools, focusing on self harm in general, including stress management, self esteem, coping skills to deal with challenges, handling peer pressure, building self confidence, learning self-forgiveness, saying no to drugs and alcohol, avoiding cutting, handling bullying, including cyber bullying…

As well, we expected to read that Minister is planning to work with parents teachers association within the schools to train parents in basic prevention strategies such as emphatic communication and safe use/storage of pesticides and to provide them with easy and quick access to help, should that become necessary.

Perhaps the Minister ought to note what experts, advocates and activists in the field have to say about preventing suicide. Among the strategies suggested are:

  • Strengthen economic supports
  • Strengthen access and delivery of suicide care
  • Create protective environments
  • Promote connectedness
  • Teach coping and problem-solving skills
  • Identify and support people at risk
  • Lessen harms and prevent future risk

In effect suicide prevention has to embrace a comprehensive approach of which talking to/lecturing people is not a recommended strategy. In fact the Guyana Government’s National Suicide Prevention Plan (NSPP) does embrace a comprehensive approach and provides related specificities for all strategies. And because TCV knows that the Minister cannot only be interested in suicide prevention in Linden, given who she is, we are certain that Honorable Minister will use the NSPP to launch a national suicide prevention campaign and that among the measures that she would soon put in place are:

  • Counselors in every school, drawing from the recent graduates of the UG psychology program.
  • Sensitization for all police officers and health care workers.
  • Total integration of mental health care into the physical health care system.
  • A program to tackle pesticide suicide, perhaps an adaptation of the Shri Lankan Hazard Prevention model that has been so highly successful in that nation.
  • Speeding up the total renovation and equipping of the National Psychiatric Institution.
  • Ensuring that all public hospitals have psych wards and mental health specialists including psychiatrists, psychologists, and traumatists.
  • Establishing protocols for licensing of all counselors and piloting legislation to criminalize quack counseling.
  • Steps to decriminalize suicide
  • Making counseling easily and quickly accessible to all Guyanese regardless of their ability to pay.
  • Getting the University of Guyana to embark on a comprehensive suicide survey the results of which can then be used to drive prevention nationally.

Madam Minister please know that The Caribbean Voice stands ready to join you in this effort to tackle suicide throughout our nation!

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If You Witness Physical Abuse, Do Something


A few days ago, a Guyanese-American man murdered his wife and then hanged himself. According to a co-worker of the deceased, “It was noted that Dojoy (the wife) would tell her friends that Budhidat (the husband) was controlling and violent. She talked about him abusing her, controlling her, beating her, scaring her, threatening to kill her…She never took it seriously because she loved him.”

During the same week, the Barbados media was filled with articles and reactions to the fatal stabbing of a 16-year-old student, by a 15-year-old student, after an altercation between the two.

In Guyana, a 17-year-old young lady was raped, then murdered, two days before she was to graduate from high school. Subsequent information indicated that she was being sexually and physically abused for quite a while.

And in Jamaica, there is a lament over the fact that cyber bullying is on the rise, and sex abuse victims are getting younger and younger.

Similar concerns abound in every Caribbean nation. So what is the connection among all of this? It’s the do nothing mentality!

The murdered wife in New York City and her coworkers were aware of her abuse — but did nothing! Relatives and neighbors of that young lady in Guyana were aware of her abuse — but did nothing. Teachers and parents of that16-year-old Barbadian student must have been aware of his tendencies towards violence — but did nothing.

In fact, often one reads or hears about suicide whereby loved ones say the victim had always talked about killing himself or herself, but it was taken as joke; or that they were aware of signs of depression — but they did nothing. Or that someone being abused “must sleep on the bed she/he has made”; or the victim so loves the abuser that somehow love would make it all right. Or that someone with a violent temper is really a good person, as if being “good” cancels out the consequences of the spurts of violent actions.

Far too often, counseling never seems to come to mind. Yet there is a copious amount of research that clearly shows that counseling is generally effective.

According to Shannon Sumrall, in ‘Counseling Effectiveness’, “high success rates appear in meta-analysis of the literature” on counseling effectiveness. She added, “the vast majority of the research, when examined as a whole, seem to indicate very positive outcomes for counseling”.

Anger management can be tackled with counseling; so too violence, among the young especially. Depression, stress, anxiety, suicide ideation, abusive behavior can all be tackled with counseling.

So here’s the deal: if you see something, do something! Take action and save a life, rather than lament, after the fact. Remember, “it’s better to be safe than to be sorry”. Besides, you must do for someone else what you would want someone to do for you. So let’s all become involved now! Reach out, as quickly as possible, to get someone the help he or she needs!

However, counseling cannot be possible when there is a lack of mechanisms in place to enable easy, quick and affordable, if not free, access. Thus there is a need for counselors in schools, health care institutions and wherever else necessary.

After all, counseling can only be offered by trained professionals, although The Caribbean Voice is aware of persons, who claim to be counselors because they, themselves, were counseled at one time. That would be like someone sitting in a courtroom listening to a few cases, then claiming to be a lawyer; or someone who, after witnessing a doctor at work, concludes that he or she has become a doctor. A lawyer, a doctor or a counselor must have requisite professional qualifications and supervised experience, before practicing on his or her own.

The Caribbean Voice has seen firsthand the fatal results of persons attempting counseling without requisite qualifications and training (a masters in psychology and one year’s supervised clinical experience).

The latest was the case of a young lady in Guyana, killing herself after her father paid a quack counselor to counsel her, because she was suicidal.

We have also had many, many experiences, whereby people would say, “I talk to him/her but he/she does not listen to me”. Such persons may be well meaning and, out of love and concern, believe that once they talk to a depressed, suicidal, abused person or someone prone to bouts of violence, everything should be okay. But it would be, because they don’t have the tools with which to communicate, diagnose and heal and, in fact, their ‘talk’ could well make matters worse.

Very often, counselors in private practice are quoted in the Caribbean media talking about what needs to be done and how it needs to be done, but hardly ever do they volunteer pro bono help.

Given that in the Caribbean there is shortage of counselors to adequately fill the need, counselors in private practices must put aside some of their time for volunteer services, possibly working in tandem with NGOs, Community Service Organizations, local government organs, public institutions and even faith-based organizations.

Without this access, counseling would be nonexistent for far too many.

I am aware that a traditional taboo against counseling exists among Caribbeans, to a greater or lesser degree, with some feeling that “only mad people need counseling”. But I have seen, time and again, that individuals, from all walks of life, who fail to seek counseling, end up becoming fatalities or creating mayhem, including taking lives.

Even in our own experiences, while every one of almost 500 cases The Caribbean Voice has handled since we launched our campaign in 2014, has been successful, other cases, of which we are aware, that did not get counseled, ended up as fatalities and/or causing fatalities and horror or both.

This is where the media has a critical role: to publish contact information for all helplines and hotlines, as well as pro bono counseling access; to emphatically and continually promote counseling under all related circumstances; informing their readers about the conditions, under which help must be sought; and by regularly publishing counseling success stories. Now, more than ever, media must rise to their social responsibility!

Annan Boodram is the President of The Caribbean Voice, a registered volunteer-driven, not-for-profit NGO, engaged in suicide and all forms of abuse prevention in Guyana, Trinidad and Tobago, Barbados, Jamaica and St. Vincent and the Grenadines — in partnership with sister NGO ‘Say Enough is Enough Support Group — and the Caribbean Diaspora in North America.

For information about how we can help or to become involved please email caribvoice@aol.com or thecaribbeanvoiceinc@gmail.com or what’s app 646-461-0574, 845-504-0500, 592-621-6111. Also check out our website at www.caribvoice.org.

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If you see something do something: Counseling Save Lives


Forty-eight years old, Shamwatie Loutan, a Guyanese American woman living in New York City, took her life recently following a period of depression. According to a report in the New York Daily News, the mother of three, who had been awaiting the final decree in a divorce from her husband of more than 20 years, set herself ablaze in the backyard of her Rosedale home. First responders pronounced her dead at the scene.

One daughter, as well as a neighbour, indicated that Loutan began displaying signs of depression, as the divorce progressed. The daughter is also quoted as saying, “It was just out of nowhere”. Really?

The Daily News also stated that a man coming out of Loutan’s former home confirmed that “she was depressed” while a cousin said: “We have no idea what caused this.”

Again, we ask?” That a number of persons recognized growing signs of depression begs the question: Did they not know that unless urgently addressed, depression can and usually does lead to suicide?”

In fact, research clearly shows that depression is one of two mental illnesses that lead to suicide, the other being anxiety. Even if they did not know that, surely, they would have known that depression can be addressed through counselling. Research indicates that counseling for both depression and anxiety generally prevents suicide. In fact, several studies have shown that counseling is generally effective.

According to Shannon Sumrall in ‘Counseling Effectiveness’,  “high success rates appear in a meta-analysis of the literature” on counseling effectiveness. She added, “the vast majority of the research, when examined as a whole, seem to indicate very positive outcomes for counseling”.

As well, counseling is covered by most insurance and requires only the same co-pay paid for any other medical issue. All it would take therefore is for someone to make a call.

So, here’s the deal: If you see something, do something.

Take action and save a life rather than lament that the person was depressed after the person has killed him/herself. In effect, suicide prevention is not only everybody’s business but it is a proactive endeavor whereby one must act as soon as one suspects depression or suicidal intent. As the old saying goes, ‘it’s better to be safe than to be sorry’. Besides, you must do for someone else what you would want someone to do for you.

Yes, counseling saves lives, but counseling must only be done by trained professionals. If you are not a trained counselor (with at least a master’s degree and clinical training) please do not attempt to counsel.

We know of persons who claim to be counselors because they, themselves were counseled at one time. That would be like someone sitting in a courtroom listening to a few cases then claiming to be a lawyer or someone who, after witnessing a doctor at work, concludes that he or she has become a doctor. A lawyer, a doctor or a counselor must have requisite professional qualifications and in the case of counselors, supervised clinical experience, before practicing on his or her own.

The Caribbean Voice has seen first-hand the fatal results of someone attempting counseling without requisite training. The latest was the case of a young lady in Guyana, who killed herself after her father paid a quack counselor to counsel her because she was suicidal.

 

We have also had many, many experiences, whereby people would say, ‘I talk to him/her but he/she does not listen to me’. Such persons may be well-meaning and out of love and concern believe that once they talk to a depressed or suicidal person everything would be ok. But it would not be, because they don’t have the tools with which to communicate and, in fact, their ‘talk’ could well make matters worse. We don’t know if anyone attempted to talk to Shamwatie Loutan but that could well be possible. And if that did happen, we have now seen the fatal result.

The Caribbean Voice is aware that a traditional taboo against counseling exists in the Caribbean, to a greater or lesser degree, with some feeling that ‘only mad people need counseling’. But we have seen, time and again, that depressed individuals, from all walks of life, who fail to seek counseling, end-up dying by suicide. Even in our own experiences every one of almost 500 cases we have handled so far, have been successful, while several cases, of which we are aware, that did not get counseled, ended-up as suicide fatalities. Yes, suicide is a killer just like any other fatal disease.

Most Caribbean nations have suicide helplines or hotlines.

Links to our website provide information: http://caribvoice.org/global.html; and/or http://caribvoice.org/resources.html

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Mental health parity


Mental health parity refers to the equal treatment of mental health conditions and substance use disorders in insurance plans and healthcare 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. Guyana needs mental health parity legislation for many reasons.
With Government moving towards an integrated healthcare system that places mental health care on par with physical healthcare, parity would ensure that all healthcare institutions must not only have medical personnel trained to diagnose mental health issues, but also to follow up with requisite treatment. In effect, mental health care must be as normal as care for physical illnesses and must, therefore, include the presence of clinical counsellors, psychiatrists, psychologists, traumatists and other mental health experts at all healthcare institutions.
Of course, the process of parity must begin with an updated and expanded mental health act that takes into consideration all developments in mental health care since the 1930s when the current act was legislated. As well, current mental health-related laws must be revised to update and maximise provisions for mental health care. And the National Insurance Scheme, as well as any private insurance schemes that exist, must cover mental health care in the same manner that they cover physical healthcare.

A male and female side silhouette positioned back to back, overlaid with various sized words related to the topic of mental health and depression.

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 4 per cent higher, adding significantly to national output. As well, psychological treatment can reduce a person’s annual physical healthcare costs by 20 per cent. 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”.
Thus, as political parties gear up for elections The Caribbean Voice and other mental health activists and advocates look forward to hearing about plans to ensure mental health parity as a priority, given that more than 200,000 Guyanese or 25 per cent of the population is suffering from some form of mental illness (Dr Jorge Balserio, Bhiro Harry et al). With economic growth expected to increase from 4.4 per cent in 2019 to 86 per cent in 2020, surely mental health care should also reflect a corresponding level of growth. After all, it would take the totality of Guyanese with absolute wellbeing to effectively manage and man such an economy. And when mental health care lags behind, it acts as a drag on all other sectors of the economy and quality of life.

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Suicide is not about culture


The Caribbean Voice (www.caribvoice.org), a US and Guyana registered volunteer-driven, not for profit NGO focused on suicide and all forms of abuse prevention in Guyana, Trinidad & Tobago, Barbados, Jamaica and St Vincent & the Grenadines (in partnership with sister NGO ‘Say Enough is Enough Support Group) and the Caribbean Diaspora in North America.

By Annan Boodram – The Caribbean Voice

UK based cognitive-behavioral psychotherapist, Meera Baahu was recently quoted in the Guyana media stating: “Cultural change, promoting greater awareness and acceptance of mental health is necessary for promoting good mental health locally”.

In Guyana and the Caribbean, those working and volunteering on the mental health landscape are not only already aware of the need for greater awareness, sensitization, and education, but are actively engaged in delivering these necessities. And so, we wonder about the need to bring someone from the UK to inform of the obvious.

In the same vein, we also wonder why bring overseas ‘experts’ to spread misinformation and inaccuracies. After all mental health issues are not a product of culture but social, economic and political realities and the consequential stressors and emotional/psychological deficits. This has been and continues to be borne out by the work of The Caribbean Voice and other stakeholders, supported by primary info gathered through our many surveys and the empirical evidence garnered through our workshops, outreaches, and varied interactions.

At the third Caribbean symposium on suicide, held in May this year in Trinidad and Tobago, suicidologist, Dr Silvia Canetto of Colorado State University, presented a paper on ‘cultural scripts of suicidal behavior, the implicit and culturally specific blueprints for when, where and how people engage in suicidal behavior – and how to respond to such behavior’.

However, Dr Canetto’s references are to societies that are significantly homogeneous – religious such as Islamic states, or tribal such as the Eskimos.

In fact, as much as those scripts are ‘cultural’ they are more broadly social/societal because of the homogenous nature of the societies but the causes/triggers for suicide are same as obtain globally – poverty, abuse, alcohol, drugs use, the Werther effect, depression and other mental illnesses (Suicide among Inuit: Results from a large, epidemiologically representative follow-back study in Nunavut; Eduardo Chachamovich and others).

The research and attendant literature reveal that similar findings exist for suicide in Islamic nations and among Indian farmers, [for example].

Besides, Dr Canetto’s presentation made no references to heterogeneous societies such as Guyana, Trinidad and Tobago and other Caribbean nations simply because her argumentation does not fit such mental health landscapes. In effect, it is not culture that drives suicide but overall attitudes, which become normative over time. Thus, all scripts of suicidal behavior are social/societal, transcending all groups – cultural, religious, ethnic, gender and otherwise.

According to president of The Caribbean Voice: “Culture is being used as a scapegoat by individuals, entities, and governments to excuse concerted and comprehensive efforts to address mental health with Caribbean nations providing a minuscule budgetary allocation for such care. In fact, most Caribbean nations allocate less than a small percentage of their health budget to mental health with only Suriname exceeding six percent at any given time”.

The Guyana government is in possession of a National Mental Health Action Plan 2015-2020, drafted under the Peoples Progressive Party (PPP) and finalized under, A Partnership for National Unity (APNU).

This plan states, “Complex socio-cultural factors and the presence of a mental disorder are likely very significant attributable risk factors.” However, “Risk factors for mental illness in Guyana are related to environmental, lifestyles, biological and psychosocial factors and include, social class, gender, racial conflicts, housing, occupational risks, access to services, smoking, limited national policies, globalization, macroeconomics, national politics, and urbanization.”

This indicates that culture is used in an encompassing rather than a group-specific manner, making it clear that it is not cultural change itself that is required but a change in attitudes.

The simple fact is that the ‘culture’ argument does not apply to the Caribbean. Thus, instead of giving scope and credence to flying visit ‘experts’ who sow confusion and misinformation, is it now time to affirm and foster the work of those who are familiar with the realities that prevail? It is these stakeholders who know that it’s not a cultural change that is needed but an attitudinal change at both the governmental and individual/community levels, which can only be catalyzed by all-stakeholders collaboration, spearheaded by the government, and reaching across the nation on an ongoing basis.

The Guyana ‘Plan of Action’ itself, is comprehensive and focused, but its implementation has been mostly at the level of rhetoric and especially so concerning collaboration building. With hundreds of entities and activists involved in mental health activism and advocacy, at some level across Guyana, the government arbitrarily collaborates with a selective handful while the rest are completely side-lined and ignored. As well, there is hardly any piggybacking, or inter-agency/ministerial collaboration, which would broaden outreach and scope at a minimal cost.

Based on content analyses of the media and empirical evidence it would seem that mental health plans where they exist in the rest of the Caribbean (Trinidad and Tobago, Jamaica, Barbados, Suriname, Grenada, Bermuda, Belize, Montserrat and Turks, and Caicos), also do not identify culture, per se, as a significant factor driving mental health issues.

And it would also seem that mental health care is as piecemeal and ad-hoc in the rest of the Caribbean as it is in Guyana, although Jamaica seems more advanced than other Caribbean nations in health care delivery.

Need help!

If you need help for a suicidal person or an abused victim please reach out to any related hotlines where you live, any NGOs offering such help or any ministry of health or social protection – for contact info please check here: http://caribvoice.org/resources.html

 The Caribbean Voice can be reached via email at caribvoice@aol.com or what’s app number 646-461-0574.

 You can also reach out on Facebook to Annan Boodram (North America), Bibi Ahamad (Guyana) Tynika James (Trinidad & Tobago), Kissandra Fox (Barbados).

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Pesticide suicide


The Caribbean Voice is thrilled that the Pesticides and Toxic Chemicals Control Board (PTCCB) is planning to discontinue the use of all pesticides and toxic chemicals in Guyana. It is the hope of The Caribbean Voice that politics will not get in the way of this plan and that if there is a new Government after the March elections, this endeavour will not be ditched.
As has been pointed out by TCV and other stakeholders, toxic chemicals like paraquat absolutely need to be banned. And while promoting reduced pesticide use and more organic farming, the Ministry of Agriculture should also be aware that there are a set of pesticides, known as “organic pesticides” that are being used to replace the toxic poisons.

These “organic pesticides” occur naturally. For example, spinosad comes from the soil bacterium Saccharopolyspora spinosa. It can fatally scramble the nervous systems of insects. It’s also poisonous to molluscs. Synthetic compounds can also make it onto the list of safer pesticides, if they are relatively nontoxic combinations that include minerals or natural elements, such as copper or sulfur. But some naturally occurring substances, such as nicotine and arsenic are off-limits.
While farmers are being weaned off toxic chemicals and assisted in engaging in organised agriculture, they can still have access to the “organic pesticides”. The use of these far less toxic chemicals would mean that suicides by ingestion of pesticides can be reduced significantly since the chances of survival for those who ingest such pesticides would be much greater, especially if immediate action is taken. As TCV had previously pointed out, UWI toxicologist, Dr Verroll Simmons, has emphasised that such measures do exist.
Thus, the Ministry of Agriculture should offer training that would pass on to farmers especially, but others as well, these tips which can increase the chances of saving the life of anyone who ingests pesticides. As well, the Ministry should expand its programme for safe usage and storage of pesticides across Guyana and seek the partnership of saw millers, timber merchants and construction companies to ensure that storage cupboards are available at affordable prices for farmers across the nation. Businesses and international agencies may also be willing to offset costs or even donate the storage cupboards. The World Health Organisation collaborated with Sri Lanka in implementing a suicide prevention programme that included distribution of such storage receptacles.

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16 Days of Activism Against Gender Based Violence


The Caribbean Voice will be having activities in the Caribbean and the US – panel discussions on TV, radio, FB and at selected venues.

 

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