Guyana, an English-speaking country situated on the northern coast of South America, has one of the highest suicide rates in the world. The country tallies about 29.2 suicides for every 100,000 deaths, a number surpassed only by Lithuania and Russia. This unsavory statistic can be an important indicator of a country’s relationship with mental health. The seven facts about mental health in Guyana show the variety of complex and interconnected factors that contribute to its high suicide rate.
7 Facts About Mental Health in Guyana
- Poverty in rural areas and alcohol abuse are major risk factors for poor mental health. While anybody can struggle with mental health, there are certain social patterns in Guyana that put some communities at greater risk for developing mental health issues like depression. Health workers have cited poverty in rural areas and the prevalence of alcohol abuse as possible factors that increase the risk of depression in Guyana.Rural poverty: About three-quarters of Guyana’s population lives in rural areas, both along the coast and in the interior. Of the 12 percent of people living in the rural interior, about 73.5 percent live in poverty and of the 60 percent of people living in rural communities along the coast, about 37 percent live in poverty. The poverty levels in these more remote communities are much higher than in urban areas, and they represent more dire situations as access to resources is more limited. About 70 percent of the country’s suicides take place in these rural areas.
Alcohol abuse: Some health experts have suggested a link between alcohol abuse and poverty in rural regions of the country. An article by NPR cited Guyanese government psychologist Caitlin Vieira in saying, “In these rural communities, there is nothing to do but drink.” Alcohol abuse can have detrimental effects on mental health, especially if the consumer is already struggling. In the long-term, experts have suggested that dependence on alcohol can worsen mood disorders such as depression. In the short-term, excessive drinking lowers inhibitions and can result in impulsive suicide.
- There is a severe lack of trained mental health professionals. With very few healthcare professionals trained in mental health treatment and those who are trained working primarily in urban centers, Guyana’s most at-risk populations often cannot receive the care they need. Part of the reason there is so few people trained in this field is because Guyana has an extremely high emigration rate. With over 55 percent of the country’s citizens living abroad, there are typically not enough professionals in medicine generally to meet the population’s needs. Luckily, the government is mobilizing to address this issue. In 2015, Guyana pledged to a National Suicide Prevention Plan that aims to increase the number of trained mental healthcare workers. Over the past two years, about 120 medical doctors have received training for depression and suicide intervention and are now scattered across the country. The number of psychologists and psychiatrists in the country remains low, at around 27, but has increased from just seven in 2014.
- Access to treatment facilities is extremely limited. Along with the lack of healthcare professionals, access to adequate mental health treatment facilities in Guyana is very limited. There are only two inpatient rehabilitation facilities in the country, and only one allows women. While some people find it easier and more effective for trained healthcare workers to visit their communities, others benefit from and require the immersive atmosphere of inpatient care. More health workers are being trained, but presently there does not seem to be any plans to expand care and rehabilitation facilities.
- The stigma surrounding mental health stops many struggling citizens from seeking help. The stigma around mental health in Guyana is stubborn and pervasive. Especially in the rural communities where people are most at risk, talk spreads quickly and citizens avoid getting the help they need for fear of backlash from their neighbors. Part of the reason for this stigma involves the Mental Health Ordinance of 1930, which continues to serve as the legislative framework for mental health services. The document refers to people suffering from psychological disorders as “idiots” and “deranged,” language that establishes those seeking help for mental health issues as unwelcome outcasts. Some areas even attribute mental illness to witchcraft, further ostracizing those struggling. Fortunately, researchers at the University of Guyana are working to address the problem. To promote wellness, they plan to study and share “local practices for building community mental health resilience” among certain Guyanese neighborhoods. Because these stories and solutions are community-based and not focused on the individual, the study is expected to decrease the stigma around mental illness and promote collective acceptance.
- Fear of prosecution also acts as a deterrent for seeking help. Aside from stigma, fear of prosecution and mandatory enrollment in a treatment facility are other reasons why people do not get treated for mental illness. According to the NPR article, 85 percent of patients seeking treatment end up spending more than five years in psychiatric facilities with no legal protections outlining their right to leave or refuse treatment. People are scared that if they seek help, they will be sent away with no way to protest. Additionally, because suicide is illegal in Guyana, those considering taking their lives are sometimes fearful that a report will get them in legal trouble. The police operate the country’s suicide prevention hotline, a fact that intimidates many people, even though very few have been prosecuted. Many citizens suffer in silence for fear that there will be consequences if they seek help.
- East Indians have the highest suicide rate among ethnic groups in Guyana. According to the National Suicide Prevention Plan, East Indians made up about 80 percent of Guyana’s suicides between 2010 and 2013, even though East Indians make up just about 40 percent of the population. Some have considered the history of East Indians in Guyana an important indicator of why suicide rates are so high. When slavery was abolished in the 1800s, landowners enlisted indentured servants from India as the new form of cheap labor. Therefore, despite being the largest ethnic group, East Indians have always been associated with poverty and low status in Guyana.
- Progress is ongoing. In addition to the various aforementioned steps being taken to address mental health in Guyana, a non-profit organization called The Guyana Foundation has been instrumental in developing “sunrise centers” in communities with high suicide rates. These centers focus less on psychiatric treatment and more on community-based wellness programs to reshape suicide-prone areas from the ground up. Sunrise centers offer courses that teach valuable life skills, such as IT training, photography and music lessons, in order to increase economic opportunities and provide stress relief.
As a result of the efforts from non-profits and legislation like the National Suicide Prevention Plan, Guyana’s suicide rate has dropped from 44.2 percent in 2014 to just under 30 today. While it is clear that improvements are being made, the country still has a long way to go in holistically addressing mental health. An overhaul of the outdated legislative framework surrounding mental illness may be the next step towards improving mental health in Guyana.
– Morgan Johnson