#38 - JAMAICA, MENTAL HEALTH FRONTRUNNER

ISSUE # 37

Real success is finding your lifework in the work that you love. - Warren Buffett

FUTURE REALITY

I am designing IkoCiti – a People's Impact Platform – to empower the powerless. We empower the powerless with resources to rebuild the barrios (neighborhoods/regions) they live in. We offer them an opportunity to become paid changemakers who design and implement social projects in their barrios. That sounds wonderful but how would it work in real life? Let’s make a journey in the future in which IkoCiti sets up shop in one of my favorite countries - Jamaica.

After gaining independence in 1962, Jamaica became one of the first countries in the world to take decisive steps to deinstitutionalize its mental health system and integrate it into primary healthcare, despite limited resources.

Mental health is unfortunately still a sensitive topic all around the world, and certainly so in the Caribbean. But notwithstanding, Jamaica has managed to build a mental health model that is worthy to be reinforced.

JamaiCAN

The Guardian published an interesting article [here] on mental health care in Jamaica. The efforts are focused on deinstitutionalizing mental health care. Of course, people are still institutionalized in Bellevue, Jamaica’s only psychiatric hospital, but staff and directors want Bellevue to be a frontrunner as a modern treatment center. The main challenge is as always – lack of funding.

Up to 80% of people with mental disorders live in low and middle-income countries. And while mental health has received increased attention after the Covid pandemic, this has not been reflected in global funding for psychiatric health. Only 0.3% of global health development funding is dedicated solely to mental health projects.

Jamaica has been a frontrunner in mental health innovation over the last decades. Today, up to 80% of Jamaicans with chronic mental illness are not hospitalized in Bellevue but receive treatment in local health centers or at home, thanks to mobile teams made up of psychiatrists and specially trained nurses. And that is impressive, given the financial constraints. So, how could the IkoCiti platform be instrumental in building the current, progressive model in Jamaica? Our role (the Maveriqs' role) is not to intervene in what the Jamaican specialists are doing – we are not specialists. What we could do is work on the other side of the equation – activate The People Factor.

• SHAME. By allowing patients to receive healthcare without being committed to Bellevue, [doctors] hoped to avoid the shame associated with mental illness while making treatment more accessible and cost-effective....... One thing Maveriqs could do is design different kinds of events to openly discuss mental health issues to reduce/eradicate the shame that still hangs around the topic.

• TREATMENT. What we found is that if patients are part of the decision-making process and accept treatment, they are more likely to recover and remain well over a long-term period. The biggest cause of relapse, especially for patients with schizophrenia, is non-compliance with treatment. When a patient is on board with their medication, the relapse rate can be cut from 50% to 3%. ………. Maveriqs could design projects that could raise treatment compliance. Optimally they would come up with projects that encourage people with mental issues to support each other to comply with successful treatments. Some sort of ‘buddy system’.

• SUPPORT FAMILIES. Inge Petersen, a professor of public mental health at the University of KwaZulu-Natal, says: To help patients live in the community families need to be offered support. Often in low and middle-income countries, the money does not follow the patient after they are discharged from the hospital………………. Maveriqs could implement (small) projects in which peer-2-peer support groups are formed to help support families. And when we say families, we are saying women as they carry almost all of the weight on their shoulders. Another avenue for some of the projects could be to confront and encourage more men to be helpful in the family caring part.

The Maveriqs don't have be original. They can copy successful projects from abroad and adapt them to the local situation. The most important thing is that they go out and be active in the barrios, (literally) touching as many people as possible.

IKOCITI ACTIVITIES

To achieve the impact we have described above, many different activities and interactions will take place in different districts in IkoCiti.

• The Collaboration District. Maveriqs, innovators, and local organizations come together to create a micro/macro strategy.

• The Manufacture District. Maveriqs design and implement social projects as well as collaborate on the so-called Peoples’ Impact Light projects run by social entrepreneurs.

• The Innovation District. Innovators come up with new or adapted ideas for the local situation.

• The Sales District. To support the Maveriqs, we trigger several creative (social media) marketing campaigns to raise awareness of the good work

• The Buyer$ District. Based on the marketing campaigns, we go out and raise extra money (buying power) to fund the local mental health projects.

• The Activist District. If need be, the local PI Movement formulates an activist strategy to reduce the negative impact of – let’s say – man-made socio-economic obstacles.

• The Smart District. Developing (third-party) educational materials suitable for the target groups becomes an important success factor.

• The Barrio District. The main factor is to formulate smart strategies to touch and activate the people of the barrios. And any approach needs to trigger self-propelling dynamics - positive momentum sustained by the barrio itself.

USEFUL FAILURES

There is one thing certain about our approach. It will generate setbacks, disappointments, frustrations, and failures. But when it starts working (not if) it will create a completely new ball game. It will fundamentally change how things are done. In the case of Jamaica and the mental health care system, IkoCiti will leverage – like nothing else - the great work of the specialists.

True social progress is painful because people have to deal with a lot of human pain and psychological conflicts. And you cannot navigate through without failures and setbacks. Empowering the powerless is not a wine-tasting party on a sunny Sunday morning in the park.

IkoCiti does not guarantee a fixed outcome. What it does is offer people are opportunities and the resources to convert opportunities into sustainable progress – at the individual and collective levels.

THE END

P.S. Don’t stay on the sidelines too long. It is cold out there.