The stigma surrounding mental illness and substance abuse throughout the Caribbean was at the forefront of topics discussed during the third annual Health Disparities Institute.
The gathering was hosted by the Caribbean Exploratory National Center on Minority Health and Health Disparities Research Center and held at the Frenchman’s Reef & Morningstar Marriott Beach Resort all day Thursday and Friday. This year’s theme, “The State of Mental Illness and Substance Abuse: An Issue for All Ethnic/Minority and Caribbean Populations”, brought together almost 100 university educators, healthcare professionals, politicians – including Delegate to Congress Donna Christensen and Senate President Louis Patrick Hill – and members of local community organizations to share statistics and collaborate on solutions to some of the issues surrounding mental illness and substance abuse in the Caribbean.
The Virgin Islands is not alone when it comes to the severe lack of services available to serve people with mental illness or suffering from substance abuse. After listening to healthcare professionals from other Caribbean islands detail the shortage of psychiatrists and the absence of facilities designated to treat the mentally ill and substance abusers, keynote speaker Dr. Izben C. Williams, St. Christopher and Nevis Ambassador to the United States and permanent representative to the Organization of American States, said, “The U.S. Virgin Islands has an essential role to play in collaboration with the rest of the Caribbean.”
Hemsley Stuart, professor of nursing at the University of the West Indies in Jamaica, described Jamaica’s lack of resources and commended a program that island nation has started, in which nurses are trained in psychiatric mental health, a successful solution to Jamaica’s shortage of psychiatrists. One of the requirements of the program is that the nurses must live in the communities where their patients reside.
Substance abuse and mental illness often go hand in hand, according to the National Institute on Drug Abuse, and the stigma attached to both perpetuates the continued suffering of those who need help. People with mental illness are afraid to seek treatment for fear of derision and ostracism in the community. In a message to conference attendees, Gov. John deJongh Jr. said, “Those afflicted with mental illness and substance abuse need the support and understanding of their families, the healthcare system and the community as a whole.”
Cheryl P. Franklin, dean of the University of the Virgin Islands School of Nursing, referred to mental health issues as “the elephant on the table.” Everyone tiptoes around it, she said, pretending they don’t see it and hoping it will just disappear.
It doesn’t disappear. It doesn’t go away. While everyone is busy keeping up appearances, the person suffering gets progressively worse. Virgin Islands Department of Health Commissioner Julia Sheen, in her welcome letter to conference attendees, listed some of the consequences of untreated mental illness and substance abuse, including homelessness, unemployment and inappropriate incarceration. These consequences affect not only the untreated individuals and their loved ones but the entire community.
“Too often, and especially in the Caribbean,” said Sheen, “we tend to view people with mental health illnesses as taboo, rather than recognizing that with treatment, recovery is possible. We also tend to forget that mental illness is not the result of personal weakness, but it can affect persons of any age, race, and religion or income.”
The availability of mental health services in the territory may soon improve thanks to the recent appointment of Doris Farrington Hepburn as the territorial director of the division of mental health, alcoholism and drug dependency services of the U.S. Virgin Islands.
According to Farrington Hepburn, $115,000 of federal monies given to the VI for substance abuse treatment were about to be returned unspent due to the territory’s inability to provide those services. Farrington Hepburn was able to subcontract with two community service agencies to provide treatment to substance abusing women.
“Substance abuse is a major issue in the territory,” said Farrington Hepburn.
Although the mental health division served 647 clients in 2009, Farrington Hepburn said, “We have a lot more persons suffering in this community but people don’t come forward until it’s critical.”
The division has also applied for a $221,000 grant that Farrington Hepburn plans to use to hiring two substance abuse counselors and one community outreach worker, alleviating the staff shortage and enabling to division to better serve the community.
Along with an increase in staff, Farrington Hepburn and her team have put together a new anti-stigma campaign, a combination of radio and television spots intended to educate the community about mental illness and substance abuse that will premiere in November.
Basil Halliday, a Virgin Islander who left the territory in 1980, is president and CEO of Alternative Integrated Methods Health Services, LLC., an outpatient substance abuse clinic in Durham, N.C. Halliday, who attended the two-day conference, said, “The mental health problem in the Virgin Islands is a problem we can solve. All we need is the involvement of the community.”
Halliday plans to return to the territory after the first of the year to open a substance abuse clinic here.
“I’m coming back to simply make a difference,” he said.
At the conclusion of Friday’s panels and presentations, which included topics such as “Social Determinants of Drug Abuse in African American Baby Boomers” and “Lost in Communication: Depressed African American Men and Clinician Interaction,” attendees divided into round table groups to identify the two most urgent issues needing to be addressed in order to improve mental health services in the Virgin Islands and the Caribbean and to suggest practical, achievable strategies to address those issues.
Of the three round table groups, the issues varied substantially. While one group called for still more research and needs assessments to be done in order to have current data and knowledge of “who is doing what” so that services are not overlapping, another group saw inadequate funding and the lack of a qualified work force as the main obstacles.
No Virgin Islands conference would be complete without politics, so the third group’s cry for an “effective visionary leader who is knowledgeable about mental health issues” quickly increased the noise level in the room and sparked a political discussion.
Caribbean Exploratory (NCMHD) Research Center Director Gloria Callwood brought the focus back to the conference topic, thanking attendees, speakers and researchers for coming together in the hopes of reducing the Caribbean’s health disparities in the areas of mental illness and substance abuse.
The research center, referred to as CERC, was established by UVI’s School of Nursing through a grant they were awarded by the National Center on Minority Health and Health Disparities. They are currently conducting a major study on intimate partner violence throughout the territory.