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Mental health stigma down, drug abuse up on St. Maarten


~ More needs to be done ~

DAWN BEACH–Even with all the strides that have been made for mental health patients in St. Maarten, much more still needs to be done, Mental Health Foundation (MHF) Board President Felix Holiday told attendees at the opening of the Addiction and Psychiatry Congress on Transforming Care on Saturday evening.

Holiday said while the stigma against mental health illness is decreasing, youth problems and drug abuse are on the rise. “Substance abuse consequently is the cause of mental and physical abuse not only seen between adults, but abuse of children is becoming more and more prevalent,” Holiday said at the event held at the Westin St. Maarten Dawn Beach Resort and Spa.

Holiday expressed hope that the cooperative effort of all involved will prevent more abuse in the future. “We hope that this congress will provide knowledge and tools for formal cooperation between stakeholders, enhance prevention methods and provide the necessary economic advantages for sustainable quality care,” he said.

Although officials from several ministries were present, there were no government ministers at the opening of the conference, which was coordinated in collaboration with several ministries. MHF Director Eileen Healy said Prime Minister Sarah Wescot-Williams and Justice Minister Dennis Richardson were off island and would attend sessions this week. She said Education Minister Patricia Lourens-Philip and Health Minister Cornelius de Weever could not make it. De Weever sent his presentation by video, which was aired for attendees.

In his video presentation, De Weever said the issue of mental challenges is so important that one would expect it to be at the top of the political agenda and authorities would be “falling over” each other with solutions for the challenges. He said there has been almost complete silence on this subject for too long and the “taboo needs to be addressed.”

The Minister described mental illness as a taboo that runs across society affecting culture and politics. “It must be broken,” the Minister said, adding that far too many people still feel they have to pretend that there is something else wrong with them when they are struggling with depression or other forms of mental health illness.

Representative of the Parnassia Group in the Netherlands Kwidama said mental health disorder is a vulnerable topic with many masked prejudices and stigmatisation. Mental health disorders, including addiction, warrant attention from the individual member of society as well as the government organisation, he said.

The burden of the disease is very high due to the social and emotional consequences with regard to disability and impairment for the affected individual and his family, also for society as a whole with regard to the financial burden.

He said in 2020, mental health-related prevalence and subsequent expenses are expected to be within the top three alongside, for instance, cardiovascular disease. One of the reasons is that mental health disorders express themselves relatively early in life and persist over the life span. This, he said, leads to a high prevalence of the disease overtime and is different for a disease such as Alzheimer’s, which starts relatively late in life and has a short disease period.

Another aspect that deserves attention, he said, is that mental health and addiction often co-occur with severe and chronic somatic disorders such as cardiovascular disorder, hypertension, diabetes, obesity and autoimmune disorder. He added that this implies that the chances of having a somatic disorder, and dying from it, are significantly higher for the patient with a mental disorder than the general population.

“Many people in governmental or other public organisations are familiar with the impact of mental health and addiction problems on feelings or public safety. Strange or even aggressive behaviour leads to anxiety and insecurity, and at times, is too easily blamed on persons with mental health problems,” said Kwidama.

“Restriction, control and seclusion are quite often the reaction introducing a vicious circle leading to recidivism. In fact, also to high costs as a small number of patients can disrupt the service system dramatically. So instead of treating, constraint is used with subsequent costs.”

He said the number of patients suffering from mood or anxiety disorder, alcoholism or other addictions are high and leads to suffering at times behind closed doors of the house as people are ashamed to come out with their burden.

“St. Maarten is like all societies confronted with the question of how to deal with these challenges given the reality of dwindling financial capacities,” Kwidama noted. “One lesson may be clear given the fact that you can spend a dollar only once. The time that various service providers offer overlapping and costly service paid by public money is dwindling rapidly. This means that collaboration, regional or otherwise, is of paramount importance.”

He said the Parnassia Group, as one of the larger providers of mental health addiction services, sees its societal responsibility to support the development of proper patient services. “This is the reason we collaborate with many other organisations offering and developing education, research, and training in Curaçao, Bonaire, Aruba, St. Eustatius, Saba and St. Maarten,” he said, adding that a win-win situation is achieved this way.

The Mental Health Foundation actively started with a clinic in 2006 and has grown and developed into the organisation it is today, with care products such as outpatient care, ambulant care, (community based care), “Faraja Center” for re-socialisation, crisis intervention, guided living, admission and information and prevention.

Holiday said one of the main pillars in successfully developing mental health care in St. Maarten is the fact that the Board, together with management and staff, continued to focus on quality care efforts for the patients. To be able to continue to provide quality care, the Board ensured that the financial management of the Foundation was solid.

One of the most important measures in providing quality care, however, is cooperation with stakeholders. From the onset, MHF worked closely with the police in caring for crisis patients, till date this cooperation is developing and improving. MHF has been cooperating with the prosecutor for a patient’s freedom of choice to be honoured and respected, as well as objective reporting on the mental status of persons that have committed a crime.

It has also been cooperating with Capriles Clinic in Curaçao; SVP-CN, for patients in Saba and St. Eustatius; White Yellow Cross Foundation, for psychiatric counselling and guidance of their patients; the prison, for those incarcerated who need psychiatric care; the Parnassia Group, which was instrumental in advising MHF during the renovations; Turning Point Foundation; Social Welfare and Labour Department, Stichting Justitiele Inrichtingen SJIB; Court of Guardianship, general practitioners and specialists.

The congress, which starts today, is a combined effort of MHF, the Ministry of Public Health, Turing Point Foundation, the Parnassia group in the Netherlands and SVP-CN of the Bonaire, St. Eustatius, and Saba (BES) islands. The congress is also supported by the Ministries of Justice and Education in an effort to create cooperation between the two ministries.

The goal of the congress is to transform how care is delivered with the intention of improving lives of patients, prevention of criminality and community disruptions, including the economic advantage of cooperation and prevention. The focus will be on the youth as the programme focuses on “co-creating younger people’s programme for resilience.”

A number of other persons spoke at the conference opening including representatives of the SVP-CN, Chief Minister of Anguilla Hubert Hughes and Claire Elshot of the recently formed Mental Health Caregivers and Patients Association.

Source: The Daily Herald, St. Maarten

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