The Tribune

By ADRIAN GIBSON

ajbahama@hotmail.com

“The importance of good mental health in any society needs no explanation or justification and is a priority of the Government.” – Dr Perry Gomez.

IN the Bahamas, there appears to be a lack of political and social will to transform our mental healthcare system from its archaic functioning capacity to a well-funded, more human undertaking. Of late, I have heard a number of stories about mental health patients—even prisoners—being warehoused at the Sandilands Rehabilitation Centre which, as alleged by several interviewees, is poorly run. Indeed, the state of public health services—across the board—leaves much to be desired.

Beyond the Sandilands Rehabilitation Centre, there are no community mental health programmes and the poor and underprivileged, for the most part, bear the brunt of any misfortune that such lack of foresight incurs. The Sandilands Rehabilitation Centre purports to offer psychiatric, geriatric and substance abuse services. It is projected that mental and neurological disorders will likely be representative of the greatest disease burden by the year 2030. Despite the recent upgrades at the government-run healthcare facility, even the minister stated his recognition of the overwhelming demands on the infrastructure and resources that the centre provides to an increasing population.

Indeed, one must applaud Minister of Health Dr. Perry M. Gomez for seeking to re-brand healthcare by offering a new model of care for patients with mental health concerns via the incorporation of mental health care services into primary health care facilities. According to local healthcare officials, the plan would be “affordable”, heighten incidences of early detection and treatment and improve access to mental health care by offering services in an outpatient setting. The Minister of Health stated his belief that such an amalgamation would lead to a reduction—over time—in the number of persons needing hospitalisation.

In the Bahamas, many people are afraid to acknowledge that mental health issues impact and affect us all. Many Bahamians see it as a sign of weakness and seem to hold the view that people who suffer from mental disorders should be ashamed, that they have brought shame on their families. Indeed, based on much of what I have seen and heard, it seems like we have a very primitive understanding of mental illness; it carries a real stigma, it is not something that we want to invest in, we run from it! How is it that people show sympathy in a community for people with illnesses such as cancer, hypertension and HIV/AIDS, but people seemingly shy away from the families of a person who has had a mental breakdown/s or schizophrenia, etcetera?

In Bahamian society today, we’re watching an epidemic of mental illnesses—mild and major—ranging from personality disorders to adjustment disorders to situational disorders to widespread depression, among other disorders. According to physician Dr Duane Sands, milder mental disorders affect one in four Bahamians nowadays, whilst others—such as schizophrenia—are rarer. Whilst conditions such as depression and other milder mental issues are more prevalent, we continue to hear pejorative remarks—such as “going in the white buss” or “on crazy hill”—being made. If one is admitted into Sandilands, the stigma is hard to shake because of a scornful view that our people have adopted towards mental illnesses.

Frankly, there is a need for more psychiatrists and psychologists to address many of the major depressive symptoms and psychiatric challenges we face. One can just look at the increasing numbers of suicides, year over year, to see the impact of mental illnesses and, in some cases, the failure of some persons to seek help due to feelings of humiliation. Substance abuse—which emanates from mental illnesses—is also rampant in the Bahamas, from alcohol to drugs to sex. We must get to the point where mental illness is seen like the common cold, not as an illness that Bahamians see as either being representative of weakness, not having Jesus, not praying enough, not having enough faith, among other things. When one looks at the root cause of mental illness, it emanates from abuse (sexual and physical) and also from genetic predispositions.

According to Dr Duane Sands:

“Bahamians have no tolerance for the philias either. People will not entertain the possibility that some individuals are ill—we just have a black and white view of it, despite the fact that every psychologist and psychiatrist is overworked in this country. We refuse to acknowledge that some views could lead to change. We adhere to overwhelmingly religious views of the mind, the brain and manifestations of sexuality.”

Indeed, there is a greater need for leadership relative to this subject matter. The ideal person to address mental illness would be Prime Minister Perry Christie, who has an autistic child. I believe that greater input from the PM would cause people to recognize the challenge of mental health and also help to mould a kinder, gentler nation as regards mental illnesses.

Yes, Bahamians laugh at the bums on the streets, seeing many of them as a puppy show. The woman in the video “Anybody home with the door crack” clearly appears to be feeble minded. The video is amusing to watch and has become a national joke; however, we should not merely disseminate that video over the internet, track the lady down to exploit her in other videos or produce T-shirts about it. If assistance can be offered, we must do so in tangible ways whilst also seeing to it that she’s mentally stable. Even more, the woman who is seen on Bay Street cursing tourists, and subsequently filmed in a another video talking about the charges that were filed against her and her impending trial, clearly seems to be mentally ill. Why else would someone publicly shout and curse people/tourists, telling them to “suck her (expletive)”?

As a nation, we must endeavour to take people suspected of being mentally ill off the streets, providing them with ambulatory care, medicine, psychological/psychiatric help and so on.

Some of the minor mental illnesses—for e.g. well-adjusted sociopathic behaviours, that we find appealing in certain politicians—seem to be taken as a badge of honour, seemingly projecting a politician as being a “roughneck” or a “hard man.” We have a very bizarre view of what’s normal and that’s not helpful.

It will take a huge change in our approach to the funding of healthcare. Frankly, I agree with Dr Duane Sands when he asserts that we should sell our healthcare system, which would provide capital to re-engineer healthcare and allow individuals to invest whilst saving the government and the Bahamian people from further exposure. Frankly, the government could lease facilities to medical investors over 25 year periods and guarantee them returns of eight per cent. In my opinion, this would jell well with any future national strategic plan!

Sadly, even local insurance companies do not provide the requisite coverage relative to mental illnesses, limiting an insured person to a maximum benefit of maybe 20 total visits to a psychiatrist/psychologist. We must provide the support for mental health; if we do so, we’re likely to see a dramatic change in this country.

MARK HUMES QUITS AS DNA CHAIRMAN!

I would be lying if I said that I did not expect my neighbour Mark Humes to resign his post as chairman of the Democratic National Alliance (DNA). As I told Mark when I spoke to him on Thursday evening, I thought ‘finally, he has dropped the hammer! Mr Humes is busy with other endeavours and one would posit that he may have felt stymied and stifled continuing on in the DNA. Mr Humes told me that he felt that he could not get the DNA, and its executive, to seriously sit down and plan the party’s future. One of the foundational pieces of the DNA has left the scene and that puts that party at a great loss because he was a valuable asset to them. These days, it seems that no one else in the DNA, besides the leader—not even the deputy leader—is energized enough to say anything.

The death knell of the DNA has already sounded and—like a cockroach on its back with its legs moving as ants consume it—the DNA seems to be in its agonal throes. Much like the FNM, the DNA seems to be suffering from internal disharmony.

According to Dr Duane Sands:

“They don’t have much left to say. Ross Perot and the Tea Party created a buzz on the political scene in the US as well. But, the Tea Party is a dying movement, it was merely a fiat! The DNA reflected a response to the peculiarities of the time, it was the perfect storm of the time. When one calculates the Ingraham factor, crime, the economy, unemployment and the unfinished roads and put them all together, it was the right mix.”

“The DNA had the financial backing and a fella who had the hubris to believe he could pull it off. They will not create that mix again—that formula cannot be recreated in the Bahamas anytime soon. None of the third parties have gotten any traction. There was nothing more special about Bran McCartney as opposed to Bernard Nottage. There are people who form the government today, and in the last administration, who came from third parties. The third parties had the raw materials, just not the coalescence of fate and time,” Dr Sands said.

The cardiothoracic surgeon went further and stated:

“The DNA was a reaction to everything perceived to be wrong with the PLP and FNM. There will be someone playing Trivial Pursuit—the Bahamas edition—20 years from now, holding a green shirt and asking, ‘who was Branville McCartney and what organization was he associated with?’ I believe that Bran McCartney is going to try to maintain his relevance and some are saying that we should bring him aboard the FNM, but to where and what post?”

Indeed, it will be interesting to see how this saga plays out…

CONGRATULATIONS TO ELSWORTH JOHNSON

In the last two weeks, the members of the Bahamas Bar Association elected Cat Islander Elsworth Johnson to its top post. Mr Johnson—who was endorsed by 4-year outgoing president Ruth Bowe-Darville—is well-liked among the members of the Bar and is a former police officer who now lectures at the Eugene Dupuch Law School and is the deputy director of the Legal Aid Clinic.

Whilst I congratulate Mr Johnson, I thought that it would have been an apparent conflict of interest if Dr Peter Maynard was elected to the presidency, particularly as his sister currently sits as the Attorney General. In such an instance, would the Bar Council have seriously been seen as an independent authority?

Moreover, Dr Maynard had already served six years as President of the Bar and many attorneys felt that it was time to give someone else a chance. Don’t get me wrong, I have nothing against Dr Maynard—he is also my former lecturer (UWI) and I deeply respect his understanding and knowledge of the law and his contributions thus far. However, I believe that the choice of Elsworth Johnson to lead the bar was fitting and well-deserved.

Speaking about her protégé, Ms Bowe-Darville told me on Thursday:

“There are four things I can tell you about Elsworth Johnson. He is a gentleman; he is humble; he is honest; and he is trustworthy. I have never one day had to question his loyalty (he served as Vice President), not only to me but to the Bar Council. He is committed to serve and I fully support him.”

Congrats!