Psychiatry in Jamaica—Growth and Development

Abstract

The history of psychiatry in the Caribbean island of Jamaica is presented based on ethnohistoriographic accounts of large group meetings of patients and staff of the Bellevue State Mental Hospital in the late 1970s. The development of psychiatric services is described from pre-colonial days of the indigenous Arawak Indians. The existing mental hospital was established in 1862 by the British Colonial Government, and the Mental Hospital Act of 1873 created the system whereby the mentally ill were arrested for lunacy and incarcerated in the mental hospital by Magistrates order. The development of a Community Psychiatric Service and the establishment of a deinstitutionalization programme for the mental Hospital in the decade ofthe 1960s and 70s is described, and a review of the private and public community services presently existing in the island is also described. A brief review of the existing literature on Jamaican psychopathology is presented, including a discussion on schizophrenia in Afro-Caribbeans, other common psychiatric conditions, developments in psychotherapy in Jamaicans, and psychodynamic issues of cultural identity. Int Rev Psychiatry Downloaded from informahealthcare.com by University of Newcastle Upon Tyne on 11/04/14 For personal use only.

Young Jamaicans' attitudes toward mental illness: Experimental and demographic factors associated with social distance and stigmatizing opinions

“…Systematic research on mental illness in Jamaica is quite sparse. Hickling's (1993) ethnohistoriography of psychiatry in Jamaica noted that early colonial practices of incarceration and isolation of the mentally ill were commonplace until the 1960s and 1970s when policies of decentralization, public education, and integration of the mentally ill into society were implemented. Program developers believe that these programs and policies have contributed to a decrease in the stigma surrounding mental illness in Jamaica (Hickling, 1991(Hickling, , 1993.…”

“…Hickling's (1993) ethnohistoriography of psychiatry in Jamaica noted that early colonial practices of incarceration and isolation of the mentally ill were commonplace until the 1960s and 1970s when policies of decentralization, public education, and integration of the mentally ill into society were implemented. Program developers believe that these programs and policies have contributed to a decrease in the stigma surrounding mental illness in Jamaica (Hickling, 1991(Hickling, , 1993. However, this shifted in 1980, after a change of government, and the old colonial practice of incarceration was re-established, reversing positive changes made in the 1970s (Hickling, 1993) and facilitating the entrenchment of public stigma.…”

“…Program developers believe that these programs and policies have contributed to a decrease in the stigma surrounding mental illness in Jamaica (Hickling, 1991(Hickling, , 1993. However, this shifted in 1980, after a change of government, and the old colonial practice of incarceration was re-established, reversing positive changes made in the 1970s (Hickling, 1993) and facilitating the entrenchment of public stigma. Currently, there are no published studies on stigma or public attitudes toward mental illness in Jamaica.…”

Help-Seeking Among Jamaican Adolescents

“…Similar school-based programs may prove useful in reducing negative attitudes toward mental illness and improving help-seeking among Jamaican adolescents. Interestingly, programs aimed at reducing the stigma associated with mental illness were previously attempted in Jamaica in the 1970s (Hickling, 1993). According to Hickling (1993), the most important factor in reducing stigma associated with mental illness was to describe the beneficial effect of treatment and the provide information on the availability of psychiatric services on the island.…”