Guyana Mental Health & Well-Being Conference     December 5 – 8, 2023 | Georgetown, Guyana


2023 Abstracts

Integrating Road Safety Education Into the Schools’ Existing Curriculum

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The spatial and temporal correlation of suicide in the United States

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Best Practices For Addressing Intimate Partner Violence (IPV) In Healthcare Settings

Intimate partner violence (IPV) is a major public health concern worldwide, with 1 in 3 women experiencing physical, emotional, sexual, and/or financial violence perpetuated by a current or former intimate partner. The prevalence of IPV is reported to be even greater in Guyana. According to data released by the United Nations, one in every two Guyanese women ages 16-64 have experienced such violence in their lifetime. Over half of the victims did not seek help, with the leading reason being the belief that violence is normal and not serious. IPV has significant mental health consequences, including PTSD, depression, and suicide, and is thought to contribute to Guyana’s high rates of suicide. The UN report also found that the majority of Guyanese women seek help from the police, religious leaders, and healthcare workers, with 98% reporting they did not seek help from institutions aiming to address IPV such as shelters and hotlines. These data reveal the critical role of healthcare workers in intervening in IPV and providing support to victims. However, the report found that fewer than 1/10 women who sought help from healthcare workers received counselling on IPV, revealing gaps in sufficient training and preparedness in the healthcare field.

This educational workshop aimed for healthcare workers will provide psychoeducation on how to screen for IPV and provide brief psychosocial therapies for survivors. The workshop will review evidence-based screening tools, risk assessments, and safety plans, including important questions to ask victims and how to provide trauma-informed care. It will also provide community resources available for survivors in Guyana. The workshop will also highlight effective therapeutic approaches to address IPV in global settings that have been identified in current literature. It will review important themes to emphasize when counselling survivors such as, motivational interviewing, promoting self-efficacy and empowerment, and addressing self-blame.

How To Cope With Patient Death

Introduction: Proficiency in handling the emotional impact of patient death is crucial in nursing practice, yet, the examination of how nurses navigate these situations is often overlooked in educational and care contexts. This research aimed to investigate the coping strategies employed by nurses in Guyana to manage the emotions triggered by the death of a patient. Objectives: The study sought to identify the prevalence of nurses who have encountered patient deaths in their careers and assess the coping strategies employed by those who have experienced such situations in Guyana. A quantitative approach was adopted, involving 85 Registered Nurses at New Amsterdam Hospital. A sociodemographic questionnaire and Lazarus’ coping style questionnaire were utilized, and all collected information was treated with strict confidentiality for ethical considerations. Methods: Participants, primarily women of African ethnicity with a diploma-level education, were predominantly engaged in medical units. An overwhelming 88% of nurses in the study had encountered the death of an adult patient during their careers. Strikingly, none of the participants had undergone any formal workshop or training sessions on coping with patient death. The
coping styles most frequently endorsed by nurses included planned problem-solving, self-control, and positive reappraisal. Results: Religious affiliation, particularly Hinduism, was associated with a higher tendency toward escape avoidance as a coping strategy. Notably, the study found that the frequency of religious practice did not significantly impact the adoption of coping styles in response to patient death. Conclusion: The findings suggest that Guyanese nurses exhibit effective coping strategies when confronted with patient death. Cultural factors, notably religion, were identified as influencing the coping styles adopted in the face of such challenging situations. This study underscores the need for increased emphasis on practical training and support mechanisms for nurses dealing with the emotional aspects of patient care.

Perceptions and Challenges of Nursing Students Towards Online Learning in Guyana During COVID-19: A Qualitative Study

Objective: To explore the nursing students’ perceptions and experiences of online learning during the COVID-19 Pandemic and to identify barriers and facilitators to online nursing education in Guyana. Design and Methods: A qualitative phenomenological approach was used. Five focus group discussions (6 to 8 students each) with durations of 60 to 90 minutes from five respective schools of nursing were conducted via zoom and recorded during January to March 2022. Data was transcribed from audio file to text file. Codes were generated using MAXQDA analytics Pro 2022 version 22.2.1.   Results: Thematic analysis led to the following themes and subthemes: There were mixed perceptions towards online learning. Some preferred online learning due to its “flexibility,” “Convenience” and “access to recorded sessions,” and others preferred face-to-face: Online learning is “good for theory only”, but for practical sessions face to face interactions is necessary, “Sense of isolation” “No student interaction” “less student- faculty interaction”. Barriers identified were “internet connectivity issues”, “Electricity issues” and “Technological issues”. Facilitators were “convenience” “reduced cost in transportation” “saves time” and opportunity to become “tech savvy”.
Conclusion: Online classes are suitable for theoretical aspects but require face-to-face interaction for practical components. Training is required in how to use the following online platforms. Students also encouraged tutors to use innovative ways of teaching.

Evaluation of Risky Sexual Behavior and Associated Factors in University Students in Guyana.

This study aims to create and strengthen Mental Health and Psychosocial Support by identifying gaps and opportunities for further Mental Health and Psychosocial Support programming and to share recommendations for planning future interventions with the MSM HIV community in Guyana.
Research Objectives: 1.) To assess participants’ perception of Mental Health and Psychosocial Support services in relation to the availability and accessibility for MSM HIV communities residing in studied regions 3,4, 6, and 10. 2.) To identify the most common mental health challenges faced by the MSM HIV population in Guyana. 3.) To identify what kind of Mental Health and Psychosocial Support needs are more desirable and relevant according to MSM HIV participants residing in regions 3, 4, 6, and 10. 4.) To inquire about the participants’ responses to the identified Mental Health and Psychosocial Support needs among the MSM HIV population residing in studied regions of Guyana. Methodology: The population of interest for the assessment consists of Human Immunodeficiency Virus-infected men who have sex with men residing in Guyana. A purposive sampling strategy will be employed for the target population, in which the researcher will rely on accessibility, availability, and willingness when choosing members of a population to participate in the study. Coverage: The participatory assessment of the HIV-infected men who have sex with men (MSM) population will be focused mainly on four Administrative Regions of Guyana, Regions 3, 4,6, and 10. Inclusion Criteria: Selection criteria will be based on the sociodemographic profile of the population: 1.) Gender: Males 2.) Sexual preference: Males 3.) Age: 18 years and older 4.) Health status: Infected with Human Immunodeficiency Virus. Exclusion Criteria: 1.) Individuals that are not HIV infected 2.) Individuals under the age of 18 years 3.) Gender: Females 4.) Sexual preferences: Females.

Electronic Medical Records (EMR) To Engage Support Services For HIV Patients That Become Follow Up (LFTU)

Clients enrolling in HIV/AIDS programs are expected to appear regularly for medical checkups, to collect Antiretroviral drugs (ARVs) and receive adherence counseling. When patients do not honor an appointment, they are considered non-compliant with clinic visits. After three consecutive and unsuccessful attempts, patients become “lost to follow-up (LFTU), a term used to define patients with no contact with the health services for 90 days or more” (Boulle, 2008). ” LTFU can cause serious consequences such as discontinuation of antiretroviral treatment and increased risk of death. In resource-limited settings, such as Guyana, where treatment has become available through the use of antiretroviral therapy (ART), LTFU hampers prevention, treatment and mental health services for patients enrolled in HIV/AIDS programs (Zhou, 2012).When clients default on a clinic appointment, information is passed to the staff to enter an electronic patient database called International Quality clinical chart (IQ Chart) (AIDS Relief, 2009). During this period, the program initiates methods to contact the patients using the information provided by the EMR. When a patient becomes lost to follow-up, the healthcare facilities are no longer required to provide prevention, treatment and support services for the client. The staff will continue to follow up with clients but these efforts are unsuccessful because patients may migrate, relocate or transfer to another healthcare facility. This paper is a pilot study conducted in 2011 to assess the capacity of staff at two of Guyana’s private healthcare facilities, St Joseph’s Mercy (SJMH) and Davis Memorial Hospital (DMH) on how effectively patients are tracked who are non-compliant and LTFU. The presentation will examine IQ Chart’s use to monitor patient retention in treatment and initiate contact for those who become LTFU to provide support services (counseling and support group meetings) in a bid to bring them back to treatment.

Wellbeing Assessment Tool And Data Management System For Psychologists is an innovative and comprehensive online wellbeing assessment tool and Data Management System for Psychologists in schools across Guyana. This powerful tool has the potential to transform the way we support students’ mental health, personal development, and academic success. By harnessing the advantages of this initiative, we can truly empower the Psychologist and enhance the overall growth and prosperity of our students in the education system.
How does it work? 1.) Selected schools will be registered on the website 2.) Each Psychologist will be given a login credentials 3.) Students visiting the psychologist/counsellor or the one needing intervention will take the tests/Assessment on the portal 4.) The counsellor generates the reports instantaneously and initiates intervention plan 5.) The Counsellor provides intervention and if needed a post test can be conducted to see the improvement 6.) The student and the institution data can be accessed throughout the year 7.) The data can also be accessed by the central office . Key Advantages of using this Software: 1.) Early identification and intervention for students who may be facing mental health issues, social-emotional difficulties, or other wellbeing concerns 2.) Enhanced Efficiency: Streamlines the wellbeing assessment process and data management, increasing counsellor productivity. 3.) Easy Data Collection: Facilitates comprehensive data gathering through digital assessments, eliminating manual entry. 4.) Centralized Data Storage: Provides a centralized location for secure storage and easy access to student wellbeing data. 5.) Real-Time Monitoring: Enables counsellors to track students’ wellbeing in real-time, allowing for early intervention and support. 6.) Data Analysis and Reporting: Generates insightful reports and analytics for identifying trends and areas of concern. 7.) Personalized Interventions: Utilizes individual student profiles and assessment results to tailor interventions and support.

Workshop: Professional Self Care For Mental Health Professionals

Exploring the premise that Mental Health has become the “Pandemic” within the Pandemic. Little or limited attention has been paid to how Mental Health professionals have been affected in their efforts to provide care for their patients. Mental health professionals have been overwhelmed in their efforts to care for their patients. The author and presenter has developed a clinical selfcare plan to empower support for Mental Health Professionals to engage in a self-development process to gain support for themselves and their peers. The presenter draws on his clinical experience of over two decades to develop an interactive seminar to engage the Mental Health professional in the process of understanding and implementing the importance of selfcare. The seminar will explore: Workplace mental health and the professional use of self, Personal Self Personality, Cultural Heritage, Belief System, Cultural Competency and how that informs our professional self.

Public Mental Health Policy

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Pesticides And Passion – Researching Suicide In Guyana

Background: The suicide rate in Guyana has consistently ranked in the top ten globally, yet there is only limited literature related to the context in which these suicides occur. This study aims to better understand the psychosocial circumstances and characteristics of suicides in Guyana. Methods: This case series study utilised a qualitative psychological autopsy method. One to three informants per deceased person (N = 31) were interviewed regarding the lives of 20 Guyanese who died by suicide (14 M, 6 F, aged 10-74 years). Interpretative Phenomenological Analysis was utilised for the data. Findings: Four superordinate themes were identified: Interpersonal Conflict, Trauma, Health, and Unknown Reasons. Interpersonal conflict included subordinate themes of Domestic Abuse, Marital Separation, and Financial Disputes. Health included subordinate themes of Physical Health and Mental Health. Pesticide poisoning was the method used by Guyanese people whose suicide was triggered primarily by interpersonal conflict. Interpretation: The findings illustrate the complexities of suicide in Guyana and the importance of adopting a biopsychosocial perspective to suicide prevention. Suicide prevention should include mental health and suicide literacy training of medical professionals. It is recommended that the importation of highly toxic pesticides be restricted, and that less toxic substitutes be promoted. Convenience sampling, recall bias, and limited informants are limitations of this study. Future research should focus on suicidal behaviour using larger sample sizes.

Access To Mental Health Care In Brazil: A Comparative Analysis Between The 2013 And 2019 National Health Surveys On The Association Between Individuals With Depression And Suicidal Ideation.

Suicide today is responsible for at least 800,000 deaths worldwide. Around 30% of suicides occur in low- and middle-income countries (LAMIC), making it the eighteenth cause of death in 2016 (WHO, 2016). Therefore, the objective of this present work was to investigate the evolution of suicidal ideation in Brazil, using the National Health Surveys (Programa Nacional de Saúde, em português) of 2013 and 2019 in the stratum of people with depressive symptoms, seeking associations between sociodemographic variables and geographic areas of Brazil. Methods: The study uses PNS data base from 2013 and 2019, a national household-based survey, focusing on samples of individuals who had depressive symptoms (14,303 individuals in 2013 and 2019), assessed using the Patient Health Questionnaire-9 (PHQ-9). Results: Today there is an increase in the prevalence of depressive symptoms, proportional to the increase in suicidal ideation, by approximately 10% between 2013 and 2019. In 2013, approximately 1,495 individuals presented suicidal ideation and in 2019, approximately 2,609 individuals in the depression symptoms sample.Furthermore, the proportion of individuals with suicidal ideation does not depend so much on the category or macro-region. This variation exists according to the population with depressive symptoms. Around 30% of people who present depressive symptoms have some level of suicidal ideation. Conclusion: Today there is a direct correlation between depressive symptoms and the existence of some level of suicidal ideation in this population. More studies are needed regarding which variables may be attributable to suicidal ideation in Brazil, as well as effective interventions in terms of public health in Brazil are extremely important.

The Struggle Is Real: Mental Health Issues Among Incarcerated And At-Risk Juveniles

I will seek in this presentation to shed some light into the challenging and often slighted and complex topic of mental health issues among at-risk and incarcerated juveniles. In a society where the Government is grappling with the realities of the juvenile justice system, even as it struggles to enact its own Juvenile Justice laws, and where civil society seems challenged by these new realities, this presentation will address the profound impact of mental health challenges on this vulnerable population. The presentation will look at some of the realities that underscore the prevalence of mental health disorders among juveniles under the care criminal justice system. It will draw on real-life examples and will explore the various factors contributing to the development and exacerbation of mental health issues among our local demographic. There are some limitations that Guyana, as a developing nation faces, so this presentation will address what I perceive to be some of the systemic barriers that incarcerated and at-risk juveniles face with regards to their mental wellness support. It will also address the issues of the importance of early and sustained interventions and offer some best practices and evidence-based treatment modalities to improve the lives of these juveniles and reduce the recidivism rates among them. This presentation will also include a discussion of Cognitive Behaviour Therapy, with a client-centered approach and the potential to transform the lives of these juveniles, creating more compassionate and effective rehabilitating results. Additionally, I will highlight successful programs and initiatives aimed at addressing mental health disparities among this population, showcasing international and accomplished models for future interventions. In conclusion, this presentation will seek to raise awareness and expand the understanding of the mental wellness challenges faced by incarcerated and at-risk juveniles. By recognizing the critical intersection between mental health and the juvenile justice system, Guyana can get to a place where equitable and compassionate approaches are afforded to support the well-being of these young individuals, and also promote positive outcomes for their future reintegration.

Parental Involvement With The Criminal Justice System (CJS) And Higher Risk Of CJS Involvement In Their Children: Modeling Causal Pathways To Children’S CJS Involvement With A Causal Discovery Machine Learning Approach

Children of parents involved with the criminal justice system (CJS) have higher rates of CJS involvement (e.g., being arrested) than the general population. However, research in children of parents involved with the CJS is scarce, and little is known about the factors involved in the “transmission” of risk for CJS involvement from parents to children. We will present findings from the Stress and Justice study, a two-wave representative study of parents involved with the CJS and their children, plus control parents and their children. We examined the relationship between parental involvement with the CJS and three main sets of variables: children’s psychiatric disorders, delinquent behavior, personality disorders, functional improvement, and CJS involvement. We applied a state-of-the-art machine-learning causal discovery analysis (CDA) algorithm that can distinguish causation from correlation due to confounding variables. With this CDA, we modeled the causal relationships among all variables in the data set to identify causal pathways leading to children’s CJS involvement. Discovering causal factors involved in children’s CJS involvement is essential to identify candidate intervention targets to reduce the risk of CJS involvement during childhood and adolescence.

The Intersection Between Structural Violence, Mental Health, And Racism

In New York City and many other states in the US, police officers are tasked with addressing issues of public health – homelessness, substance abuse, alcoholism, sex trafficking, mental health disorders and domestic violence. However, insufficiently trained officers and the disconnect between the law enforcement system and public health systems have resulted in police brutality, excessive use of force, and the continued cycling of socially marginalized and vulnerable groups through a deeply flawed criminal justice system. People of color experience a disproportionate impact of this form of violence. Similarly, in Guyana, police officers are frequently called to assess and intervene in matters associated with people with mental illness and thus, play a major role in the management of these individuals. Racism and particularly the negative stereotyping of people of color, both Afro and Indo-Guyanese in the case of Guyana, results in the dehumanization, stigmatization, and lack of investment of healthcare resources for people with mental illness. We will delve into examples of mental health co-response teams abroad as well as the intentional use of language to dismantle prevalent stereotypes that contribute to preventable, negative outcomes.

Considering The Role Of Religion In Mental Health And Well-Being

Religious belief has long been associated with lower rates of suicide. Despite its consistent presence in the suicide literature, the potentially protective mechanisms of religion remain little understood, much less implemented in mental health screening and intervention. The fact that this topic has received little attention is particularly surprising given that (a) 84% of the world’s population is religiously affiliated, with 68% of unaffiliated individuals believing in a higher power, and (b) that religion is an inexpensive and widely accessible resource to a significant portion of the population. Further, faith-based communities are often a source of hope and resilience for many, including those who lack access to licensed mental health practitioners. Here, we will present a training workshop for mental health practitioners, religious leaders, and community health workers on the potential role of religion in mental health care. We will consider the aspects of religion that may confer risk and resilience, respectively, when it comes to suicidality and will review research on the potential neuroprotective effects of religiosity and spirituality, as well as its impact on individuals and families across generations. Participants will be invited into discussion to consider various facets of religion as they apply to mental health and well-being. The training is intended to empower frontline workers and families to consider the role of religious/spiritual belief in the care of those struggling with suicidal thoughts and ideations, as well as other mental health challenges (e.g., depression, anxiety). Participants in the training will consider the ways religion may serve as a light in the darkness — as a source of hope and compassion for all those affected.

Assessment And Management Of Depression In Primary Care Settings

This is a clinical training for primary care clinicians in managing Depression in the primary care setting.

Putting Prevention Into Practice

Objectives: At the end of this Seminar, the participants should be able to: 1.) Delineate and describe the Preventive Medicine principles of primary, secondary, and tertiary prevention. 2.) Discuss the six precepts of Lifestyle Medicine, along with the underlying scientific evidence supporting each of them. 3.) Apply the principles of Prevention to enchance self-care and prevent burnout among pharmacists. 4.) Explain how pharmacists can help to ensure the broad delivery of high-quality patient care while preventing adverse events.

Attitudes Of Women Towards Domestic Violence In Guyana: Analyses Of A Nationally Representative Survey

Objective: To assess the attitude of women towards justifying domestic violence in Guyana. Methods: We used data from the publicly available Multiple Indicator Cluster Survey (MICS) conducted in Guyana in 2019. This survey uses a standardized questionnaire to collect data on sociodemographic, geographic and attitudinal indicators for a national random sample of women aged 15 to 49 years old across Guyana. The prevalence of women who agreed that a husband is justified in beating his wife was the main outcome we analyzed. Respondent reasons included if she: “goes out without telling him”, “neglects the children”, “argues with him”, “refuses sex with him”, “burns the food”, “has another partner”, “stays out late/partying”, “refuses to cook or clean”, “overspends”, and/or “he doesn’t have access to her cellphone”. We assessed women’s attitude towards DV for any of these 10 respondent reasons. Descriptive analyses were carried out for all the variables. Multivariate logistic regression and backward stepwise variable selection were used to identify factors associated with the outcomes.
Results: The prevalence of women’s attitude towards DV if there was a ‘yes’ response to any of the 10 reasons was 17.9% (95%CI: 16.6-19.3%) and varied from 2.7% if she “goes out without telling him”, “burns the food”, or “overspends” to 10.0% if she “has another partner”. This prevalence ranged from 10.2% in the urban area to 19.3% in the rural area, and from 16.1% in the Coastal to 30.1% in the Interior (p<0.001). About 40% of women in region 1 agreed that a husband is justified in beating his wife for any of the 10 reasons compared to 9.3% in region 10 (p<0.001). Similarly, 25.9% of the poorest women agreed with such attitudes compared to 11.6% of the richest women (11.6%) (p<0.001). Rural place of residence, ethnicity, geographic region, level of education, wealth quintile, use of a computer, and frequency of listening to radio were key factors associated with women's attitudes towards

Trauma Interventions For Men Who Use Violence In Relationships

Child abuse and neglect increase the risk of behavioural, physical, and mental health consequences that threaten health and well-being. It continues to be a global problem despite decades of research, the existence of child protective services, legislation, and other support services. Most intervention approaches do not adequately support fathers, husbands or partners who use violence as it does not address trauma-related issues and the need for reparation (Humphreys et al., 2019). Building services and programs that integrate a trauma-specific approach to support men and/or fathers who use violence within their families is needed. When working with fathers who perpetrate violence in their interpersonal relationships toward their children and family, it is critical to see them not just as perpetrators of violence but also as victims of their own history of child abuse or trauma who are traumatized themselves. Family Services of Peel developed a trauma-specific manual to train service providers who work with individuals who have been exposed to trauma. The modules are evidence-based and address the effects of trauma on the brain, behaviour, self-concept, and interpersonal relationships. Some tools that have been shown to have some effectiveness in men who use abuse are Narrative Exposure Therapy (NET), Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET), Integrated Cognitive Behavioural Therapy (CBT), Trauma Focused CBT (TF-CBT), Integrated Addiction and Trauma treatments (i.e., ATRIUM, TARGET, TREM, COPE, etc.). Integrating skill-building around stress management, emotion regulation, relationships, and parenting can support clients to function more effectively in their daily lives and support their trauma recovery. It is essential that counsellors adopt these approaches from an equity, anti-oppression intersectional, social determinants of health perspective that acknowledges experiences differ across groups based on various individual, familial, community, and societal factors that intersect to influence past, current, and future life circumstances. Such a perspective will also enable counsellors to take a client-centred approach, understanding the specific experiences and needs of the individual client in order to build a trauma-specific treatment plan that is most appropriate for