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      Capacity building in mental health: preparing Caribbean psychologists for the future

      The Journal of Mental Health Training, Education and Practice
      Emerald

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          Abstract

          Purpose

          The English-speaking Caribbean is currently at a crossroads regarding the education and training of home-grown psychologists meeting the ever-increasing demands for mental health care in the region. This paper recommends an innovative approach to build capacity in mental health care in the English-speaking Caribbean that will require partnerships between the regional university, experienced registered practising psychologists, professional resources in the diaspora, public health and education institutions, which will produce trained clinical supervisors, PhD psychologists and improved mental health services in the region.

          Design/methodology/approach

          Documents about the postgraduate programmes in psychology from the regional university were sourced. PubMed, Medline and Google Scholar were searched for the English language published articles using the key phrases psychology AND/OR psychologist AND/OR education AND training AND mental health. Searches of the reference lists of included articles were also undertaken.

          Findings

          Postgraduate psychology programmes in the region have become stalled at the master’s level. Meanwhile, doctoral-level training is being sought outside the Caribbean largely due to the lack of availability of trained clinical supervisors. Moreover, training outside the region may lead to deficits regarding cultural relevance of practices, as well as impede the overall development of Caribbean psychology.

          Research limitations/implications

          This paper provides insights into the current practice of education and training for Caribbean postgraduate psychology students and the implications for the development of the practice of psychology in the region. Recommendations for educational and training strategies are provided.

          Practical implications

          The proposed framework presented will help upgrade experienced master’s-level trained psychologists to PhDs with training in clinical supervision through Research Advancing Intensive Supervision Education (RAISE) doctoral programmes and can cultivate improved mental health services with a wider reach across the Caribbean.

          Social implications

          Raising the training standards of the psychologists, preparing clinical supervisors and increasing access to practicum sites will improve the trajectories of psychologists within the English-speaking Caribbean and the mental health of the population. Such changes will help to ensure the use of culturally appropriate therapies with Caribbean clientele. There are many social implications for capacity building within the practice and research domains of the preparation of psychologists. For example, increased access to psychological care, improved well-being of citizens, decreased prevalence of work absenteeism and improved management of citizens’ mental health and well-being.

          Originality/value

          This paper provides insights into the current practice of education and training for Caribbean postgraduate psychology students and the implications for the development of the practice of psychology in the region. Recommendations for educational and training strategies are provided. The proposed organising framework presented offers a new conceptual model that can be used to guide the capacity building of psychologists within the English-speaking Caribbean. The proposed framework will help upgrade experienced master’s-level trained psychologists to PhDs with training in clinical supervision through RAISE doctoral programmes and can cultivate improved mental health services with a wider reach across the Caribbean.

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          Most cited references17

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          • Article: not found

          Iatrogenic harm from psychological therapies--time to move on.

          The problem of adverse effects of psychotherapy has been recognised for decades, yet research on causes and prevention of harm has failed to progress. There is confusion between different definitions and a lack of systematic recording and reporting. A new framework for moving this field forward is proposed.
            Bookmark
            • Record: found
            • Abstract: found
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            Mental health policy and service system development in the English-speaking Caribbean.

            The countries and territories comprising the English-speaking Caribbean (ESC) have made some strides in the development of mental health policy, services and systems with the expenditure in mental health as a percentage of health budgets ranging from 1% to 7%. The ESC countries have well developed primary healthcare systems. However mental health legislations in many countries are in need of reform. Some countries have developed an innovative community based, secondary care treatment model: treatment in the medical wards of general hospitals. These countries have made progress in integrating mental health into primary healthcare and have made psychotropic medication widely available at the primary care level. Notwithstanding the progress in some countries, greater effort is required in phasing out mental hospitals and integrating mental health into primary care in other ESC countries.
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              • Record: found
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              • Article: not found

              Owning our madness: Contributions of Jamaican psychiatry to decolonizing Global Mental Health.

              The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country's only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change. The mental health challenge for descendants of African people enslaved in Jamaica is to reverse the psychological impact of 500 years of European racism and colonial oppression and create a blueprint for the decolonization of GMH. The core innovations were the gradual downsizing and dismantling of the colonial mental hospital and the establishment of a novel community mental health initiative. The successful management of acute psychosis in open medical wards of general hospitals and a Diversion at the Point of Arrest Programme (DAPA) resulted in the reduction of stigma and the assimilation of mental health care into medicine in Jamaica. Successful decentralization has led to unmasking underlying social psychopathology and the subsequent development of primary prevention therapeutic programs based on psychohistoriographic cultural therapy and the Dream-A-World Cultural Therapy interventions. The Jamaican experience suggests that diversity in GMH must be approached not simply as a demographic fact but with postcolonial strategies that counter the historical legacy of structural violence.
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                Author and article information

                Journal
                The Journal of Mental Health Training, Education and Practice
                JMHTEP
                Emerald
                1755-6228
                1755-6228
                January 06 2023
                May 04 2023
                January 06 2023
                May 04 2023
                : 18
                : 3
                : 195-204
                Article
                10.1108/JMHTEP-08-2022-0067
                25681eba-f999-4ebf-a947-21273c879189
                © 2023

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