Depression on the rise: Mental Health Foundation still lacking adequate funds and staff

POSTED: 07/24/13 1:02 PM
20111227 Eileen Healy - Mental Health FoundationDirector of the Mental Health Foundation, Eileen Healy. Today File Photo

St. Maarten  / By Jason Lista – “Depression is terribly on the rise,” said the director of the Mental Health Foundation (MHF), Eileen Healy, in her office yesterday. Years ago, there was virtually “no psychiatric care on the island” for people whose mental health and well-being needed special care or expert attention, never mind for less urgent mental health issues.

On a small, socially conservative island like St. Maarten these things were – and still are to some extent – often a taboo subject associated with shame. It’s a topic better left in the dark, or at least left unspoken in polite company. In fact, “the adaptive response to private and public shame is secrecy,” writes Peter Byrne in Advances in psychiatric treatment, a mental health publication.

Yet according to the World Health Organization (WHO), 1 in 4 individuals in any given population may at anytime in their life suffer from some sort of mental disorder and need help.

Thankfully “today the stigma is much less” than it was, said Healy. Due in no small part to efforts people like her have made over the years at places like the MHF, the stigma of mental illness on St. Maarten has lessened and the discussion is taking its rightful place in any properly functioning society: out in the open.

Mental health care for the island started at the White and Yellow Cross, yet up until 2001, when the MHF was established, there was little local professional and comprehensive care available. Prior to that, all patients had to be flown out to Curacao, a tedious and costly process that often didn’t work in the interests of the patient, who was cut off from home and family in a strange place far away. The person would be accompanied by a local doctor, nurse, and police officer. “The disadvantage was that the family was not involved in the care,” she continued.

Perhaps those worse off were people suffering from schizophrenia and who were often held in police cells during an emergency. “It was treatment in a police cell. Prison cells are the worst situation for schizophrenics,” Healy lamented. The echoes of a tiny confined space coupled with the voices of merciless strangers in the same cell and others nearby only make the hell more vivid and disturbing for the afflicted individual.

Schizophrenics are often troubled by auditory hallucinations, or hearing voices in their minds. Placing someone with the disorder in a holding cell, then, can lead at times to “serious accidents in prisons,” the director warned.

But mental health is a broad spectrum that covers a range of psychiatric disorders besides schizophrenia and obvious erratic and anti-social behavior. There are more subtle and insidious illnesses that people may suffer from that go undetected, like depression and bi-polar disorder, which are more prevalent than many realize and which may have far reaching socio-economic consequences.

Healy also pointed out that, because of depression, substance abuse is on the rise and “mainly among young people,” a worrying trend for the future well-being of the island, which is why the foundation maintains “lots of contact with schools.”Depression and substance abuse are often viciously intertwined, feeding off of each other in a nightmarish cycle.

The MHF building itself is an old converted hotel tucked away on a quiet street in Cay Hill. Nearly every square inch of the building has been turned into something useful and productive toward the treatment of those in need of care and support. Patients there are given a place of tranquility and respite for a time. There are therapeutic arts and crafts activities, like candle making and painting, which can be purchased on MHF’s website.

Still, a lot of care on St. Maarten is also handled domestically by family members, which is more beneficial to the patient as well as being cost effective. MHF helps by educating and supporting the family on proper care. “Family support is huge” here on the island, Healy said. “Love and care” is there.

The director estimates from her experience that at least “90%” of families looking after patients “really do care.” She added that there are “even employers that care and support employees” who are patients or who have suffered recently from a bout of mental illness.

The general, international trend in mental health care is moving toward domestic care and away from large, impersonal institutions, which are “closing down,” Healy said, especially due to rampant human rights abuses.

Patients at the MHF have since increased nearly tenfold since 2006, from about 50 to over 400 in 2012. This figure is still, however, quite low given the overall prevalence of mental health issues in a given population. If, for example, 1 in 4 individuals suffer from some sort of mental illness like the WHO states, St. Maarten may have just over 11,000 individuals out of its 45,000 or so people who suffer from at least a mild form of a mental disorder at some point in their lives. More often than not, it is treatable once identified.

“We’re still not seeing adequate financing and qualified staff,” Healy stressed. The island simply doesn’t have enough “locally trained staff,” while “salaries for qualified foreign staff is an issue” the director said, alluding to MHF’s biggest challenge in providing quality mental health care on St. Maarten: financing and qualified staff.

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