Ministry of Health & Wellness Commemorates World Mental Health Day 2022 October 6, 2022 / Ministry of Health & Wellness Commemorates World Mental Health Day 2022 October 6, 2022

On October 10, 2022, the world will commemorate World Mental Health Day under the theme "Make mental health and wellbeing for all a global priority." The theme was chosen to address the inequalities exposed by the COVID-19 pandemic and its impact globally on people's mental health.

Impact of COVID-19 on the intimate relationships of young adults between the ages of 18-30 years in Trinidad and Tobago

The COVID-19 pandemic caused a sudden halt in normal day-today movements & interactions across the world. Restrictive measures were implemented to lessen the spread of the virus, however, it altered social interactions. In times of stress, persons usually turn to social support for comfort. However, this pandemic has forced individuals to be isolated. Although the physical health of individuals has been addressed somewhat, their mental health has not been prioritized. Young adults in relationships were either isolated with or away from their partner, while single young adults were generally without a stable companion. With the impacts discovered from this research, new measures can be adopted in society & health facilities to mediate the harmful effects this pandemic caused & will cause on the mental health of young adults with respect to dating and relationships.

The Prevalence of Negative Coping Mechanisms and Its Association with The HealthRelated Quality of Life of University Students: Impact of the COVID-19 Pandemic

Mental health of young adults has become a relevant matter amidst the COVID-19 pandemic. Individuals employ various coping mechanisms to deal with their stresses and mental health challenges. The type of coping strategy determines the outcomes of their Health-related Quality of Life (HRQo). This study investigated the stressors of students at the University of the West Indies, St Augustine Campus (UWI-STA) and how their coping mechanisms influenced their HRQoL during the COVID-19 pandemic

Health-related quality of life (HRQoL) during the COVID-19 pandemic on undergraduate students at the University of the West Indies, St. Augustine

▪ During the COVID-19 pandemic, the shift to online education led to behavioural/lifestyle changes, whichcan affect health-related quality of life (HRQoL). ▪ HRQoL is an individual's perceived physical and mental health over time, and highlights how these changes can impact health.

A Comparison Between Online and Traditional Methods of Curriculum Delivery in the COVID-19 Era to Dental and Medical Students of the Faculty of Medical Sciences, St Augustine Campus, UWI

▪ With the inability to conduct classes in the traditional classroom setting due to the Covid-19 pandemic, students have been forced to adapt to an online curriculum delivery. ▪ There is limited data about the impact of e-learning on students enlisted in medical programmes within the Caribbean. ▪ Recent research has found that many students' mental health were affected, and it is crucial for this data to gathered and understood to take steps in combating mental health challenges.

A web-based cross-sectional survey on computer-related visual and ocular symptoms and perceived stress, amid the COVID-19 transitional online learning among students in the Faculty of Medical Sciences: A Caribbean perspective

The current COVID-19 pandemic has impacted various sectors of human life, in unprecedented ways. Inevitably, many educational institutions transitioned to online learning due to worldwide 'lockdowns'. Digital technology is significant. However, studies have been reported that it has short- and long-term negative effects on people's biopsychosocial wellbeing; particularly, mental and visual issues. The current study focused on the effects of the transitional online learning mode on the ocular and mental health of students.

An investigation into the Mental, Social and Physical impacts of online learning on the students at The University of The West Indies, St Augustine

The Covid-19 pandemic has forced many educational institutions worldwide to a mandatory online format. The sudden switch to online learning courses from traditional face-to-face classes has been noted to come at a great cost, especially concerning students. The effects of this sudden transition was noted both internationally and regionally especially regarding student internet accessibility and usage. However, this study attempts to delve into online learning's impacts on students' mental, social and physical health.

Impact of COVID-19 Pandemic on Medical Students' clinical training, their learning behaviours, perceived stress and performance as future medical professionals

The COVID-19 pandemic led to a global lockdown of all levels and types of educational institutions, prompting the implementation of online education worldwide. Undoubtedly, the traditional delivery of medical education was directly affected by this development. Challenges created compromised the proper delivery of clinical training as face-to-face teaching was restricted due to social distancing measures. Inevitably, this sudden change affected the learning behaviours and stress levels of medical students in their penultimate years, as well as the standard of their clinical training and their perception of their performance as future medical professionals.

Self-perceived stress among medical students in relation to their perceptions on virtual learning during the COVID-19 pandemic

Medical education has shifted from the traditional face-toface method to virtual learning due to the COVID-19 pandemic, bringing with it many challenges. Medical students already experience high levels of stress due to may stressors such as excessive workload. This together with the new challenges encountered during virtual learning, such as technological barriers, can cause physiological distress which can affect the mental health of medical students.

A review of the health risk behaviours among adolescents in the Englishspeaking Caribbean: 2006 to 2020

• Adolescents comprise around 25% of the Caribbean population. Past studies report that the challenges faced by this target group include substance use, mental health, violence, high risk sexual behaviours such as HIV, juvenile delinquency, obesity, accidents and injuries, among others. • Through the understanding of the adolescent health risk behaviours, challenges, their health risks and protective factors, can we then comprehend and generate solutions to the challenges faced by youth in the Caribbean. This review will focus on the years 2006-2020, where we will determine what has or has not changed from the last review (from 1985-2005) and what solutions can be implemented.

The prevalence of burnout, psychological distress and frequently used coping strategies among primary care health workers in North West and North Central Regional Health Authorities

Background: The prevalence of mental health issues among health care workers, including primary care workers, has reached concerning levels globally. The presence of the more common conditions such as the burnout syndrome and psychological distress among primary care workers in Trinidad and Tobago has not been examined. Objectives: This study aimed to determine the prevalence of the burnout syndrome and psychological distress among primary care health care workers in Trinidad, as well as their associations with socio-demographic factors, workplace factors and stress coping strategies. Research Design and Methods: This was a cross-sectional study of 245 primary care physicians and nurses within the North West and North Central Regional Health Authorities. The Maslach Burnout Inventory, General Health Questionnaire and the Brief COPE measured outcomes through a self-administered questionnaire. Results: The overall prevalence of burnout among participants was 32.7% and 25.3% were distressed. Younger age groups (<45 years) had significant associations with both burnout [OR 2.91 (1.66-5.12)] and distress [OR 2.73 (1.48-5.04)]. Physicians were also significantly more likely to be burnt out as compared to nurses [OR 2.95 (1.69-5.14)]. Increased odds for burnout were also found for those who had no children, or less than three children, those with postgraduate qualifications or enrolled in a training programme. Spending less thanfour hours a day in leisure activities increased the odds of both burnout and psychological distress. Avoidant and emotion focused coping were significantly associated with burnout and distress. Use of religion was significantly associated with those in the non-burnout and non-distressed groups. Conclusion: The results reveal that prevalence of mental health issues is significant among primary care workers in these two settings. Individual and organizational prevention and intervention strategies can be utilized to address this issue, targeting physicians, younger workers and addressing stress coping strategies.

Mental health, sexual and reproductive health, substance use and connectedness among adolescents in the overseas Caribbean territories

OBJECTIVE: To analyse mental health, sexual and reproductive health (SRH) and substance use behaviours and outcomes among adolescents in the overseas Caribbean territories and their association with family and school connectedness. SUBJECTS AND METHOD: The data were collected through aschool-based survey administered to secondary school students in Aruba, British Virgin Islands (BVI), Cayman Islands, Montserrat, St Eustatius and St Maarten. Multi country analysis was conducted through pooling and weighting of the data from the six territories. Data analysis included descriptive analysis and odds ratios to examine associations between family and school connectedness and mental health, SRH and substance use. RESULTS: Data on 4883 respondents in the age group 15–19years were used for the analysis, equally divided in males(49%) and females (51%). More than half (58.8%) of the girls reported feelings of sadness or hopelessness for more than a day and 31.2% seriously considered suicide. Approximately one-third (34.9%) made a suicide plan and 70.6% of these girls attempted suicide at least once. A quarter (23.2%) of the girls and 30.1% of the boys initiated sex before age 15 years; 58.2% of the females and 57.7%of the males used alcohol in the past 30 days and 44% ofthe boys got very drunk at least once. More than half of the adolescents reported lifetime marijuana use. Statistically significant associations were found between low family and school connectedness, and feeling sad or hopeless, suicidal thought, sexual initiation before age 15years, pregnancy, alcohol and substance use. CONCLUSIONS: The results highlight the critical importance of connectedness for adolescents to be healthy and thrive.

Analysis of intervention and counselling for at-risk youth to reduce crime, violence and improve outcomesfor the individual, the schools and the family

OBJECTIVES: In this study, we examined how counselling of students and their parents can change youth misbehavior and reduce school violence and crime. Our primary objective was to derive empirical data on successful counselling therapies for at-risk secondary school students within Trinidad and Tobago. SUBJECTS AND METHODS: Participants included 145 secondary school students from selected secondary schools in one school district in Trinidad and Tobago. Of these, 49(17.3%) participants were referred by the school principals as suspended or at risk of being suspended. Participants had to complete a 12-week counselling programme consisting of individual, group and parent guidance sessions. RESULTS: After controlling for demographic characteristics, results indicate that a 12-week counselling intervention and participation in multi-modal therapeutic counseling sessions was statistically significant in changing at-risk youth negative mood states and student misbehaviour and school violence. CONCLUSION: The results of this study show that the socioeconomic environmental factors present in high-risk communities contribute to hopelessness and depression which manifest themselves in physical and mental health problems. In our study, more than 50% of school youth involved in school crime and violence are afflicted with health problems. These health problems include maladies such as depression, emotional, verbal, or physical abuse, unresolved grief and loss. Research is needed to determine the potential causal nature of the relationships between mental health problems (ie hopelessness, depression) on youth violence and crime and its potential effects on health and well-being.

The determinants of young adult social well-being and health (DASH) study: the influence of parenting and religious involvement on mental health

OBJECTIVE: The DASH longitudinal study found better mental health for ethnic minorities compared to White British adolescents in the UK, despite more disadvantage. This paper investigates the impact of parenting style and attendance at a place of worship on mental well-being from adolescence to young adulthood. DESIGN AND METHODS: In 2002/03, 6643 11-13 year olds in London, ~80% ethnic minorities, participated in the baseline survey. In 2005/06 4,782 were followed-up. In 2012-14 665 took part in a pilot follow-up aged 21-23y, including 42 qualitative interviews. Measures of socio- economic and psychosocial factors and health were collected. RESULTS: In adolescence, ethnic minorities generally experienced more adversity but reported better mental health. Regardless of ethnicity, low parental care vs. high parental care (e.g. males coefficient: 1.32, 95% confidence interval 0.94-1.70), high parental control vs. low parental control (males: 1.37, 1.00-1.74), and attendance to a place of worship vs. no attendance were independently associated with mental health. At 21-23y, the ethnic patterning of mental health appeared to track, with increasing parental care, but not religious involvement, continuing to have a protective effect on mental health. Education levels signalled potential for socio-economic parity across ethnic groups, and family support appeared to reduce stress of transitions to adulthood. CONCLUSIONS: DASH provides evidence for a protective effect from parenting styles and religious involvement for young people growing up in ethnically diverse and deprived urban contexts. This suggests the value of cultural and social resources for psychological well- being.

Reducing re-admissions at St. Ann’s psychiatric hospital

OBJECTIVE: This study addressed the psychoeducational approach to understand mental illness, illness self-management and social skills. It evaluated the effects of a structured-mannualized psychoeducation programme that taught inpatients about their illness and how to maintain remission after discharge and avoid re-admissions. DESIGN AND METHODS: A total of 505 inpatients admitted with mental disorders were randomly assigned to either an experimental group or control group. The psychoeducation programme consisted of six teaching modules distributed in 219 sessions of 45-minute-sessions in each of 5 wards, on a continuous, five-day-a-week schedule. The effects were measured reviewing the records of admissions and re-admissions after discharge. RESULTS: Results indicated that inpatients of the experimental group significantly improved their knowledge and performance of the skills taught in sessions, compared with the control group who did not participate in the educational group sessions. Re-admissions of participants of the experimental group were significantly less than the control group (2.1 percent versus 16.6 percent). CONCLUSIONS: Not only can patients learn relatively complex material during a typical inpatient stay despite the acuteness of their illness, but they can also meaningfully improve the continuity of their own care by participating in brief and highly structured teaching programmes in inpatient and outpatient settings.

The mental and physical health of severely and non-severely abused U.S. Black Caribbean women

OBJECTIVE: The study examined the mental and physical health of U.S. Caribbean Black women using a nationally representative sample, with a special emphasis on the role of severe intimate partner violence. DESIGN AND METHODS: Data from the National Survey of American Life, the largest and the only known representative study on 1621 non- institutionalized Caribbeans residing in the United States, were used. The mental health (i.e., mood, substance, anxiety, eating) of participants was based on structured mental health assessments (DSM-IV) and physical health was based on self-report of physician-diagnosed conditions (i.e., arthritis, high blood pressure, liver problem, HIV or AIDS). Chi-square tests of independence were used to address differences in rates of mental and physical health conditions between severely abused and non-severely abused women. RESULTS: Rates of mental and physical health problems were generally higher among women experiencing severe intimate partner violence in comparison to women who had not experienced intimate partner violence. This was apparent for conditions such as bipolar disorder (12.4% vs. 1.3%), panic disorder (11.9% vs. 1.9%), alcohol abuse (5.5% vs. 1.8%), suicide attempts (12.7% vs 1.4%), kidney problem (6.0% vs. 1.8%), liver problem (3.7% vs. 0.8%), and HIV or AIDS (1.3% vs. 0.1%). CONCLUSIONS: The study had intervention and preventative implications for both detecting and addressing the health needs of women who are abused by an intimate partner.

Experiences of mental health professionals counseling young survivors of sexual abuse in the Cayman Islands

OBJECTIVE: To explore the experiences of mental health professionals counseling young survivors of sexual abuse in the Cayman Islands; how they navigated challenges in their experiences and sustained themselves through their work with young survivors of sexual abuse. DESIGN AND METHODS: The present study incorporated a qualitative approach using a phenomenological design to elicit a description of the experiences of mental health professionals who counseled young survivors of sexual abuse in the Cayman Islands. Five mental health professionals were recruited using purposive sampling methods. Semi-structured interviews were facilitated to answer the research questions centered on describing their experiences in counseling young survivors of sexual abuse in the Cayman Islands. Data analysis resulted in four core themes that described their lived experiences as notably punctuated with both significant systemic challenges and significant posttraumatic growth. RESULTS: The findings indicated that mental health professionals compensated for the systemic influences such as patriarchal belief systems and oppressive and complicit attitudes objectifying children by diversifying and expanding their interventions. CONCLUSION: The present study supported recent literature from the Caribbean region that described the embedded oppressive belief systems and traditional patriarchal attitudes that have perpetuated abusive treatment of children. Furthermore, the study provided a greater understanding of mental health professionals’ experiences in the Cayman Islands that also supported expanding the scope of the mental health professions to include social justice and advocacy efforts.

Indentureship as a contributory factor to mental and physical illnesses in the Indo-Caribbean diaspora

There is an ethnic pattern of mental and physical diseases associated with the export of Indian labor overseas between the period of 1830-1920. The establishment of Indian communities overseas emerged from the culture and civilization of the Indian sub-continent and was a direct consequence of mainly British exploitation of economic wealth overseas. This movement of Indians from their homeland with the maintenance of the practice of their religion, culture and lifestyle is referred to as the Indian diaspora. This chapter looks at the effects of the 'coolie migration' particularly to Trinidad, but with reference to other Caribbean islands and at least a dozen countries across the seas. Information is gathered from published reports but more importantly, from dozens of immigrants and hundreds of first generation Indians with whom the author has been in contact during their treatment. There appear to be a commonality of social, psychological and physical diseases in these migrant groups within the diaspora. A possible explanation is the similarity of the genetic pool and environmental influences experienced by the migrants overseas.

Consultation-liaison psychiatry in Trinidad and Tobago with reference to suicidal behavior

Consultation-liaison psychiatry (C-LP) has been defined as the area of clinical psychiatry that encompasses clinical, teaching and research activities of psychiatrist and allied mental health professionals in the non psychiatric divisions of a general hospital. Over the years, consultation-liaison services have expanded to provide care in health care facilities other than the general hospital, such a community health clinics, rehabilitation centers, convalescent hospitals, nursing homes and doctors' private offices. The term Consultation-Liaisons reflects two interrelated roles of the consultant. Consultation refers to the provision of expert diagnostic opinion and advice on management regarding a patient's mental state and behavior at the request of another health professional. Liaison refers to a linking up of groups for the purpose of effective collaboration. The present chapter reviews how these roles are addressed in Trinidad and Tobago.

Physical activity and health

In this final issue of Nayam News in this physical activity series we attempt to collate the main evidence for the various health indicators. Clearly, physical activity is positively related to health. However to reap maximum benefits from physical activity, individuals (2yrs and older) are recommended to participate in a minimum of 30 minutes or more on most or all the days of the week. Health can be defined as a state of physical, emotional, social and psychological well-being. In promoting health, one must take into consideration the importance of psychological well-being. It can therefore be assumed that , in an effort to improve health and wellness, physical activity is of major imortance.