The Jamaican LMIC Challenge to the Biopsychosocial Global Mental Health Model of Western Psychiatry

Abstract

The mental health challenge for descendants of Africans enslaved in Jamaica and the New World is described. The urgent need to negate the psychology of five hundred years of racism and colonial oppression and to create a psychosocial decolonization blueprint of GMH suitable for LMIC’s is outlined. The colonial history of the exploitation of the Caribbean, as part of the European appetite for conquest and settlement, and the ruthless, socially engineered, European imposition of African slavery in the New World set in place the pathologizing of freedom. A novel historical and political methodology of psychological analysis called psychohistoriography is described here, which identifies complex trauma: physical abuse, long standing sexual abuse, domestic violence, and enslavement, occurring over a long period of time, as the progenitors of contemporary mental illness in Caribbean people. The gradual deinstitutionalization of the colonial British lunatic asylums in Jamaica is then chronicled, along with the development of novel community engagement modalities. Primary, secondary, and tertiary prevention strategies that have metamorphosed Jamaican psychiatry and revolutionized treatment and outcomes for psychosis are discussed. The Psychohistoriographic Dream-A-World Cultural Therapy, a means to reduce dysfunctional behavior and academic underachievement in primary schools, is then explored. The challenge to the Jamaican people to overcome the epigenetic effects of slavery by owning our madness is summarized. Current outcome data on primary prevention mental health programs in Jamaica continues to buttress the efficacy of the Jamaican challenge to the biopsychosocial Global Mental health model.