Caribbean Review: Erasing The Stigma: A New Mental Health Facility For Sint Maarten
Island nations, particularly those in the Caribbean, often struggle with limited resources and skilled personnel, making it challenging to deliver high-quality services. As seen in many Caribbean nations, programs and agencies addressing cybersecurity, healthcare or even education often lack the necessary tools and capabilities to be fully and appropriately accessible to people who face differing types of challenges. For Sint Maarten, one of the ABC-SSS Island nations under the jurisdiction of the Netherlands, changing the stigma and reputation for mental health services in the Caribbean is a national priority.
Studies indicate that there exists a high prevalence of anxiety and depression among adolescents and young adults in the Caribbean. According to a study conducted by the National Institutes of Health (NIH), 1 in 5 Caribbean adolescents demonstrate symptoms consistent with some type of mental disorder, a statistic that indicates the dire need for more mental health services and resources. In Sint Maarten, 16% of mental health cases that were reported were also related to anxiety and depression and required the consultation of a mental health professional according to the Ministry of Public Health, Social Development and Labor.
Meeting with the Minister
Hoping to build a modern mental health facility to enhance patient care and expand the healthcare system, Minister of Public Health, Social Development, and Labor, Richinel Brugg, met with the National Recovery Program Bureau (NRPB) for updates on the facility's construction progress. A press release from the official website of the Government of Sint Maarten detailed that during the December 10th meeting, Minister Brugg had asked the NRPB to expedite the timeline of the construction in order to address the crisis within the healthcare system of Sint Maarten as the amount of patients requiring mental health care had skyrocketed. A crisis that can only be addressed by increasing the capacity of the healthcare system in Sint Maarten which is mandated to serve around the 43,000 inhabitants of Sint Maarten.
Yet, the root causes of mental health illnesses in Sint Maarten are difficult to pinpoint and address. According to the Sint Maarten Mental Health Foundation (MHF), its awareness campaign urges citizens to recognize key risk factors, including frequent drug or alcohol abuse, a history of childhood abuse or neglect, ongoing medical conditions, previous mental illness, or brain trauma. However, other mental health experts would also highlight the sociocultural plight and stigma of mental health that remains within the Caribbean at-large as well as in Sint Maarten. The approach to mental health services in the Caribbean, as described in a study conducted by Dr. Oscar Noel Ocho warns, “There appears to be a disconnect in how health services incorporate sociocultural nuances in determining how mental health services could or should be shaped and informed by the communities served.” The stigma surrounding mental health services in the Caribbean not only discourages citizens from seeking care but also raises the concern that, even where such services are available, they may be applied to a population that is unreceptive to them.
While the application of mental health services might face an alarming gap in its outreach to local communities, Sint Maarten seems to be aware of the importance of tailoring mental health services to the needs of local communities. In developing the Mental Health Project, supported by the Ministry of Public Health and the NRPB, Sint Maarten ensured that one of the main partners for the staffing of the new facility would be the Trimbos Institute. According to a press release from the Government of Sint Maarten, Minister Brugg praised the Trimbos Institute; “Trimbos’ expertise will help us build a strong foundation for mental health services in Sint Maarten with long-term benefits for the community. We aim to improve service delivery, reduce the stigma associated with mental illness, and ensure all residents have timely access to high-quality mental health care.” Sint Maarten’s partnership with the Trimbos Institute not only ensures a well-rounded approach to addressing the mental health crisis but also represents an effort by the government to recognize a problem, seek reliable technical advice, and turn the page on a neglected sector of healthcare for many SIDs.
Trimbos and its impact
The Trimbos Institute is a Dutch think tank and registered non-profit organization in the Netherlands, focusing on policy research and practice-based advice for professionals on mental health and addiction. Some of their key functions are advising governmental or corporate entities about best practices for mental health promotion and prevention. Critically, in their role as a consultant, the Trimbos Institute will be launching an assessment of Sint Maarten’s mental health apparatus to analyze areas for improvement in addition to their efforts to shape an integrative and inclusive mental health plan and also provide comprehensive training to local mental health professionals to prioritize preventative mental health care. This effort will easily differentiate Sint Maarten’s direction on mental health care apart from its counterparts elsewhere in the Caribbean such as Haiti or Jamaica where access to these services is near impossible.
Yet, unlike Haiti or Jamaica, Sint Maarten has received robust international support for the expansion of its Mental Healthcare Project in order to introduce a revolutionary partnership to the island. Due to its association with the Netherlands, Sint Maarten receives special access to a think tank like the Trimbos Institute which has played a large role in coordinating a comprehensive national response along with the Ministry of Public Health.
Most importantly, Sint Maarten has secured substantial funding to advance its mental health initiatives. The project, supported by the Sint Maarten Trust Fund, received an $8 million contribution from the Government of the Netherlands, which is managed by the World Bank and implemented by Sint Maarten. This funding is a crucial factor in the success of any mental health initiative, setting Sint Maarten apart from other Caribbean nations. On average, Caribbean countries allocate only about 4.3% of their healthcare budgets to mental health, highlighting the competing priorities that shape the region’s healthcare landscape.
Critiquing the Mental Health Project
While the MHF and NRPB work together to improve mental health services with the introduction of a new facility, they are pushing Sint Maarten to be a leader in the Caribbean on mental healthcare. Still recovering from the aftermath of the COVID-19 pandemic and Hurricane Irma, these organizations are reorganizing the island to transform it into a well-rounded society rather than only a destination for tourists. Sint Maarten’s efforts are commendable but one critique of their recent project is that the Trimbos Institute, a foreign think tank is being contracted to think of local solutions for the local communities in Sint Maarten, when there is already an existing partnership between the University of St. Martin’s Medical Program and the Ministry of Public Health to improve mental health service. One solution that could encourage medical students to remain on the island and counter the widespread trend of brain drain happening in the Caribbean as well as generate a robust and well-trained workforce for the mental health crisis is to open residencies for students at this new facility to both gain experience and aid the local population. Sint Maarten’s new Mental Healthcare Project is intergovernmental, revolutionary and innovative and others in the Caribbean should take note.
