A sharp increase in mental illness and suicide attempts is prompting new calls for action to help combat a growing health crisis in the Cayman Islands.
Data released this week by the Mental Health Commission indicates 107 people were admitted to hospital in 2021 after attempting to take their own lives.
Meanwhile, almost 7,000 people on the islands were diagnosed with anxiety or depression in that year.
Now mental health professionals are calling for greater access to support for those who need it, including through mandating insurance coverage for therapy and other outpatient services.
That ‘deeply troubling’ statistic on suicide attempts is almost double the incidence for the previous year and Dr. Marc Lockhart, the outgoing chair of the Mental Health Commission, has warned that Cayman is facing a crisis situation.
Diagnosis for anxiety disorders have also increased significantly, with mental health experts warning of a ‘perfect storm’ of stressors, from the pandemic lockdowns and associated social isolation to money worries, inequality and social media pressures.
Shannon Seymour, a clinical psychologist and founding director of the Wellness Centre, said she had seen more patients admitted to hospital in the last few years than in the previous two decades.
She said the numbers were shocking, even to a veteran mental health professional.
“We are in real trouble here if we don’t get a handle on this,” she said.
Young people are particularly impacted. A record 3,659 people under the age of 18 sought help from mental health services in 2021, according to data from the commission.
Lockhart said recent trends showed an increase in both the number and severity of cases.
“The most dramatic increase is among young people and the most troubling aspect is the suicide attempts.”
The 107 people who were admitted to the Health Services Authority after attempting to take their own lives in 2021, represents a 72% increase on the previous year.
Lockhart said the data, shared with the Compass, had been in the hands of public health officials for some time. He feels they should have been released to the public so more open discussion could take place.
The long-time chairman of the Mental Health Commission resigned form the role earlier this month, citing frustration over the lack of action on what he believes is a key issue for Cayman.
“We need to have a public discussion about how to address this crisis we are in,” he said.
What can be done?
While there is no panacea for Cayman’s mental health challenges, Seymour said there are key practical steps that the island could take – including expanding insurance coverage for outpatient care and finally completing the in-patient facility.
Seymour warns that most insurers don’t cover outpatient care – for therapy or other early interventions – in a particularly thorough way.
Most policies offer up to US$1,000 in coverage a year, which is enough to pay for no more than a handful of sessions with a mental health professional.
If people aren’t getting the support they need in the community, then it is inevitable, says Seymour, that we will see an increase in the kinds of severe manifestations of mental challenges – such as suicide attempts – which therapy and other interventions work to prevent.
“There are issues with access to resources. We have a wonderful and robust community of mental health providers, but access in inequitable across our society,” she added.
“We have been saying this for over a decade. Health insurers are not likely to voluntarily provide more benefits unless there is legislation compelling them to do so.”
Post-pandemic issues expected
Lockhart said the issues Cayman is now experiencing were anticipated in the aftermath of the pandemic.
He said stress is a driver of other mental health issues and for young people, in particular, social isolation could exacerbate other challenges.
He had patients who had spent their freshman year of university in socially distanced dormitories attending classes online, he said. Others had moved home with parents and seen their futures delayed amid the uncertainty of the pandemic.
Meanwhile, younger children’s social and educational lives gravitated even further towards the online space, which he warns is fraught with potential headaches for children developing a sense of self.
“We can’t pin it all on the pandemic,” he added.
“A lot of these trends were happening before.”
Schools at the forefront
As the school counsellor at John Gray High School, Pastor Christopher Murray is familiar with many of these issues.
He said the three counsellors at John Gray were seeing pupils constantly for a variety of problems.
“Anxiety and depression took a great leap after COVID and of course we have seen that among young people at the school.”
He said the statistics on attempted suicides were particularly shocking.
“Any figure is too high. Two is too many but to hear that there were more than 100, that is very concerning.”
If there’s a silver lining to the alarming statistics it is that people in the Cayman Islands are more comfortable talking openly about mental health problems. The numbers, to some extent, reflect a greater willingness from people to seek help for feelings of depression and anxiety.
Murray said he and his staff visit each class at the start of the school term to let the children know there is somewhere “they can find a listening ear”.
He added, “The children are certainly not resistant to come to the counsellor’s office.”
There is even a strong culture of pupils bringing friends to the counsellor when necessary.
Seymour adds that a heightened awareness of mental health is a good thing if it influences people that need help to seek support.
There remains evidence of people, particularly older generations, self-medicating.
Lockhart said there had been an increase in drug-related incidents, highlighting newer drugs, including opioids, ecstasy and fentanyl, being seen on island for the first time.
He hopes the data, particularly around depression, anxiety and suicide attempts, will help inform a national conversation about how to make things better. Getting on with the mental health care facility, broadening access to care and partnering with the private sector to fill gaps in service are all practical steps he says can begin today.
“We are not trying to catastrophise or frighten people but we are seeing Cayman reflect what is happening elsewhere in the world with an increase in numbers of people with mental health challenges and especially among the youth.”
Mental health resources
If you, or someone you know, is struggling with issues similar to those raised by this article, there are resources available to help.
- In an emergency, call 911.
- Mental Health Helpline. Call 1-800-534-6463 (MIND) Monday to Friday, 9am to 5pm, to talk to the Mental Health Helpline, which was established during the pandemic to provide support.
- The Alex Panton Foundation. The non-profit’s primary objective is “raising awareness of mental illnesses affecting children and young adults in the Cayman Islands with a particular focus on anxiety and depression”. It aims to “provide hope and resources to friends, family, teachers, classmates and carers to help save the lives of children and young adults struggling with mental illness”. The Foundation was established in memory of Alex Panton, who succumbed to the effects of severe depression at the age of 16.
- Department of Children and Family Services. For non-critical services provided by the Department of Children and Family Services, email [email protected] or call 949-0290 in Grand Cayman and 948-2331 in Cayman Brac Monday to Friday, 8:30am to 5pm.
- The Cayman Islands Crisis Centre. The charity provides support to all victims of domestic violence via “services and programmes focusing on domestic and sexual abuse”. Among its services, it provides shelter, counselling, a 24-7 crisis helpline on 943-2422 and a kids’ helpline on 649-5437.
- There are a number of private health care providers, offering counselling and support, such as Infinite Mind Care and the Wellness Centre.
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