Making mental health a mainstream issue

The issue of mental health comes up regularly in the press conferences updating the nation on covid19, but discussion on the issue has been would-be reassuring but unconvincing.

It was impressive to hear Assemblyman Farley Augustine take the lead on Thursday during a debate at the Tobago House of Assembly, making a bold call for a rethinking of the institutional approach to mental health patients and substance abusers.

Mr Augustine, a deputy political leader of the Progressive Democratic Patriots, pointed to a troubling Catch-22 in the formal systems for managing patients with a chemical dependency, referencing a cocaine user he knew who could not go for rehabilitation because he would lose his job.

He pointed to the related practice that determines a mentally ill person is “medically unfit,” and terminates employment pending treatment.

He also called for more intervention from mental health facilities on the island among the population of street dwellers. Currently, mental health workers don’t get involved with socially displaced people in Tobago unless they have an apprehension order from the court or are directly referred by a family member.

At the best of times, the response of state medical facilities to the mentally ill has been inadequate.

For anyone prone to anxiety or with poor coping mechanisms, this pandemic is the worst of times.

The ability to respond to stressful situations diminishes significantly in these circumstances of enforced isolation. While such restrictions demonstrably reduce the spread of covid19, they create an environment in which mental illness and substance abuse are likely to flourish.

Helpful and supportive communities are key to managing both forms of disability. Without any ready way to provide or encourage such groupings, there is a need to establish state-driven virtual responses to managing mental health.

It definitely makes sense to review the concerns raised by Mr Augustine, which identify points of failure in the first response management of mental illness. The establishment of adequate, publicly accessible virtual points of contact, staffed by qualified mental health professionals, is another.

Mental illness festers in solitude, and chemical addictions thrive on secrecy. Drug-abuse relapses and mental health collapses are an entirely predictable consequence of the way we must live today.

In Trinidad and Tobago, we need to create systems to handle issues of mental health and substance abuse that acknowledge the difficulties of covid19. We need to establish or refine workplace systems and protocols to handle these issues, allowing treatment without terminating employment.

Formally acknowledging these realities, which can affect as many as one in four citizens, is a start toward raising of empathy and awareness and will benefit the country beyond the challenges of the pandemic. The mental-health issues aggravated or triggered by the pandemic will last long after the physical challenges of the virus are brought under control.