1. Objectives
To promote mental health through public
education and sensitization;
To eliminate the stigma associated with
mental illness;
To improve the efficiency in the delivery
of mental health care;
To provide for more equitable access to
care
      

2. Objectives (Cont.)
To empower citizens to be active participants in the Management of their health
Encourage healthy lifestyles by the sharing of information and the provision of technical assistance to the communities
    

3. To reduce the long-term unit cost of
mental health care
 To contain the aggregate cost in the
medium and long-term
  To reposition the focus on mental health
care from institutional to community
base care
  To contain the aggregate cost in the

4. Objectives (Cont.)
To encourage public and private sector
cooperation in the delivery of mental health
care
To fully integrate mental health care into
the primary health care system;
·    To encourage and prepare persons
affected by mental illness to return to the
society and to engage in meaningful
economic and social activity.

5. Mental Health Reform
The reform process benefitted from information from various sources
Facility Assessment Study
Health Sector Rationalization Study
PAHO technical cooperation in Health
A new vision for Caribbean Health 11
Psychiatric Hospital Strategic Plan
Needs Assessment
Service Mapping exercise

6. Development of Framework Plan
Based on the recommendation made in the
Psychiatric Hospital Strategic Plan, the Ministry of
Health developed a strategy for the reform of the
Mental Health Services and a project proposal for
the physical development of the Psychiatric
Hospital.
Requested PAHO technical assistance in costing
the various options

7. Development (Cont.)
August – Jose Miguel Caldas de Almeida,
Coordinator of PAHO’s Regional Mental Health
Programme visited Barbados to review the options for the development of the physical plant.
Recommendations:
Acute psychiatric care should be viewed
within the context of an overall of mental
health plan, with careful attention being paid to
the size of the acute care unit and the
strengthening of the community mental health
services.

8. The recruitment of a consultant to advise on the
reorganization of the mental health services
within the framework of a plan

9. Development of Current Plan
January - Recruitment of consultant,
Dr. Colin Rickard, Planning Director of Royal
Free Hempstead NHS Trust
With the input from a number of local
stakeholders the plan was completed in Sept
2001

10. Proposal for The Reform The Mental Health Services
Main Components:
Reposition the major focus of mental health care
from Institutional to community base Care.
Emphasis on health promotion
Development of a communication strategy for
public education and sensitization and
interagency collaboration

11. Review and update current legislation to
facilitate the change of focus and to address
the civil and human rights of the patients.
Refurbishment of current physical facilities
to accommodate 300 patients
Appointment of a project coordinator for the implementation of the project.
Development of the necessary human
resources to support the programme

12. Six-year plan to be implemented in two phases Phase 1. Pilot Project
Plan For Implementation
Six-year plan to be implemented in two phases
Phase 1. Pilot Project
Development of the infrastructure for the main
Programme.
To test operational policies &inter-agency
workings
Develop a costing model for the main
programme

13. Full expansion of the programme
Main Programme
Duration – four years
Full expansion of the programme

14. Achievements
Human resources
Training of the first batch of six
Community Mental Health Nurses
completed. The second batch is currently
being trained at the BCC
Accelerated training especially in nursing
Over 70 persons currently being trained at
the BCC

15. Continuous Quality Improvement programme
started
Interagency collaboration
Mental Health Officer assigned to the court to
assist the magistrate in assessing the mental
health of defendants and broadening the
sentencing options.
Public Education and Sensitization
Community outreach programme started
Publication of a magazine “Brain Wave,” 1500
copies distributed. This will be an annual
publication

16. Mental Health Practitions visit school, churches and other communities groups to give talks or Mental Health.
Seminars conducted by PAHO for police
and prison officers
Project Coordinator
There has been no formal appointment to
this position but a social worker from the
ministry has been assigned to coordinate the processes.

18. A draft revision of the Mental Health Act has been completed and is currently being reviewed by the Legal and Human Rights division of PAHO

19. The Ministries of Health and Education are
The Ministries of Health and Education are conducting a survey on Mental Health Issues Among Primary School Children
Workshops being planned for the sensitization
and education of health care workers
A five year plan to renovate the Psychiatric Hospital has begun. This is designed to make the plant more clients friendly and improve its therapeutic value.

20. Facilitating Factors
Private sector involvement in the area of
substance abuse
Training being conducted at BCC and UWI
Incorporation of the mental health plan into
the National Strategic Plan for Health
PAHO’s Support

21. Challenges
Housing
Stigma
Human resources