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PAHO Chief Urges Caribbean to Expand Mental Health Services


WASHINGTON– The director of the Pan American Health Organization Director (PAHO), Dr. Carissa F. Etienne, is urging Caribbean countries to expand and invest in mental health services to cope with the effects of the COVID-19 pandemic.

“The COVID-19 pandemic has caused a mental health crisis in our region at a scale we’ve never seen before,” the Dominican-born Dr. Etienne said, adding “it’’s a perfect storm in every country, as we see growing needs and reduced resources to address them.


“It is urgent that mental health support is considered a critical component of the pandemic response. Mental health and domestic violence services are essential services, and we must place emphasis on addressing the gaps that have been laid bare by the pandemic.

“Today, I ask countries to take the steps required to ensure everyone can receive the care they need and deserve,” she urged.

Dr Etienne noted that coronavirus cases in the Americas have reached almost 11.5 million and over 400,000 people have died.


“The Americas have approximately 13 per cent of the world’s population, but 64 per cent of officially reported global deaths,” she said, stating that the pandemic is having a serious impact on health workers, “who are working longer hours than ever before and risking their own lives as hospitals struggle to maintain sufficient Personal Protective Equipment.

“After months of operating in crisis mode, our health professionals are facing burnout, anxiety and depression,” she added.


Dr. Etienne said the most effective steps are to hire and train more health workers, and integrate mental health and psychosocial support within primary health care systems, “so they’re easily accessible to those who need them most.

“Everyone who needs mental health support should feel comfortable asking for help. No one should have to suffer alone and without professional support, especially now.

“Naturally, some of the same concepts apply to domestic violence.These services must be accessible and integrated at the local level; we need innovations to reach and support survivors, and it is paramount to fight stigma. Violence is never acceptable, and survivors of domestic violence should not be blamed.”

The PAHO director said the real extent of domestic violence during COVID-19 is likely under-estimated, “as survivors are stuck at home and support and outreach services are interrupted.

“With reduced contact to friends and family or barriers in access to services and shelters, we’re leaving survivors with nowhere to go. The costs of violence are extraordinarily high, so support to survivors cannot be put on hold.”


Dr. Etienne said PAHO has been helping countries to strengthen policies and services, and expand online learning for health workers, “so they know how to identify and support survivors of violence during the pandemic, and some places using novel approaches to ensure survivors of violence can ask for help discreetly, such as through code words or hand signals.”

She said patients who have tested positive for COVID-19 also experience insomnia, delirium or even depression, adding that “many persons are overwhelmed with fear of developing severe illness; others are understandably worried for their lives”.

Dr. Etienne said initial research indicates that “as much as a third of patients recovering from COVID-19 can have enduring changes in their mood and suffer from anxiety or depression.”

She said mental health illness is a silent epidemic that has affected the Americas well before COVID-19, with depression and anxiety listed as two of the leading causes of disability.


In addition, Dr. Etienne said the region also has the second-highest level of alcohol consumption in the world, stating that emergencies can worsen these conditions.

During the pandemic, she said “many of us have felt fearful of infection or anxiety if we are sick; grief as our loved ones have succumbed to the virus; uncertainty about the future, as jobs and life as we knew it came under threat; overwhelmed by the news and misinformation; and lonely or isolated after weeks or even months of social distancing.

“We are all suffering – especially those affected by pre -existing mental health conditions. We must step up so those living with mental health conditions, as well as survivors of violence, have the resources and support they need.

“This pandemic reminds us, like never before, that good mental health is necessary for the wellbeing of individuals and societies,” the PAHO director added.

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