Depressive and psychotic disorders remain the two leading diagnoses among people accessing mental health services in Montserrat, according to a six-year review presented at the Ministry of Health and Social Services’ Annual Research Day.
The review, presented by Acting Community Mental Health Nurse Donique Layne, covered mental health diagnoses, referrals and service use between 2020 and 2026.
A total of 405 patients and 413 distinct episodes of illness were recorded during the period. The difference reflected patients who were seen on separate occasions with different diagnoses.
The review found an almost even division between female and male patients, with 203 females and 202 males recorded.
New patient presentations increased by 12.7% when the most recent three-year period was compared with the preceding three years.
The largest age group represented in the data is now children and adolescents between 10 and 19. Layne said the change did not necessarily mean more children were developing mental health conditions. Instead, the appointment of a child and adolescent clinical psychologist has enabled the service to assess and formally diagnose more young people.
Women were more frequently diagnosed with depression, anxiety and trauma-related disorders, while substance-use disorders were more commonly recorded among men.
Minister of Agriculture John Osborne questioned whether depression among men could be obscured by substance use and called for further research into the underlying economic and social causes of depression in Montserrat.
A separate qualitative study presented during Research Day identified stigma, fear of breaches of confidentiality and limited knowledge of mental health conditions as major barriers to seeking help.
The study involved interviews with 11 patients and members of the public, as well as eight health professionals.
Participants reported that people with mental health conditions were still labelled as “crazy” or “mad”. Some also relied primarily on prayer, churches and faith leaders, turning to professional care only as a last resort.
Researchers recognised faith communities as a valuable source of emotional and social support but cautioned that faith-based assistance alone may not be adequate for severe or persistent mental health conditions.
Limited financial and human resources and Montserrat’s outdated Mental Treatment Act were also identified as barriers to improving services.
The continuing psychological effects of the Soufrière Hills Volcano crisis emerged as another concern.
Acting Director of Primary Health Care Services Penny Maloney described seeing Montserratians cry and experience strong emotional reactions while watching coverage of the volcanic eruption in St Vincent and the Grenadines.
The reactions, she said, suggested that trauma from Montserrat’s own volcanic crisis remained unresolved for some residents.
Participants discussed the need for a dedicated study into the long-term psychological effects of the Soufrière Hills Volcano eruption, particularly around its 30th anniversary.
Recommendations from the research included stronger confidentiality safeguards, increased public education, additional mental health personnel and updated legislation.
The day’s discussions also highlighted the need to add a health psychologist to Montserrat’s multidisciplinary health team and to provide care that is more personalised and less “robotic”.
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