More effort being plugged into ‘suicide first aid’


Through recent strategic workshops spearheaded by The Caribbean Voice [TCV], a number of key persons are now able to employ a more informed approach when dealing with persons with suicide ideation.
The workshops were designed, among other things, to raise awareness on suicide first aid. Suicide first aid refers to the tactics employed to help dissuade an individual from opting to commit suicide. But according to TCV National Coordinating Director, Mr. Nazim S. Hussain, “one of my concerns is that many people do not understand suicide first aid.”
Hussain noted that the response of many untrained persons to an individual contemplating suicide is that they shouldn’t worry about the problems that they have since things are likely to get better.
“If it is a money problem, they might say, ‘man don’t fight up, you’re going to get money soon’. But these are things that they have already thought of; they want solutions. They don’t want to hear what will work soon. A person in this state needs to see evidence of what you are presenting to them that things will work out,” Hussain explained.
He underscored that a primary element of suicide first aid is emphatic communication. “Don’t tell people that things are going to work out if you don’t have evidence of that. What we need to do is embrace and inculcate emphatic communication,” insisted Hussain.
Employing emphatic communication, he asserted, suggests that an individual lending support avoids making empty suggestions and is willing to listen to the troubled person’s problems without being judgmental, and if possible find a solution to their problem.
But if that person lending support is unable to derive a plausible solution, Hussain shared that he or she should be able retain the attention of that person until the service of a professional is sought.
Doing something as simple as “lending a listening ear” is of paramount importance to a person with suicide ideations, since, according to Hussain, “that person does not really want to die…”
“The mere fact that that person sought you out means that they need help… You don’t need to establish guilt, you want to build trust, you want to build confidence, you want to have them talking as long as possible to you until you can contact someone to help them further.
“That is not betraying their trust but finding a way to help them when you can’t.”
He continued, “All Guyanese should be able to have the simplest knowledge of how to apply suicide first aid…”
Getting additional help for a person contemplating suicide could be as simple as calling one of the Suicide Prevention Helpline numbers. In addition to a toll free number offered by Digicel, [600-4444], persons can also call the other helpline numbers: 223-0001, 223-0009 and 623-4444. Both mobile numbers [600-4444 [Digicel] and 623-4444 [GTT]] are also Whatsapp enabled for assistance, Hussain said.
The participants of the recent workshops were exposed to forgoing information and are now in a better position to help with the ongoing fight to help prevent the incidence of suicide in the society. The workshops, which took on the form of Addiction/Mental Health/Anti-Suicide sessions, were held earlier this month. Among the key facilitators was Canada based Guyanese, Mr. Shirvington Hannays, who is a Certified Addiction Counsellor and Behavioural Change Coach. The first in the series of workshops was held in the boardroom of the Childcare and Protection Agency and saw the attendance of some 28 individuals including: Ministry of Social Protection officials, representatives from the Guyana Prison Service, among others.
Another workshop on the Essequibo Coast was held in the boardroom of the Suddie Hospital. It saw the attendance of some 40 individuals including seven doctors and other public health workers others.
There was yet another workshop in Berbice targeting young cricketers at the Fort Wellington Secondary School.

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Children should be the most critical reason not to stay in an abusive relationship


Very often victims of gender based abuse say that they choose not to walk away because of the children. The fact is that staying in an abusive relationship because of the children will cause the children to be scarred for life as growing up in such a home is one of the most terrifying and traumatic experience a child can go through.

Children in abusive relationships may blame themselves for the abuse, thinking if they had not done or said a particular thing, the abuse would not have occurred. They may also become angry at their siblings or their mothers for triggering the abuse and may display increased aggression towards peers or mothers.

Such children may feel rage, embarrassment, and humiliation. They generally feel isolated and vulnerable and can easily engage in self-harm or even become suicidal. They are starved for attention, affection and approval as they become physically, emotionally and psychologically abandoned. Thus, they can also be continually angry and act out or they can become depressed and withdraw, too frightened and embarrassed to speak out and easy to be bullied. Also they can be anxious to please and thus become easy to manipulate and be taken advantage of.

Since children have a natural tendency to identify with strength, they may ally themselves with the abuser and lose respect for their seemingly helpless mother. In fact, there is a definite correlation between violence and child abuse. Growing up in a violent home can set patterns for children – patterns that can cause them to commit violence and abuse thereby continuing that cycle. In effect, witnessing domestic violence is the single best predictor of juvenile delinquency and adult criminality.

As well females can also become accepting of abuse thinking that it is normal, as they grew up seeing it happen continually, with the victim staying rather than leaving. And so they will not only tolerate intimate-partner abuse as they get older but may actually think such abuse is normal.

Children in abusive relationships may experience developmental delays in speech, motor or cognitive skills. They are also more apt to use poor judgment, have health problems, social and emotional issues, higher risks of alcohol/drug abuse, post-traumatic stress disorder. They are also more apt to become school dropouts, pregnant teens and gun users. They grow up to suffer from low self-esteem, stay in dead end jobs or worse…not being able to keep a job.

According to a 2002 US Department of Justice Special report, children who grow up in homes where violence is present are:

> 6 times more likely to take their lives

> 24 times more likely to be sexually assaulted

> 67 times more likely to engage in delinquent behavior as adolescents

> 100 times more likely to be abusers themselves

> 500 times more likely to be abused or neglected

In effect children should be the most critical reason not to stay in an abusive relationship.

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Abuse prevention starts with you


Like many others, The Caribbean Voice noted with horror the experiences of a young lady who was attempting to seek legal advice with respect to sexual groping at her workplace. It is clear that the legal fraternity needs immediate training on dealing with abused clients and that staff of all lawyers need to be provided with clear guidelines in this respect. The Caribbean Voice is willing to work with Bar Association to help in this respect. Also a client’s bill of rights needs to be formalized and posted in the offices of all lawyers and law firms. We urge urgent action by the Ministry of Social Protection and the Bar Association in this regard.
Meanwhile, like many others too, TCV is extremely happy that Two Brothers Corp. took immediate action to fire their HR Manager for inappropriate interview and touching. They have certainly set an example for all other businesses but we also hope that the Ministry of Labor will ramp up enforcement of workplace safety requirements to include abuse and mental health in general. As well businesses must set the parameters for interviews with workers or potential workers and take necessary measures to ensure that parameters are adhered to – perhaps recording those interviews for quality control as is done in North America, Europe and elsewhere. The Caribbean Voice has held training workshops for a number of businesses already with more being planned based on invitations. Businesses can reach out to us via email at caribvoice@aol.com or by calling Nazim at 644 1152 or 646 4649.
On a related matter, while rape offenses are indictable we urge that they should also be made non-bailable not only to prevent the accused offender from threatening, abusing or even fatally attacking the complainant but also to ensure that that person does not leave the jurisdiction and not subsequently be found. As well TCV supports the call by the Gender Equality Commission (W&GEC) for stand-lone sexual harassment legislation. Such legislation must include guidelines for the manner in which sexual harassment cases are handled, especially by workplaces and the police. The legislation must provide stipulations to ensure victims/complainants as well as whistleblowers privacy and protection. And it must ensure the safety and privacy of witnesses to sexual harassment/abuse so they would be encouraged to report what they see.
Meanwhile, given that latest police reports show an increase in rape and sexual abuse, an ongoing sensitization campaign is needed. – public service announcements via media, messages at various events, flyering and postering, banners and billboards if possible. One message that needs to be driven home is that ‘no’ means no, even if one is in a relationship. Another is that mode dress is neither an excuse nor a justification for rape.
Also, given that three quarters of rapes are committed by someone known to the victim — fathers, grandfathers, uncles, neighbors, brothers, sons, nephews, boyfriends, family friends — there is need for guidelines to be provided to children and teenagers especially, on recognizing where to drawn the line in any interaction and what to do if attempts are being made to cross that line. As well parenting sensitization is necessary so parents understand that when their children say they have been abused they must be taken seriously instead of being called liars and threatened into silence.
Additionally, there is need for mechanisms to enable abused victims to break the silence by sharing their experiences and publicly calling out abusers as well as seek help. A hotline would be one such mechanism. Or perhaps the Suicide Helpline can be expanded to include abuse. Gatekeepers/lay counselors would be another mechanism. As well, the government should foster the creation an app that would also enable sharing and reporting of such abuse.
Also, the otherization of the call to action must be addressed. On the one hand almost all who suggest what should be done, expect some hazy other to take action, as they remain dismissive of the call for abuse prevention to be everyone’s business, the need for each one of us to tackle the issue in our homes, communities and workplace as that is really where the walls of silence need to be broken down and misplaced concepts such as family honor and status need to be shunted aside. On the other hand the deafening silence fosters abuse, sometimes with fatal consequences, often because victims and others know not what to do and how to do it. This need to know is critical since abuse prevention starts with you and you and you. And workshops, such as the ones offered by The Caribbean Voice, can meet this need.
Finally, some years ago TCV launched an online petition calling for a registry of sex offenders to be raised. Now we are rooting for the realization of the Director of the Childcare & Protection Agency, Ann Green’s plan to have such a registry of sexual predators of children and we hope that plans for a similar registry for sexual predators of adults will also come into being in 2018. As well, we appeal to readers to please sign our petition calling for such a registry and urge others to do so by clicking on the ‘Petitions’ link on the left hand bar of the index page on our website – http://www.caribvoice.org – and then click on the ‘Registry of Sex Offenders’ link, so that we can boost the registry’s chances.

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Caribbean Voice gearing to raise mental health awareness through strategic workshops


“We condemn that which we do not understand.” This has been the notion embraced by National Coordinating Director of The Caribbean Voice [TCV], Mr. Nazim S. Hussain, as he considered the impact of substance abuse on mental health.
Substance abuse has been found to be one of the key contributors to mental instability, said Hussain, as he stressed the need to sensitise as many members of the public as possible to understand the link.
It is for this reason that Hussain has taken the initiative, through TCV, to convene workshops targeting key stakeholders in the society.
Among those who will be targeted for the workshops, the first of which is slated to commence tomorrow, are Social Workers attached to the Ministry of Social Protection’s Childcare and Protection Agency [CPA], officers of the Guyana Prison Service, the Guyana Police Force, among other officials.
Hussain disclosed that while those attached to the CPA are normally tasked with recognizing the issues that could lead to mental illness, the other targeted participants could also help to lend their support to, simply by employing a greater degree of empathy. But empathy can only be utilized if these individuals have an appreciation for the circumstances [such as substance abuse] that can lead to mental instability, Hussain asserted.
Hussain highlighted that once under the influence, “they may not want to respect authority; they won’t respond kindly to questions, because they are on a high.” As such he noted that “those exposed to training will be able to empathize, so that they understand that this person is inebriated and then they will be able to use techniques to deal with them…”
In addition to Hussain, who is an Anti-Suicide/Violence Advocate, the planned workshops will be facilitated by renowned officials the likes of Canadian Certified Addiction Counselor and Behavioural Change Coach, Mr. Shirvington Hannays, and United Kingdom-trained Nurse and TCV Training and Education Director, Ms. Leslyn R. Holder.
According to Hussain, “with the addiction discussion, you get to understand the mind-set of the person…what could cause a person to become addicted…and it is not only the persons who are drinking and driving on the roads, but drugs are even getting into the prison system.”
He added, “If prison officers can understand how these people are thinking and how they could react and how you can help them, you would have done a national good. When officers have that training, it helps them to improve how they do their job and it helps this country too.”
As such, Hussain emphasized that spreading the word about the importance of mental health training cannot be confined to selected factions of the society but across the board. For this reason, the TCV Coordinating Director said, “we want to help the participants to understand the factors which may predispose people to suicide, violence and mental illness, and addiction is one of those factors.”
“All of us will not end up being psychologists, psychiatrists and counselors and so, but the focus is to create more awareness. With more awareness we will be able to get more people involved to understand mental illness,” said Hussain.
Among the known manifestation of mental illness, which some people may not even be aware of, could be sleep apnea [a potentially serious sleep disorder in which breathing repeatedly stops and starts] and even anxiety which, Hussain said, has been known to be a major trigger of suicide.
“What has happened in Guyana is that for too long we have not been doing anything about these mental illnesses and there have been too many myths attached to mental illness,” Hussain added. He, however, noted that like any illness, “if mental illness goes on untreated it gets worse. So when we become more aware of our condition, others’ condition and where they can get counseling and training, that will make what we are doing more vital.”
The first workshop will kick off tomorrow [July 12] in the CPA boardroom and another will follow on Thursday July 17 in the Boardroom of the Suddie Hospital.
According to Hussain, Region Two is viewed as a hot spot for the issue being addressed. The final workshop will be held at the Fort Wellington Primary School on Friday, July 19, 2018 which will see TCV collaborating with the Berbice Cricket Board to target youths.

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Mental illness does not catalyse violence


THE FEB 14 shooting in a Florida high school once again brought to the fore the issue of the relationship between mental illness and violence. US President Donald Trump felt that the shooter’s mental illness inevitably catalysed his mass killings. But what are the facts?
A 2000 article in Psychology Today entitled “Are the Mentally Ill Really Violent?’ by Edward P Mulvey and Jess Fardella, stated, “The overwhelming majority of people with diagnosed mental disorders do not engage in violence.” In fact the article pointed out, “Certain factors that appear to be associated with an increased likelihood of violence are in line with common sense’. In effect it’s the same for persons with and without mental illness.
A 1998 study published in the General Archives of Psychiatry by the MacArthur Risk Assessment Project, “shows that the circumstances in which mental patients most commonly commit violence do not differ markedly from those surrounding crimes committed by people who are not mentally ill. In both groups, violence most often arises from everyday stress, such as conflicts with spouses, family members and co-workers.” That study also found that patients discharged from psychiatric facilities, who did not abuse alcohol and illegal drugs had a rate of violence no different than that of their neighbours in the community. In fact, research indicates that fewer than 5 five per cent of gun-related killings are committed by the mentally ill.

In effect, as the American Psychiatric Association emphasised following the Florida shooting, the “disparaging and inaccurate remarks about mental illness serve only to perpetuate stigma and prohibit honest and open dialogue about an illness (or disorder) that affects one in five people in the nation.”

For people with mental illnesses such stigma makes an already difficult existent much harder. As columnist` The Mighty ‘puts it in the February 24 issue of the Huffington Post, “When you have a mental illness, you can feel utterly alone. You feel like a mime in an invisible box you can’t escape. The pain is not like that of a physical illness. The pain is deep and the sorrow or burdens hold on to you, sometimes for years. You live like that, a constant cycle of feeling like you will never get better because of what has happened or what will happen if you don’t “try harder”. Of course, part of getting better is putting work into it, but it takes a long time for some people.“ And, for some people, never.
The need to bring clarity to this issue is important given that according to a study by Dr. Bhiro Harry and others, more than 200,000 Guyanese are mentally ill. As well, there is the habitual abuse meted out to the mentally ill. This issue, often ventilated by social activists, was again raised in a February 22 column, by Freddie Kissoon, who detailed the beating of a mentally ill man by government workers who had disembarked from a garbage truck on the Camp Street seawall.

In fact, according to a WHO report released in 2014, Guyana is still struggling to fight the stigma of mental illness. Hidden or left to roam at will, the mentally ill are often abused or neglected or both. In the courts, far too often they are sentenced without any psychiatric evaluation or mandated treatment. And, the 1930 Mental Health Ordinance does not include many basic elements of protection in legislation. Nor has it ever been updated, although plans to do so were announced last year.

The WHO report adds, “Persons with mental disorders are reported to suffer discrimination in their communities, the workplace, educational institutions, judicial services and the health-care system. Safeguards to protect individuals with mental illness from involuntary admission and treatment and mechanisms to oversee treatment practices within health facilities are lacking. There are no independent review bodies established to protect the human rights of users of mental health services. Stigma against the mentally ill is reported to be pervasive and considered by stakeholders to be expressed by the public, as well as by many health professionals, the police, and policy makers and administrators alike.”
“There are no standards, protocols, policies or guidelines for the use of psychotropic medications; the assessment, treatment, monitoring, and ongoing evaluation of patients with mental disorders; the charting of patient information; or the maintenance of health records. There is little national mental health data available for mental health service monitoring and evaluation. As a consequence, datasets of sufficient quality are not available to inform service utilisation or to provide quality assurance for mental health care.”

This sober reality emphasises the need for a basket of measures for which The Caribbean Voice and others have been lobbying, including mental health care integrated into the physical health care system with psychologists in all public hospitals; the establishment of psych wards with easy accessibility, in all public hospitals, and periodic visits by psychologists to all satellite clinics and community health centres; counsellors in schools; relevant training for all police officers and guidelines for protecting the mentally ill, publicised across Guyana. As well, the ossified Mental Health Ordinance needs to be overhauled via bipartisan cooperation to avoid political footballing, so that the deficits outlined by WHO are addressed and the legislation informed by the latest advances in treatment for mental health, including the very common conditions of depression and anxiety.

In fact, advances in brain imaging indicate that the brains of persons who are clinically depressed look different than the brains of the non-depressed, similar to a diseased heart being different than a healthy heart. A combination of genetics and environment contribute to clinical depression, and episodes of depression can be triggered by traumatic experiences such as: childhood or adult physical or sexual abuse; loss of a loved one; relationship problems; unemployment; poverty; pregnancy; childbirth; a serious physical health illness such as cancer or AIDS; an accident or a natural disaster, as well as by a family history of depression; loneliness and a profound exposure to social alienation. Sometimes, however, depression can have no obvious cause at all.

Also, scientists have found specialised brain cells in mice that appear to control anxiety levels. “If we can learn enough, we can develop the tools to turn on and off the key players that regulate anxiety in people,” says Joshua Gordon, Director of the US National Institute of Mental Health. The situation is similar with respect to treatment for depression. As well, these advances open up possibilities for other mental health issues.

Meanwhile, there is still much that Guyana and Guyanese can do to address mental health. One such measure has to do with tackling the noise level. Studies in the UK and Denmark have found that living next to loud neighbours more than doubles your risk of mental illness and almost trebles the chances of suffering severe stress. Experts found rates of depression were twice as high among homeowners constantly bombarded by a racket from nearby premises. Late night parties and loud music were cited as the most common bugbears. But noise from building works was also a major catalyst. And, in the context of Guyana we might add, minibus music, rum shop music and all night parties and various celebrations.

In effect, there is need to stringently apply the laws relating to noise control across the board. As well, government and employers can provide first-aid training in mental health. Both employers and government can also ensure that mental health experts are available to assist those who may be experiencing mental health problems.

In fact, there is need for an ongoing and extensive, all stakeholders’ education campaign, not only to tackle the taboo against counselling but also to inform the population about the realities of mental illnesses so that myths and misinformation can be dispelled and needed attitudes cultivated, so that, for example, abuse of the mentally ill, whether on the streets or at home (as exemplified by the case of Gopaul Etwaroo), would cease. Also critical, is the need for a return of the Gatekeepers Programme to train lay counsellors within communities, to be proactive first responders and to keep mental health redress grounded on reality rather than sensationalism. As the WHO pointed out, “there are many non-health professional and non-professional groups in Guyana, including teachers, community leaders, traditional/spiritual healers, herbalists, religious leaders, law enforcement (police), ambulance attendants, NGOs, and the media, who could potentially play a role in the promotion of mental health in their communities”.

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That National Dialogue on Domestic Violence


THE Caribbean Voice (TCV) fervently hopes that First Lady Sandra Granger’s upcoming national dialogue on domestic violence will consider proposals made by a number of commentators, analysts and letter- writers: a coordinated community response via a task-force; review of the domestic violence laws and a concerted effort to implement and enforce them; police training on the provisions of the domestic violence law, emphatic communication and an overall, more effective approach to domestic violence; timely and greater responses to complaints and requests for protection orders supported by stringent enforcement; domestic violence courts; social workers and/or counsellors at all police stations, a batterer’s intervention programme; an education campaign that focuses on modelling and highlighting healthy relationships and on tackling the victim-blaming and shaming mentality that currently exists; provision of more safe houses; more probation and welfare officers to service the courts; greater inter-agency and stakeholders’ collaboration; videoing by the public of inappropriate police behaviour/responses to complaints and submission to their superiors.

Meanwhile, Public Security Minister Khemraj Ramjattan was recently quoted in the media as saying that domestic violence is “a very difficult thing to prevent when someone (is) feeling angry for whatever reason…I don’t know what we can do, or how we can legislate against that…What we have to do is…ensure better education; but, there again, the officer (Orwain Sandy) that did what he did was an educated fella.”

Actually, anger is not a root cause for domestic violence. The same person whose anger leads him/her to violence in a relationship, would generally not be violent at the workplace, in a government office, or with a leader or opinion-shaper, no matter how angry. Domestic violence occurs because the abuser needs to be in control and/or dominate the other partner, and/or the abuser is socialised into thinking intimate partner violence is an acceptable way to solve conflicts.

Anger, drugs, alcohol catalyze the abuse. What, in effect is needed is the implementation of the requisite programmes, policies and strategies, some of which have been mentioned above and some of which may need legislation. Others would include programmes – anger management, anti-alcohol and anti-drugs – to address the related mental health issues.

Additionally, measures are needed to shape the socialisation process so that children, especially boys, are imbued with the right mentality from young, so that parents can apply appropriate parenting skills, so dysfunctional relationships can be re-engineered to evolve without violence and so that schools can provide discipline without violence. As tennis champ, Serena Williams stated in a June 21st article in the UK’s Daily Mail newspaper, It’s important to get the message out there — to our young men, to our boys, to our daughters.” Also, it must be noted that academic education does not necessarily prepare someone to not descend into abuse. In fact, abuse cuts across all strata and segments of society and all walks of life.

With respect to multi-stakeholders’ collaboration, a good starting point could be this national dialogue. When The Caribbean Voice held our National Stakeholders’ Conference in August 2015 over 75 stakeholders’ were present from across Guyana. Logistically and resources wise, the First Lady is in a position to do far better and so we hope that her national dialogue will see representation by all stakeholders involved at any level in addressing domestic violence — persons who already have displayed passion and commitment to addressing domestic violence, persons who are already on the ground giving of their time, efforts and resources and thus, having a grasp of the realities around domestic violence would be there for the long run, 24/7 and not only 8 to 5 until the money runs out.

Meanwhile, The Caribbean Voice is inviting the First Lady to become lead partner in the Lay Counsellor Training Programme to be launched next year. With the First Lady in charge, this programme can truly be national in scope and result in gatekeepers in all communities, individuals who can proactively tackle all forms of abuse and suicide.

Also, The Caribbean Voice is considering a national campaign to address domestic/intimate partner violence and femicide. Elements of this campaign are expected to include flyering (200,000 flyers) and postering (10,000), as well as focus groups across Guyana, supported by the lay counsellor programme, our ongoing workshops, information dissemination and advocacy. Again, with the First Lady as lead partner in this effort tremendous success can be achieved.

As well, we urge the First Lady to include a module on mental health in all training programmes planned by her office. This would be more cost-effective than separate mental health training. Besides, given that upwards of 200,000 Guyanese suffer from one or more mental health issues, that both suicide and all forms of abuse have mental health components, and that hundreds of thousands of other Guyanese have to deal with loved ones who suffer from mental health issues, mental health training becomes a critical necessity.

The bottom line is that much of what we have had so far is rhetoric, pageantry, photo ops, and similar arid activities that waste scarce resources without impacting the issue in any fundamental manner. So please Madam First Lady, please do use this national dialogue opportunity to start a process of concrete change. As a woman, wife and mother you can far better empathise with the plight of our womenfolk and as the First Lady, you have the capacity and scope to transform talk into action, not piecemeal, selectively and ad hoc, but concertedly, nationally and continually.

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Is a mobile counseling unit the best option?


If counselling is already available in each region, as recently pointed out by Chief Education Officer Marcel Hutson, shouldn’t the Ministry of Education ensure that all parents are aware of where and how this counselling can be accessed?
Also, should there not be, at the minimum, trained lay counsellors at schools, to ensure each school has a minimum level of expertise to identify and refer all cases requiring counselling?
And should there not also be a law mandating teachers to report issues such as suspected abuse, suicide ideation et al?
As well, with the move to set up a mobile counselling unit, which will be driven into different areas (and) communities based upon the needs, how would this work for regions that can only be accessed by air?
And what about the amount of time it would take to travel to distant areas such as, for example, Corriverton or the Pomeroon? And how effective would such a unit be, given that counselling is not a one-off measure, but has to be ongoing to ensure desired results? In fact has a cost benefit analysis been done with respect to this unit? With a pool of trained counsellors now available, would it not be less costly in terms of money, time and results to initially have all education districts staffed with trained counsellors who can also access other available needed resources? And with UG now offering a psychology program, secondary schools can also have their own counsellors within a few years.

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