mental health reform & forensic psychiatric services “the past, the present and the future”...
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Mental Health ReformMental Health Reform & &
Forensic Psychiatric ServicesForensic Psychiatric Services
“The Past, The Present and The Future”“The Past, The Present and The Future”
Dr. Myo Kyaw OoDr. Myo Kyaw OoSenior Medical Officer/Consultant PsychiatristSenior Medical Officer/Consultant Psychiatrist
Bellevue Hospital Bellevue Hospital December 2, 2011December 2, 2011
Mission Mission
To improve the mental health of the To improve the mental health of the people of Jamaica so that individuals will people of Jamaica so that individuals will
attain a state of well being, where the attain a state of well being, where the individual will rely on his/her own individual will rely on his/her own
abilities, be able to cope with life, work abilities, be able to cope with life, work productively, make a contribution to productively, make a contribution to
his/her community and live harmoniously his/her community and live harmoniously with otherswith others
Mental Health Reform: The reallocation of services and phasing out Bellevue Hospital June 2003Mental Health Reform: The reallocation of services and phasing out Bellevue Hospital June 2003
Principles of Mental Health ReformPrinciples of Mental Health Reform
DecentralizationDecentralization
DeinstitutionalizationDeinstitutionalization
De-stigmatizationDe-stigmatization
DecentralizationDecentralization
Four Health Regions 1997Four Health Regions 1997
Regional & Parish PsychiatristsRegional & Parish Psychiatrists
Regional Community Mental Health ServicesRegional Community Mental Health Services
Community Mental Health StaffsCommunity Mental Health Staffs
Mental Health Act 1997, Amendment Bill 1999Mental Health Act 1997, Amendment Bill 1999
Strategic Mental Health Plan 1999Strategic Mental Health Plan 1999
Strategic Mental Health Plan 2009-2014Strategic Mental Health Plan 2009-2014
Common Principles Common Principles Mental Health PolicyMental Health Policy
EquityEquity
Human rightsHuman rights
Role of scientific evidenceRole of scientific evidence
integrationintegration
Psychiatric Specialty ServicesPsychiatric Specialty Services
General Adult PsychiatryGeneral Adult Psychiatry
Child & Adolescent PsychiatryChild & Adolescent Psychiatry
Addiction PsychiatryAddiction Psychiatry
Forensic PsychiatryForensic Psychiatry
Disaster PsychiatryDisaster Psychiatry
Geriatric PsychiatryGeriatric Psychiatry
Consultation-liaison PsychiatryConsultation-liaison Psychiatry
Forensic Psychiatric ServicesForensic Psychiatric ServicesJamaicaJamaica
History of Forensic PsychiatryHistory of Forensic Psychiatry
King George III, Queen Victoria, M’NaghtenKing George III, Queen Victoria, M’Naghten
Role of psychiatry and the LawRole of psychiatry and the Law
Role of Psychiatry and defenseRole of Psychiatry and defense
Role of psychiatry and sentencingRole of psychiatry and sentencing
Role of psychiatry and disposalRole of psychiatry and disposal
Jamaica Landmarks in psychiatryJamaica Landmarks in psychiatry
Mental Hospital Act 1873Mental Hospital Act 1873Community mental health services 1960sCommunity mental health services 1960sClosure of Forensic ward BVH 1975Closure of Forensic ward BVH 1975Mental Health Act 1997Mental Health Act 1997Mental Health Strategic Plan 1999Mental Health Strategic Plan 1999Bill to amend Mental Health Act 1999Bill to amend Mental Health Act 1999Amendment to Criminal Justice Amendment to Criminal Justice (Administration) Act 2005(Administration) Act 2005
Forensic Psychiatric ServicesForensic Psychiatric Services
Regional PsychiatristsRegional Psychiatrists
Bellevue HospitalBellevue Hospital
UHWIUHWI
DCSDCS
Community Mental Health CentersCommunity Mental Health Centers
Psychiatrists in private practicePsychiatrists in private practice
Treatment services, assessment & Treatment services, assessment & expert’s opinionexpert’s opinion
Fitness to pleaFitness to plea
Fitness to stand trialFitness to stand trial
Fitness for sentencingFitness for sentencing
Diminished responsibilityDiminished responsibility
Fitness to be executedFitness to be executed
Mental Health ReformMental Health Reform
Cabinet approved reform on March 20, 2006Cabinet approved reform on March 20, 2006
The Development of Community Mental The Development of Community Mental Health Services and De-Institutionalization.Health Services and De-Institutionalization.
Mandated Ministry of Health to pursue further Mandated Ministry of Health to pursue further consultations and community involvement.consultations and community involvement.
Facilities for Forensic patientsFacilities for Forensic patients
Forensic ward closed in 1975Forensic ward closed in 1975Criminal Justice (Administration) Act (Amendment) 2005Criminal Justice (Administration) Act (Amendment) 2005Cabinet Approval Decentralization & Development of Cabinet Approval Decentralization & Development of Community Mental Health Services 2006Community Mental Health Services 2006Bellevue HospitalBellevue HospitalPolice jails Police jails Department of Correctional ServicesDepartment of Correctional Services– Tower Street ACCTower Street ACC– St. Catherine ACCSt. Catherine ACC– South Camp ACCSouth Camp ACC– Fort Augusta ACCFort Augusta ACC– Juveniles facilitiesJuveniles facilities
Bellevue HospitalBellevue Hospital
3000 inpatients in 19653000 inpatients in 1965
1500 inpatients in 19901500 inpatients in 1990
800 inpatients in 2011800 inpatients in 2011
policy decision made closure of forensic policy decision made closure of forensic psychiatric ward in 1975 psychiatric ward in 1975
Transfer of patients to TSACCTransfer of patients to TSACC
Bellevue is under reformBellevue is under reform
What do we have between What do we have between Bellevue and Prisons ???Bellevue and Prisons ???
Balanced?Balanced?
BellevueBellevue Community Mental Health Community Mental Health ServicesServices
Acute psychiatric wards Acute psychiatric wards in general hospitalsin general hospitals
Facilities for chronic Facilities for chronic mentally ill to offer mentally ill to offer rehabilitation and rehabilitation and occupational therapyoccupational therapy
Child & Adolescent Child & Adolescent psychiatric servicespsychiatric services
What we do not want to see…What we do not want to see…
Criminalization of mentally illCriminalization of mentally ill
Trans-institutionalizationTrans-institutionalization
Strategic Mental Health PlanStrategic Mental Health Plan
Amendment to Criminal Justice Amendment to Criminal Justice (Administrative) Act 2005(Administrative) Act 2005
UK, US, SingaporeUK, US, Singapore
What are the challenges?What are the challenges?
What model of care for forensic psychiatric What model of care for forensic psychiatric patients?patients?
Woodbridge Hospital SGWoodbridge Hospital SG
1851 built facility, fully restructured1851 built facility, fully restructured2000 psychiatric beds on 25 hectare 2000 psychiatric beds on 25 hectare campuscampusRange of psychiatric facilities, adult, child Range of psychiatric facilities, adult, child & adolescent, geriatric, addiction, forensic, & adolescent, geriatric, addiction, forensic, community, special clinicscommunity, special clinicsNational Mental Health Blue Print 2007-National Mental Health Blue Print 2007-2012201288 millions in 2007, 35 millions in 200988 millions in 2007, 35 millions in 2009
Caribbean/RegionalCaribbean/Regional
BarbadosBarbados
Trinidad & TobagoTrinidad & Tobago
What do we have??What do we have??
What commitment ?What commitment ?
What have we invested?What have we invested?
Mentally ill OffendersMentally ill Offenders
Jails & Remand CentreJails & Remand CentrePrisonsPrisonsOther institutions & communityOther institutions & community
What do we have?What do we have?
What do we need?What do we need?
Mental Health ServicesMental Health Services
Ministry of Health for Ministry of Health for police jailspolice jails
Bellevue & General Bellevue & General HospitalsHospitals
University HospitalUniversity Hospital
Health CentersHealth Centers
Prison Psychiatric Prison Psychiatric ServicesServices
Sessional PsychiatristsSessional Psychiatrists
PsychologistsPsychologists
Nursing staffNursing staff
Probation officersProbation officers
ChaplainChaplain
Child Development Child Development AgencyAgency
Mental Health Reform Mental Health Reform Justice ReformJustice Reform
Inter-agencies or multi-agencies Inter-agencies or multi-agencies involvementinvolvement
““Investment begins with a vision”Investment begins with a vision”
Justice Reform: Principle of Justice Reform: Principle of Therapeutic JurisprudenceTherapeutic Jurisprudence
in Criminal Justicein Criminal Justice
Criminal ResponsibilityCriminal Responsibility
Actus Reus & Mens ReaActus Reus & Mens Rea
Jail DiversionJail Diversion
Drug CourtDrug Court
Mental Health CourtMental Health Court
Objective isObjective is .. ..
There should be There should be NONO mentally ill in prison. mentally ill in prison.
To provide a comprehensive rehabilitationTo provide a comprehensive rehabilitation
To reduce recidivism To reduce recidivism
Mental illness in prisonsMental illness in prisons
Disorders present before admission and Disorders present before admission and exacerbated by incarcerationexacerbated by incarceration
Disorders develops during incarcerationDisorders develops during incarceration
Factors relatedFactors related
Widespread misconception that all with Widespread misconception that all with mental illness are a danger to societymental illness are a danger to societyGeneral intolerance of people to difficult General intolerance of people to difficult and disturbing behaviourand disturbing behaviourSensational stories in the media of some Sensational stories in the media of some charged with offencescharged with offencesFailure to promote treatment rehabilitationFailure to promote treatment rehabilitationLack of mental health services/ poor and Lack of mental health services/ poor and inefficient access to servicesinefficient access to services
Poor physical conditionsPoor physical conditions
Situational crisesSituational crises
Violence, harassmentViolence, harassment
Discrimination, stigmatizationDiscrimination, stigmatization
VictimizationVictimization
Abuse and human right violationsAbuse and human right violations
Mentally ill in prisonsMentally ill in prisons
PsychoticPsychotic
Non-psychoticNon-psychotic
Psychotic GroupPsychotic Group
GG pleasure with or without court dateGG pleasure with or without court date
RM pleasure, unfit to plea with court dateRM pleasure, unfit to plea with court date
Convicted & SentencedConvicted & Sentenced
Diminished responsibilityDiminished responsibility
psychotic during incarcerationpsychotic during incarceration
Majority Schizophrenia & Drug PsychosisMajority Schizophrenia & Drug Psychosis
Non-psychotic groupNon-psychotic group
Adjustment disorderAdjustment disorderDepression & suicideDepression & suicidePersonality disorderPersonality disorderGender identity disorderGender identity disorderSubstance abuse disorderSubstance abuse disorderConduct disorderConduct disorder
““DUAL DIAGNOSIS”DUAL DIAGNOSIS”
PreventionPrevention
No drugs …No abusersNo drugs …No abusers
No precursors…No manufacturing No precursors…No manufacturing processprocess
How are you going to make prisons safe?How are you going to make prisons safe?
How do inmates receive their supply?How do inmates receive their supply?
Zero Tolerance Policy?Zero Tolerance Policy?
Demand ReductionDemand Reduction
Educational Approach, school education, Educational Approach, school education, public education, sport & culturepublic education, sport & culture
Health & medical Measure, treatment and Health & medical Measure, treatment and rehabilitation programsrehabilitation programs
Community involvementCommunity involvement
Economic empowermentEconomic empowerment
Regional & International Cooperations Regional & International Cooperations Caribbean & OAS Caribbean & OAS
Causes of Drug AddictionCauses of Drug Addiction
Moral/SpiritualMoral/Spiritual
BiologicalBiological
PsychodynamicPsychodynamic
BehaviouralBehavioural
Socio-culturalSocio-cultural
Individual-drug-environmentIndividual-drug-environment
INTEGRATIVEINTEGRATIVE
IntegrativeIntegrative
No single causeNo single cause
Interaction of range of causesInteraction of range of causes
Bio-Psycho-SocialBio-Psycho-Social
Bio-Psycho-Socio-CulturalBio-Psycho-Socio-Cultural
General outline of demand reductionGeneral outline of demand reduction
Treatment & RehabilitationTreatment & Rehabilitation
Prevention & follow-upPrevention & follow-up
Models of Treatment facilitiesModels of Treatment facilities
Residential basedResidential based
Hospital or centresHospital or centres
Short, medium, long Short, medium, long termterm
Outpatient basedOutpatient based
Drug Court TreatmentDrug Court Treatment
Prison basedPrison based
Treatment ApproachesTreatment Approaches
Individual therapyIndividual therapy
Group therapyGroup therapy
Family therapyFamily therapy
Special program ( juvenile, Drug court, Special program ( juvenile, Drug court, prison based, combined HIV,STI, TB, prison based, combined HIV,STI, TB, therapeutic communities, cultural)therapeutic communities, cultural)
Changing Model of CareChanging Model of Care
Recovery is not an event but the processRecovery is not an event but the process
Incarceration by itself does little to break Incarceration by itself does little to break the cycle of illegal drug use and crimethe cycle of illegal drug use and crime
Offenders sentenced to Incarceration Offenders sentenced to Incarceration exhibit high rate of RECIDIVISM once they exhibit high rate of RECIDIVISM once they are releasedare released
Drug Abuse Prevalence in Drug Abuse Prevalence in prisonsprisons
Drug Abuse in prison is very commonDrug Abuse in prison is very common
Estimated 22% - 86%Estimated 22% - 86%
Most frequently used illicit drug “ Most frequently used illicit drug “ Cannabis” 8% - 60%Cannabis” 8% - 60%
British Study 60% heroin user reported British Study 60% heroin user reported use in prison, more than 25% initiated use use in prison, more than 25% initiated use in prisonin prison
Factors associated with substance Factors associated with substance abuse in prisonabuse in prison
Age, Ethnicity, Conduct disorder, abuses, Age, Ethnicity, Conduct disorder, abuses, school difficultiesschool difficulties
Psychiatric disordersPsychiatric disorders
Antisocial personalityAntisocial personality
Support systemSupport system
Length of sentenceLength of sentence
JamaicaJamaica
Proposal to establish Drug Abuse Facility Proposal to establish Drug Abuse Facility 19981998
OAS/CICAD Belize City Drug Abuse OAS/CICAD Belize City Drug Abuse workshop 2001workshop 2001
OAS/CICAD St. Lucia Drug Abuse OAS/CICAD St. Lucia Drug Abuse workshop 2004workshop 2004
DCS Drug Abuse Survey 2005DCS Drug Abuse Survey 2005
DCS Drug Abuse Training Seminar 2006DCS Drug Abuse Training Seminar 2006
Drug Abuse Survey in Drug Abuse Survey in Jamaican PrisonsJamaican Prisons
20052005
MethodologyMethodology
4 maximum security prisons 4 maximum security prisons
Sampling Frame of 3434 inmatesSampling Frame of 3434 inmates
Stratified sampling method usedStratified sampling method used
Estimated prevalence rate 45% ± 5%Estimated prevalence rate 45% ± 5%
A total of 440 inmatesA total of 440 inmates
42 items, 4 sections Questionnaire used42 items, 4 sections Questionnaire used
Results - AgeResults - Age
A Total of 440 inmatesA Total of 440 inmates
Male 82% (360), Female 18% (80)Male 82% (360), Female 18% (80)
Age range – 18 to 73 yearsAge range – 18 to 73 years
Majority 53% (Age range 23-34)Majority 53% (Age range 23-34)
Results – Age group by GenderResults – Age group by Gender
Age groupAge group MaleMale FemaleFemale TotalTotal
17-2217-22 2525 88 33 (8%)33 (8%)
23-2823-28 9999 2121 120 (27%)120 (27%)
29-3429-34 9898 1515 113 (26%)113 (26%)
35-4035-40 7171 1212 83 (19%)83 (19%)
41-4641-46 3535 1212 47 (11%)47 (11%)
47-5247-52 2020 99 29 (6%)29 (6%)
53 & over53 & over 1212 33 15 (3%)15 (3%)
Results – Education by genderResults – Education by gender
LevelLevel MaleMale FemaleFemale TotalTotal
PrimaryPrimary 224224 2525 249 (57%)249 (57%)
SecondarySecondary 128128 3737 165 (38%)165 (38%)
TertiaryTertiary 88 1818 26 (5%)26 (5%)
Results – Literacy levelResults – Literacy level
LevelLevel MaleMale FemaleFemale TotalTotal
ExcellentExcellent 5757 4040 97 (22%)97 (22%)
GoodGood 8989 2424 113 (25%)113 (25%)
Can help selfCan help self 120120 99 129 (29%)129 (29%)
Just a littleJust a little 6666 66 72 (16%)72 (16%)
Can not read/writeCan not read/write 2828 11 29 (8%)29 (8%)
KnowledgeKnowledge
Ganja is a drugGanja is a drug 72%72%
Ganja smoking is harmfulGanja smoking is harmful 61%61%
Alcohol, tobacco & beady are drugsAlcohol, tobacco & beady are drugs 78%78%
Ganja improves sexual performanceGanja improves sexual performance 33%33%
Alcohol improves sexual performanceAlcohol improves sexual performance 38%38%
Addiction is drug dependencyAddiction is drug dependency 85%85%
A link between drug abuse & STIA link between drug abuse & STI 73%73%
PrevalencePrevalence
PrevalencePrevalence NoNo YesYes
Drug abuse before incarcerationDrug abuse before incarceration 163163 273 ( 62% )273 ( 62% )
Drug abuse during incarcerationDrug abuse during incarceration 233233 201 ( 201 ( 46%46% ) )
PrevalencePrevalence
Drug abuse before incarceratedDrug abuse before incarcerated 62%62%
Drug abuse during incarcerationDrug abuse during incarceration 46%46%
Type of Substances abusedType of Substances abused(N=305)(N=305)
TypeType NumberNumber
GanjaGanja 172 (39%)172 (39%)
TobaccoTobacco 98 (22%)98 (22%)
AlcoholAlcohol 21 (5%)21 (5%)
CrackCrack 6 (1%)6 (1%)
ValiumValium 5 (1%)5 (1%)
InhalantInhalant 3 (0.7%)3 (0.7%)
Pattern of AbusePattern of Abuse
TypeType DailyDaily WeeklyWeekly OccasionallyOccasionally
GanjaGanja 98 (22%)98 (22%) 1313 62 (14%)62 (14%)
TobaccoTobacco 75 (17%)75 (17%) 77 42 (10%)42 (10%)
AlcoholAlcohol 9 (2%)9 (2%) 11 32 (7%)32 (7%)
ValiumValium 6 (1%)6 (1%) 00 6 (1%)6 (1%)
CrackCrack 4 (0.9%)4 (0.9%) 00 3 (0.7%)3 (0.7%)
InhalantsInhalants 1 (0.2%)1 (0.2%) 00 2 (0.5%)2 (0.5%)
Factors affecting frequencyFactors affecting frequency
FactorsFactors StatisticsStatistics
MoneyMoney 122 (28%)122 (28%)
AvailabilityAvailability 63 (14%)63 (14%)
Afraid of Disciplinary actionAfraid of Disciplinary action 11 (3%)11 (3%)
Afraid of being seenAfraid of being seen 6 (1%)6 (1%)
Reason for Drug useReason for Drug use
To feel more relaxedTo feel more relaxed 119119 27%27%To meditateTo meditate 9999 23%23%To cope with prisonTo cope with prison 8484 19%19%To sleepTo sleep 6565 15%15%CuriosityCuriosity 4646 11%11%LonelyLonely 3636 8%8%Peer pressurePeer pressure 2626 6%6%AddictionAddiction 2222 5%5%ReligionReligion 88 2%2%
Source of supply in prisonSource of supply in prison
Fellow inmatesFellow inmates 189189 43%43%
Correctional officersCorrectional officers 13 13 3% 3%
Over prison wall/fenceOver prison wall/fence 8 8 2% 2%
Family/friendsFamily/friends 5 5 1% 1%
Motivation for changeMotivation for change
Want to stop drug abuseWant to stop drug abuse 150150 34%34%
Request assistance to stopRequest assistance to stop 113113 26%26%
Interest to participate in program 348Interest to participate in program 348 79%79%
Best group to sensitize drug abuse Best group to sensitize drug abuse programprogram
GroupGroup StatisticsStatistics
Recovering addictsRecovering addicts 233 233 (53%)(53%)
ChurchChurch 108 108 (25%)(25%)
FamilyFamily 34 34 (8%)(8%)
Fellow inmateFellow inmate 29 29 (7%)(7%)
OthersOthers 22 22 (5%)(5%)
Correctional officersCorrectional officers 14 14 (2%)(2%)
Survey Summary Survey Summary
Prevalence of drug abusePrevalence of drug abuse 46%46%
Ganja is most commonly abusedGanja is most commonly abused 39%39%
34%34% of inmates are motivated to quit and of inmates are motivated to quit and 26%26% requested assistance. requested assistance.
79%79% showed interest to participate in the showed interest to participate in the drug abuse program in prison.drug abuse program in prison.
Principle of Therapeutic Principle of Therapeutic JurisprudenceJurisprudence
Prof. Bruce WinnickProf. Bruce Winnick
Prof. David WexlerProf. David Wexler
Application of TJApplication of TJOffenders with underlying drug abuse problems Offenders with underlying drug abuse problems
Incarceration alone does not help or reduce Incarceration alone does not help or reduce recidivismrecidivism
Therapeutic principle is applied in Judicial Therapeutic principle is applied in Judicial processprocess
Diversion Programme Drug Court & Mental Diversion Programme Drug Court & Mental Health CourtHealth Court
Prison Based ProgrammePrison Based Programme
Parallel ModelParallel Model
Diversion ProgrammeDiversion Programme
Drug Court Treatment & RehabilitationDrug Court Treatment & Rehabilitation
May 2001 Kingston, July 2001 Montego BayMay 2001 Kingston, July 2001 Montego Bay
Drug Court Act 1999Drug Court Act 1999
Offenders with Minor Offences who meet Offenders with Minor Offences who meet eligible criteriaeligible criteria
Bail offeredBail offered
Six months outpatient programme under Six months outpatient programme under court supervision and weekly urine testingcourt supervision and weekly urine testing
What about those ineligible What about those ineligible Offenders?Offenders?
Prison Based ProgrammePrison Based Programme
Prison based Prison based ProgramProgram
? Legislation? Legislation
Political willPolitical will
Budget commitmentBudget commitment
Outpatient Drug CourtOutpatient Drug Court
LegislationLegislation
Court supervisionCourt supervision
Probation period after Probation period after graduationgraduation
Criminal offence not Criminal offence not recordedrecorded
to address ALL Mental Health Issues including substance abuseto address ALL Mental Health Issues including substance abuse
Punitive Model without Rehabilitation Punitive Model without Rehabilitation does not solve underlying issuesdoes not solve underlying issues
Try innovative methods and programsTry innovative methods and programs
What we need?What we need?
Forensic Psychiatric HospitalsForensic Psychiatric HospitalsCommunity Forensic Psychiatric ServicesCommunity Forensic Psychiatric ServicesFaculty of Forensic Psychiatry & Law, UWIFaculty of Forensic Psychiatry & Law, UWIOngoing combined or cross training of Law & PsychiatryOngoing combined or cross training of Law & PsychiatryProfessionals with special interestProfessionals with special interestPartnership building & networkingPartnership building & networkingLegal & Mental Health Reform Legal & Mental Health Reform Proper enumeration & classificationProper enumeration & classificationResearch & evaluationResearch & evaluationLegislation Legislation
There is no good health There is no good health without a good mental without a good mental
healthhealth
nobody is immune to mental illnessnobody is immune to mental illness
““Making mental health a Making mental health a Jamaican Priority, investing Jamaican Priority, investing in development of forensic in development of forensic psychiatric services through psychiatric services through
advocacy and actions”advocacy and actions”
Policy directionPolicy direction
Secured Forensic psychiatric hospitalSecured Forensic psychiatric hospitalCommunity Forensic ServicesCommunity Forensic ServicesHR & legislativesHR & legislativesQuality assurance guidelines Quality assurance guidelines Training & ResearchTraining & ResearchInter-agencies co-ordination (Ministries of Inter-agencies co-ordination (Ministries of Health/Justice/National Security Health/Justice/National Security Advocacy & support groupsAdvocacy & support groupsBudgetary commitmentBudgetary commitment
Plan includes..(not limited to)Plan includes..(not limited to)
Promotion & preventionPromotion & preventionDetection & screeningDetection & screeningProper treatmentProper treatmentReferral upon releasedReferral upon releasedNon-discriminatory Non-discriminatory Respect with human right principlesRespect with human right principlesConsultation, inclusion of inmates/staff/community for Consultation, inclusion of inmates/staff/community for strategic planningstrategic planningHR issues, trainingHR issues, trainingResearch & EvaluationResearch & EvaluationNet working, inter-agencies, Regional and Global Net working, inter-agencies, Regional and Global partnershippartnership
To ensure development of forensic To ensure development of forensic psychiatric services and to stop psychiatric services and to stop mentally ill entering to prisonsmentally ill entering to prisons
We need “a change”We need “a change”
Political will & commitmentPolitical will & commitmentPhilosophical concept with a visionPhilosophical concept with a vision
budgetarybudgetary
There is no good health without a good There is no good health without a good mental healthmental health
Lets make Mental health a priority through Lets make Mental health a priority through your action and advocacyyour action and advocacy
A great push, a great investmentA great push, a great investment
Nobody is immune to mental illnessNobody is immune to mental illness
““The Great Push”The Great Push”“Investing in Mental Health”“Investing in Mental Health”
Timely investment in Forensic Timely investment in Forensic ServicesServices
Healthy minds, Healthy people, Healthy NationHealthy minds, Healthy people, Healthy Nation
One Nation, One People, One LoveOne Nation, One People, One Love
Thank YouThank You
Dr. Myo Kyaw OoDr. Myo Kyaw Oo
MBBS, DPM, DM Psych.MBBS, DPM, DM Psych.
December 2, 2011December 2, 2011
Norman Manley Law School UWINorman Manley Law School UWI