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Key points
- The Jamaican mental healthcare system is under-funded and under-resourced with few psychiatrists, psychologists, or social workers.
- There is considerable stigma associated with mental illness in Jamaica, often leading to avoidance, rejection, and even victimization.
- This can be a consequence of common misunderstandings about the causes of mental illness, which is often attributed to supernatural factors.
- There have been dozens of instances in recent years where the Jamaican police have shot people with mental illness, with other deaths in custody.
Jamaica is a small island nation with a population of around 3 million people. Despite its small size, Jamaica is a complex and dynamic society that has contributed to global culture in multifarious ways. For example, Jamaica is the birthplace of reggae and the Rastafari movement, and the Jamaican diaspora has created lively and energetic sub-cultures in places such as New York City, London, and Toronto.
As a visiting scholar at the University of the West Indies in Jamaica, and collaborator on various mental health research projects therein, I have learned much about mental health in Jamaica. Consistent with other lower-middle-income countries, this research indicates that the Jamaican mental health care system is under-funded and under-resourced.
Mental Health Services in Jamaica
There are few devoted mental health clinics in Jamaica, and there is limited access to psychological therapies and psychiatric medication. For example, A World Health Organization (WHO) report indicates that there is only around one psychiatrist per 100,000 people in Jamaica; by contrast, in the U.S., there are 13 psychiatrists per 100,000.
This report indicates that there are even fewer occupational therapists, social workers, and psychologists in Jamaica, meaning that psychosocial care for people with mental illness is often lacking. Moreover, there is only one mental hospital in the whole country, with few services in rural areas. All this means that many Jamaicans with mental illness remain untreated.
Mental Illness Stigma in Jamaica
There remains much stigma towards mental illness in the Jamaican population. For example, one comprehensive research study found that “the most commonly expressed emotional response to the mentally ill and mental illness was fear, often specifically, a fear of dangerousness.” This is especially so for those with severe mental illness such as schizophrenia, and often leads to avoidance, rejection, and even victimization.
This can be a consequence of common misunderstandings about the causes of mental illness. For example, another research study found that mental illness in Jamaica was often attributed to supernatural factors such as demon possession, witchcraft, or magic (known locally as Obeah). Indeed, this study found that exorcism was a common response to mental illness in Jamaica, indicating common fears and misconceptions.
The Police, the Law, and Mental Health
Sadly, there have been numerous instances in recent years where the Jamaican Constabulary Force (JCF) has shot people with mental illness. Indeed, a report from the Jamaican Independent Commission of Investigations (INDECOM) indicated that there were 22 incidents in 2020 involving the police where persons of "unsound mind" were shot by the JCF.
Moreover, other data indicate that people with mental health issues who are arrested and detained in Jamaica often experience physical abuse from police or other inmates. Indeed, the aforementioned INDECOM states “that about 12 detainees die yearly in the custody of the state, the majority being mentally ill people.” All this led Amnesty International to release a lengthy report decrying a pattern of “unlawful police killings” in Jamaica.
By its own admission, the JCF is not well-trained to deal with people displaying mental health issues. Indeed, the chairmen of the Jamaican Police Federation recently stated that “the police have not received special training to deal with the mentally ill,” leading him to demand more tasers as a first-line response to people with mental illness.
Clearly, this situation is not ideal and needs to change.
The Way Ahead
It is important to state that the issues identified above are common to many small lower-income nations, as they often lack the financial resources to develop and implement comprehensive mental health services. Moreover, mental health is rarely a policy priority, and mental health education in schools and elsewhere is lacking, leading to stigma and misunderstanding.
That said, small island nations like Jamaica can engage in some action to ameliorate the situation. This can include wider educational campaigns aimed at the general public to reduce misunderstandings and stigma, as well as targeted trainings to organizations such as the police to help them better deal with people with mental illness.
All this may help improve the lives of people with mental illness in Jamaica.
