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The Sub-Regional meeting of Mental Health Stakeholders in the English-speaking Caribbean countries was organized by the Office of Caribbean Program Cooperation (CPC) in conjunction with the Mental Health Unit of PAHO/WHO, Washington D.C., and was held in Barbados, on 26th and 27th of July, 2007.
It was attended by 23 professionals from the mental health field, representing 16 countries from the Sub-region. A CARICOM representative was also present.
Objectives of the meeting were:
- To review the overall current situation in the mental health field in the English-speaking Caribbean Countries and identify constraints and positive factors in implementing previous Strategic Plans/ Reports in Mental Health at national and sub-regional level,
- To agree on the process to finalize the Mental Health Strategic Plan for the Region
- To identify the way forward to implementation of the national mental health plans with particular attention to mental health component in PHC, decentralization of MH services, human resources and information system.
- To begin a process of Assessment of Mental Health System in the countries of sub-region, according to the WHO methodology (WHO-AIMS).
- To review the indicators proposed in the Caribbean Commission on Health III
- To improve the technical cooperation of PAHO in the next biennium.
In her introductory remarks at the opening ceremony Dr Gandi (CPC) emphasized the need to finalize a common mental health framework based on existing documents, aligning them with the Caribbean Cooperation for Health III, where mental health is one of 8 priorities identified.
Mrs Sandra Plummer, Deputy Program Manager Health Sector Development, CARICOM, reminded the audience that mental health was one of the three main priorities identified in the Sub-region and thus it becomes paramount to have a regional strategy that considers not only the clinical aspects but also the relationship between mental health and other social issues.
Dr Jorge Rodriguez (Mental health/PAHO) provided the regional vision and perspective of the mental health situation. Legislation and human rights in the region was also discussed, introduced by Mr Javier Vasquez (Human Rights Regional Advisor/PAHO). The WHO-AIMS (the mental health system assessment tool) was introduced by Ms Dévora Kestel.
There were two presentations from the Sub-regional perspective: Dr Margaret Hazlewood (Consultant PAHO) and Dr Wendel Abel (UWI) introduced the findings of an in-depth assessment of existing documents and current situation of mental health in the sub-region.
Four "best practices" from the Sub-region were then presented. The countries (Bahamas, Belize, Dominica and Jamaica) introduced their experience. The objective of sharing best practices was to promote their possible utilization as models for other countries with similar conditions. See Best practices examples at Annex 4.
The following recommendations are the result of the working groups’ sessions.
Recommendations – A way forward
- Data collection: Regional strategy for the collection of core mental health data for evidence based planning and decision making; Standardize across regions – attitude surveys; Public education aimed at stigma reduction correcting cultural and historical misconceptions
- Preliminary assessment: implementation of WHO-AIMS urgently (measurements conducted by each country to define the size of the problem in each country – incidence and prevalence); set goals and strategies in relation to above
- Human Rights: Training in human rights: request PAHO to provide preliminary training workshops
- Mental Health Coordinators: Strong lobby (PAHO/CARICOM) to member states for the appointment of a dedicated, mental health coordinator to "drive" all reform activities. Coordinator not necessarily a clinician! The case of St. Lucia
- Information sharing: disseminate "best practices"; print and circulate tools, instruments, manuals; to facilitate an appropriate, standardized information system to support data collection
- Need of a champion: Identify a regional champion to push the agenda through Caucus.
Immediate and mid-term follow-up activities
- Review existing Strategic Plan (draft 2002) before next Caucus meeting:
- Identify a small working group
- Define Terms of Reference and outputs
- Review and align the Strategic Plan and the CCH III with the WHO 2001 Mental Health report (10 recommendations)
- Possible short consultancy to coordinate group work
- To review the situational analysis using the AIMS to categorize countries according to their identified needs
- Do pre-Caucus lobby
- Final document submitted PAHO
- Develop vision, values, principles and objectives
- Determine Priority areas for action
- PAHO to provide technical support to assist countries to develop Strategic Plan
- PAHO to provide technical support to develop Operational Plan
- PAHO to monitor countries' implementation of operational plan
- Periodic Monitoring and Evaluation
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