Alexandra Bodden, M.A., M.S.

Colleen Brown, M.A.

What is Mental Health?

Direct Clinical Services

Mental Health in the Criminal Justice System

Mental Health in the Education System

Advocacy and Awareness

A Case Study – The Counselling Center

Mental Health in the Caymanian Context

Future Directions

“Mental health is not just the absence of a mental disorder. It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and

fruitfully, and is able to make a contribution to her or his community.”

– World Health Organization (2007)

Mental Illness has long been feared, misunderstood and stigmatized.

Mental Illness is defined as “Medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning.” – NAMI, 2012

PAHO estimated 5.5% of the population in Cayman has experienced mental illness.

Recent news releases suggest that the actual prevalence rate may be much higher.

Symptoms of mental illness are not so far removed from our everyday lives.

Symptoms are now seen as a continuum.

Introduced to Cayman through Substance Abuse Counselling.

Growth in both the public and private sector. ◦ Inpatient, residential, day treatment, intensive

outpatient and outpatient services.

◦ Specialized services: emergency, domestic violence, substance abuse.

Services across the continuum of care.

Moves towards integration of health care services.

May consist of a psychologist, case worker, psychiatrist and other professionals.

More comprehensive and

cohesive treatment. ◦ More holistic treatment.

Cayman is moving towards implementing a “National Rehabilitation Strategy.”

Involves further integration of mental health professionals into the criminal justice system.

Counselling and therapy services while institutionalized and to facilitate community reintegration upon release.

Sweeping the US and the Caribbean

Alternative sentencing programs for non-violent offenders

Reduce recidivism, provide reparations to the community and greater rehabilitation of offenders.

Cayman has a “Virtual Drug Court” and a “Drug Rehabilitation Court”

Cayman DRC highly commended by Drug Court professionals from other Caribbean countries.

55 persons have graduated from Cayman’s Drug Rehabilitation Court.

Intake and assessment with Department of Counselling Services.

Frequent Court appearances.

Drug screens regular and random.

Monitoring by probation.

Treatment through DCS.

12 month, 4 Stage Program.

Sentences are reduced or absolved.

More cost-effective than prison.

Lower recidivism than prison.

Operates with sanctions and rewards.

For non-violent offenders with mental illness that can be treated in the community.

Regular drug screens.

Team consists of a mental health professional, probation officer and the magistrate.

Oftentimes there is an underlying mental illness or symptoms that are exacerbated in times of stress.

These courts are the first step toward the acknowledgement of the role that mental health plays in deviant behaviour and the role that mental health professionals can play in improving the wellbeing of individuals and the community.

Domestic Violence is also frequently misunderstood and stigmatized.

New Domestic Violence Law was passed in 2010 to provide greater protection for victims.

Demonstrates increasing awareness and understanding within the community.

DVIP for perpetrators: treatment in the community.

Group interventions for perpetrators.

Crisis and counselling services for victims.

Increased advocacy in the community.

Development of the Mental Health Task Force in 2010.

Hopes to improve regulation of field and range and quality of services.

Changes in legislation and problem-solving courts have provided new opportunities for persons within the criminal justice system.

Education is the cornerstone of a person’s ability to reach their full potential.

Education beneficial at all stages of intervention: ◦ Improves attitudes toward school and self-esteem.

◦ Decreases recidivism in offenders.

Recent increase in counsellors, school psychologists and educational psychologists.

2006 Report on Criminality highlighted need to improve identification and accommodation of learning disabilities.

2006 Review of Education System highlighted advances made and recommended further increase in supportive professionals.

Additional services also provided in alternative schools.

Greater presence of mental health professionals in school means greater exposure to mental health services.

Mental health services have been increasing throughout the country.

Caymanians must now be educated on the ideas of mental health and mental illness in order to best utilize the services available.

Stigma against mental illness in the Caribbean is well-known and documented

Attitudes are believed to have shifted slightly in recent years with increased advocacy efforts.

Newspaper articles, television shows, public campaigns, educational programs etc.

Changes in the department’s name and focus.

More persons coming in for “other” issues and of their own accord.

Impact of Ivan.

Expatriates within the field and workforce.

Many programs have been introduced to Cayman from other countries.

Many unique facets to Cayman’s community: ◦ Small community.

◦ Unique culture and history.

◦ Transient population.

Evidence-based treatments are current focus in US.

Little is known and documented about Cayman.

In order to be most effective, need research to identify needs and structure of Caymanian society.

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**Special Thanks to Ms. Judith Seymour and Mr. Donald Potkins of the Counselling Center for their

time and assistance in gathering information for this paper as well as Ms. Susanne Clements and the rest

of the staff at The Counselling Center for their support of this paper and my training in the mental

health field thus far.**