Saint Vincent and the Grenadines (SVG) is an Eastern Caribbean country with limited inpatient and outpatient resources to meet the country's mental health needs. In preparation for integrating mental health care into the primary care setting, we assessed knowledge of and attitudes toward mental illness among primary care providers in SVG. From October 24-November 11, 2011, we visited a convenience sample of District Health Centers in SVG. We gave a multiple-choice-answer, self-administered questionnaire to primary care providers and then administered a structured interview. Survey responses were analyzed for frequencies and interview transcripts qualitatively analyzed for major themes. We completed 53 surveys and interviews representing all nine SVG Health Districts. Results demonstrated a provider population with basic, but inadequate, knowledge of mental illness diagnosis and treatment. Results also revealed a curious and interested group of providers who felt mental illness should be a health priority and were willing and eager to receive further mental health training. Providers suggested strengthening resources in existing district clinics, providing additional staff training sessions, establishing positions with a dual health and mental health role, instituting annual mental health screening examinations, and creating weekly mental health clinics. Integrating mental health care into primary care necessitates involvement of primary care staff during the planning stages, and this study initiates an intensive effort to do so in SVG. Results have led to the development of a "mental health check-up" tool, which we hope will improve access to mental health care in this community.

Objective: To pilot a newborn screening program for sickle cell disease (SCD) in St. Vincent and the Grenadines using a novel partnership method to determine the feasibility of a universal newborn screening program in this country. Methods: A prospective study of mothers and their newborns was conducted between January 1, 2015, and November 1, 2015, at the country’s main hospital. Mothers of infants born at this hospital were offered screening for SCD for their infants. If accepted, the newborn’s heel-stick blood specimen was obtained and mailed to the South Carolina Department of Health and Environmental Control Newborn Screening Laboratory for testing. Samples were analyzed for variant hemoglobins using standard laboratory techniques and results were communicated to local physicians. Feasibility was determined by a benchmark of having >50% of SCD patients receive the diagnosis and initiate disease-specific care by 3 months of age. Descriptive statistics were completed using SAS 9.4. Results: There were 1147 newborn infants screened for SCD. Of these, 123 (10.7%) had results indicative of sickle trait and 3 patients (0.3%) were diagnosed with SCD: 1 with HbSS and 2 with HbSC. All 3 patients with SCD received treatment before 3 months of age. Conclusions: A newborn screening program is feasible in this population when partnered with an established newborn screening laboratory.

The Icahn School of Medicine at Mount Sinai and the Saint Vincent/Grenadines Ministry of Health, Wellness and the Environment have been collaborating since 2012 in addressing the plight of alcoholism in Saint Vincent and the Grenadines (SVG). SVG is a middle-income country with few resources available for those who suffer from alcohol use disorders, and these efforts have centered on establishing and monitoring alcohol self-help groups based on the "Alcoholics Anonymous model" (AA model) in several communities in Saint Vincent and the Grenadines. In the summer of 2014, the efforts evolved to include an in-depth investigation of the experience of members of self-help group members via the qualitative research method known as Photovoice. Photovoice is a community based participatory research method in which a set of research questions are explored qualitatively through photographs, interviews, and focus groups. In June 2014, a Photovoice project was established with the longest running self-help group on the island of Saint Vincent in the fishing community of Barrouallie. This project consisted of three rounds of photo-taking, individual interviews, and focus groups, and analysis of the data revealed a number of broad themes relevant to perceptions about the impact of problematic drinking and about drinkers themselves; about the applicability of the AA model in SVG; and about factors that may perpetuate or mitigate problem drinking. It was evident that current and recovering alcoholics believed that there were different types of drinkers who because of their gender, public drinking or tendency for violence could be labeled as "irresponsible." These findings suggest areas for future interventions and research in SVG.

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Elements that contributed to the sustainability of self-help groups included strong local leadership from district health nurses as well as willingness of participants to seek support. However, efforts need to be made to increase community awareness of alcohol use disorders and its associated dangers. Our results suggested self-help programs to address alcohol use disorders are a feasible intervention in Saint Vincent that warrants further development, dissemination, and exploration.