Words by Nneka Samuel
Depression, bipolar disorder, schizophrenia, OCD. These and other mental health issues continue to be met with increased understanding and discussion throughout the Caribbean, thanks in part to the work of services like the Caribbean Mental Health Consultants, a Barbados-based psychotherapy service headed by Dr. Natalie Moore, who has over 10 years of experience in mental health.
Psychology is a relatively young profession in the English-speaking Caribbean. One of the biggest obstacles facing Caribbean nations when it comes to the practice of psychology, according to Dr. Moore, is “a lack of awareness about the general range of subdisciplines in psychology and, therefore, the scope of psychological services in terms of promoting health and well-being.” Some of these subdisciplines include behavioral, cognitive, developmental and social psychology, to name a few. The expansion of these area speaks to an obvious growth of knowledge, which can in turn ensure better care for respective patients.
This lack of awareness on behalf of medical professionals and patients alike, however, especially in smaller and less populous Caribbean countries, has contributed to unmet mental health care needs. According to Dr. Rita Dudley Grant of the Virgin Islands Behavioral Services, surveys conducted in numerous Latin American and Caribbean countries in 2006 concluded that nearly 80% of people with mental health problems do not have access to health or mental health services.
Dr. Donna-Maria Maynard, a lecturer in Clinical and Counseling Psychology at the University of the West Indies in Barbados, writes in the Interamerican Journal of Psychology (2013, Vol. 47, Num. 2) that in the Caribbean, people are more likely to seek medical attention for a physical ailment or illness, as opposed to a “psychological complaint.” Additionally, she suggests that many Barbadians in particular view mental illness as indicative of a loss of faith in God or some kind of demonic possession of the mind. Seeking the counsel of a priest or pastor would feel more comfortable than that of a psychologist.” Dr. Moore notes that some believe if their faith is strong enough, there should be no need to seek psychological help. However, she merits that with increasing numbers, “churches are recognizing the value of providing psychological support for congregants via universal prevention/intervention, such as inviting psychologists to speak to church groups about topical social issues, as well as by more targeted interventions, such as recommending psychological evaluations and psychotherapy.”
As a proponent of “positive psychology” – a scientific study that promotes factors that enable individuals and communities to live meaningful, fulfilling, thriving lives – Dr. Moore suggests “a perspective shift is needed from the management of mental illness to the promotion of mental health.” This shift can aid in erasing the stigmas associated with mental illness and psychotherapy. It can also promote sustainable, long-term care.
Professional long (and short) term mental health care in Barbados, where Dr. Moore practices, is free of cost at public, government-funded health institutions, such as Queen Elizabeth Hospital, Polyclinics and The Psychiatric Hospital. However, Dr. Moore says there might be significant wait times to seek treatment, which may hinder certain individuals or populations from receiving the help they need. Health insurance does pay, in part, as well as reimburse patients seeking private psychological or psychiatric help.
Curious as to what a typical treatment plan for patients dealing with issues like depression or anxiety, for example, might look like? Dr. Moore breaks the process down in seven steps. The plan includes:
i)Assessing the nature, severity and duration of symptoms,
ii)Determining what, if any, solutions the client has attempted in the past and, if so, the effectiveness of these,
iii) Examining the strengths, supports, and stressors in the client’s life,
iv)Helping client to articulate desired treatment goals,
v)Working with the client to systematically shift established patterns of thinking, feeling and behaving, by tasks inside of session and in the real world
vi)Supporting and validating client’s experiences and the challenges inherent in creating meaningful change
vii) Helping client to evaluate change, to acknowledge progress, and to utilize previously acquired skills in addressing other therapeutic goals.
The ultimate goal is for the patient to demonstrate increased psychological well-being via the consistent use of more functional cognitive, behavioral and emotional skills, while also decreasing the use of less functional skills. Once adequate treatment is sought, which can take anywhere from weeks to months to years, depending on a number of factors, patients work to maintain success out of the office and in their everyday lives. Psychologists can offer clinical, professional assessments and care void of judgement and in a safe environment. If you or someone you know is in need, help is readily available and at your disposal.