Minister of Health, Donville Inniss????

With mental illness currently accounting for 12 per cent of the total burden of disease worldwide, and likely to represent 15 per cent by 2020, Health Minister Donville Inniss believes that such projections require services be re-evaluated and programmes enhanced to meet the needs of our local population.

The Minister made this call today, as he addressed the second workshop of the National Mental Health Commission, entitled "Mental Health 101", at the Accra Beach Hotel and Resort.

??Mr. Inniss said: "With the expected increase in the incidence of mental disease, it is important to be aware, sensitive and humane to ensure that those affected, are encouraged to receive care as early as possible and to manage their condition, unhindered by stigma or discrimination."

And, he told those gathered: "…By creating partnerships with the many organisations and agencies represented here today, the National Mental Health Commission is guaranteeing that the reform efforts being initiated by the Ministry of Health are not limited to the health sector, but are being implemented at all levels within the community.

In his address, the Health Minister also registered his frustration that over time, trained community mental health nurses had been forced to return to institutions to work, in order to gain additional increments or promotion. Mr. Inniss pointed out that this

resulted in a loss of their skills in the community and a waste of resources, and investment in their training. He disclosed, however, that last year, after great efforts, the Health Ministry had been able "to have 15 such positions resolved, allowing it to continue with its community mental health programmes".

The Minister maintained that patients with mental health issues required "other kinds of care as well, within the hospital setting."

Noting that it was not an equitable or safe situation, Minister Inniss indicated: "I am pleased to see that we have been able to create some 50 posts of General Nurses at the Psychiatric Hospital, to which some 27 nurses were recently appointed, retroactively. Clearly, one recognises how the very centralised nature of public administration in Barbados, despite its best intentions, can be a major source of frustration and delays on the island."

Participants also heard too that the issue of mental health management could not be addressed by the Ministry alone and that over time the services of private sector and Non Governmental Organisations (NGOs) had been employed. "Some $2.6 million is spent on an annual basis with private entities to help us address the challenges of substance abuse in Barbados," the Health Minister revealed. However, he stated that the success of these relationships could not be measured since the Ministry lacked effective service level agreements with some of these entities.

He declared: "This is not acceptable… It is my considered opinion that each dollar provided to NGOs by the Ministry of Health must be accounted for and we must have service level agreements in place and be able to measure the success or failure of such relations; and not by just reading a glossy annual report consisting of lovely photographs, perfect English language, and complex financial reports."

Stressing that he was not condemning NGOs, Mr. Inniss underlined: "Most of them [NGOs] do succeed where Government fails and hence can be considered to be quite effective. But to have your operations almost entirely financed by Government without accounting for the subventions or other forms of payment, [is indicative of] a Government department run by the private sector, without clear rules of engagement."

He further identified that as a start, the Ministry, in collaboration with the Pan American Health Organization, recently concluded an assessment of its Residential Substance Abuse programs. The report, the Health Minister announced, would be discussed with relevant stakeholders for implementation of the necessary changes to benefit taxpayers and end-users.

On an institutional level, the Health Minister called for the development of cost effective solutions directed at each individual in the society.?? Among these, he listed the need for early childhood intervention, at the psycho-social level; support to children in the school environment, socio-economic empowerment of women, and support for the elderly.

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