World Mental Health Day: Jamaican Health Care Workers providing Psychosocial Support to Children and their Caregivers
Caregivers and families attending well child visits in Jamaica.-Photo credit: Diana Chamrad, URC.
KINGSTON, JAMAICA- I recently traveled to Jamaica for the first time. The USAID ASSIST Project has been working with the Jamaica Ministry of Health (MOH) over the past year to strengthen health services in the context of Zika. ASSIST is collaborating with the Jamaica MOH and the American Academy of Pediatrics to ensure that the Jamaican health care providers’ knowledge is up to date to assess children under two years for neurodevelopmental milestones according to the MOH guidelines and that those children identified as having suspected developmental delays are referred for and receive appropriate services.
And where I come in to the picture as a clinical psychologist, is that ASSIST is also working with the MOH Mental Health team to build on existing guidelines for health care workers to provide psychosocial support to caregivers, children, and families during their visits to child health primary care clinics, particularly as they deal with developmental delays.
Psychosocial support is assistance from a health care worker that aims to protect or promote psychological and social well-being and/or prevent or treat a mental disorder. Most people will never see or talk to a mental health counselor or therapist – however, most people do talk with their health care provider many times over their life time, especially during pregnancy and childhood--a perfect time for health care providers to be armed with tools for helping those patients with psychosocial coping skills.
In meeting with the MOH Mental Health team, they told us that they would be engaged in Mental Health Week and World Mental Health Day (WMHD) activities throughout this week. Every year on October 10th, people around the world observe WMHD, an opportunity to draw the public’s attention to mental health concerns that affect us all, regardless of nationality, sex, income, or age. This year’s WMHD theme, Young People and Mental Health in a Changing World, reminds us of the challenges that youth face worldwide as they go through the physical, emotional and social changes of adolescence in a world that is not always so easy to maneuver. And the adolescents affected by poverty, violence, epidemics, and natural disasters are particularly vulnerable to psychological distress.
Worldwide, half of all mental illness begins by age 14 years, but many of these affected young people do not receive treatment because their signs of illness go undetected. Depression is the third leading cause of disease burden in adolescents, and suicide is the second leading cause of death among 15-29 year-olds. Adolescents are typically more driven by emotion and short-term rewards than reason and long-term consequences and, especially under the influence of alcohol and drugs, are more prone to engage in risky behaviors like unsafe sex and reckless driving.
I’ve learned that Jamaica experiences similar mental health issues with their youth and young adults. The Jamaica Health and Lifestyle Survey (2016-2017) found that youth aged 15-24 years and young adults aged 25-34 years suffered the highest overall prevalence of depression (along with persons in the over-75 years age group). The Global Health Survey (2017) found that approximately 25% of adolescents aged 13-17 years reported plans to commit suicide and 18% reported they had attempted suicide.
Fortunately, we’ve learned through research that we can help caregivers, children, adolescents, and families develop the skills they need to become healthy and productive young people, contributing to their families and communities. The most common response to adversity is healing and an eventual return to normal life through resilience, the ability to “bounce back”.
Our task as health providers is to help our patients face the adversity of a health or pregnancy challenge, such as Zika virus infection, and move on to deal with their situation in a realistic and positive manner. We focus our support on the primary factors associated with resiliency, including:
• Maintaining caring and supportive relationships within and outside the family
• The capacity to make realistic plans and take steps to carry them out
• A positive view of oneself and confidence in one’s strengths and abilities (self-efficacy)
• Skills in communication and problem solving
• The capacity to manage strong feelings and impulses.
I’m looking forward to working with the health care workers in the Child Health clinics throughout Jamaica over this next year. I’ve already picked up on how incredibly committed these workers are in delivering services to caregivers and children. We will all be learning together.