Bad Mind: The Exploration of Jamaica’s Psychiatric Development

Mad Sick Head Nuh Good

Jamaica’s culture is firmly embedded in those who were raised within the culture and the music which stems from it. In 2010, dancehall reggae artists Kip Rich and Predator released a song titled “Head No Good.” iThe song epitomizes the perception of mental illness within the Jamaican culture. The video for this hit song opens up with a young child slapping the head of her doll against the concrete pavement of a sidewalk. As she is slamming the doll’s head, she is repeatedly singing the lyrics to the song’s chorus, “Mad sick, head nuh good; Mad sick, head nuh good.” In simpler terms, the song recites an equation to the Jamaican mental illness perception: Mental illness or “madness” equates to “being sick” and once one’s head is “sick”, his/her head is then “no good.” However, I needed to see if the advancements toward the study of mental health in Jamaica were outweighing the stigma. For many Jamaicans who witness the declining mental health of fellow peers and family members, they’ve come to a level of acceptance that is honestly quite hard for me to swallow. When asked about the mentally ill citizens and the health care they may or may not be receiving, a noncommittal shrug is followed after the dismissive phrase, “Mi nuh know ya sah; ah juss suh it go.”

“Ah juss suh it go”

“Mi waan go a foreign. It too hard dung yah, and money cyaa save. Jamaica anno one easy place fi live, a dat mi a tell yuh,” says one Montego Bay resident, Adrian Fraser, while lighting the larger end of a freshly rolled marijuana joint. He has been searching for steady work for over a year, and has yet to find “legitimate” means of maintaining self- sufficiency. “Nutt’n nah gwan fi mi dung yah so. Mi feel like mi ago mad to boxside.” In short, Fraser reveals that nothing good seems to be going on in his life, and he believes he might be going mad. “The pursuit of coming to America” is a common aspiration shared by many Jamaican residents. The island’s citizens say Jamaica isn’t an easy place to live in and often resolve that traveling to America is the only solution. There are also those, within the island and throughout the Jamaican diaspora, who believe the country’s system is “money-hungry” and corrupted. On the other hand, based on my own background as a member of the Jamaican culture, America is often perceived to be “the home of the rich” as opposed to “the home of the brave”—opportunities to make money seem endless here, and the opportunity for effective mental health care seem promising.

This is why Jamaicans welcome each American tourist with open arms. Jamaica's economy relies heavily upon the crisp bills these vacation-seekers have folded within leather wallets and branded purses. These tourists enjoy the numerous eye-gratifying attractions, of course, but most often they fail to see Jamaica beyond its beaches. After exiting the doors of Montego Bay's Sangster International Airport, there are unmarked taxis (or common cars) awaiting the arrival of each them, though if you're not a Jamaican, ignorance may impair the ability for one to see the spike of shuttling prices. Yes, this means you’re likely to get ripped off by these drivers of public transportation if you come ill-informed. They do not wear uniforms and the red-printed license plates are the only way to tell the difference between their shuttling services and the cars of Jamaica’s citizens waiting to pick up their loved ones. Still, Jamaica is a beautiful place, filled with welcoming folks and almost all the comforts offered here in America. But if one were to drive pass the beautifully structured resorts and villas, you would see the struggling mentally ill Jamaica’s citizens venturing to unexplored and yes, very dark places.

For the most part, they look like everyone else, and the culture aids in hiding them well. Abrasive approaches and eccentric livelihood are characteristics that tend to describe the average Jamaican, but exactly what sets the mentally ill apart from the rest? Jamaicans say it comes down to a few common features. For those who have been diagnosed and are medicated, one should notice the rotting teeth which protrude from darkened gums. The patients believe that this is a symptom of the medications they receive, but, more specifically, the infamous injections. Although you’ll find that neither the patients themselves nor their loved ones can identify exactly what are in these injections, this approach doesn’t seem to be a favorite amongst the patients who receive them. However, one may find that finances may play a huge role in this dental issue. According to reports in the Jamaica Observerii, “only 10 to 15 per cent of Jamaicans can afford to access private dental care and only 10 per cent of children actually see a dentist once per year.” Paying for behavioral health services and dental care is a strain to those living in Jamaica, especially when the minimum wage is currently set at 5,600 JMD per week (roughly, $56 USD). These rotting teeth could also be attributed to the lifestyles practiced by the culture. Jamaicans typically pride themselves on self-sufficient cleanliness as the predominately Christian-based population is swift to assert “cleanliness is next to Godliness.”

Nonetheless, mental illnesses, such as depression, can cause neglect in daily hygiene. Without proper care or treatment, these cases of poor hygiene lead to much larger problems—problems Jamaica’s citizens typically blame “the bad system” for.

Many people with mental illness don’t know their diagnosis. The statistics offered by the government have them all listed and categorized but affected families seem ignorant to what any of it means. The only diagnoses mentally ill candidates have become painfully accustomed to have been trivialized and summed up in one word: “mad.” Those are the people arguing with no one and laughed at by everyone. These people become the butt of every joke—often ostracized as if they bear a dreaded plague.

Tourists won’t see mental health campaigns. There are no posters urging the depressed to seek help. There are no commercials which advertise possible symptoms of a particular mental illness with a “new and improved” medication trailing closely behind. If one were to speak to residents, terms like schizophrenia and multiple personality disorder immediately provoke twisted expressions of confusion and when thoroughly explained, “di mad people deem” rarely receive responses of compassion.

Jamaica’s mantra “a juss suh it go,” or “that’s just how it goes” is what keeps many from seeking help, and Christian practices and beliefs which makes up more than half of Jamaica’s population is what keeps things “alright” for those who don’t believe in the efforts of science. Science can be something entirely different to residents of the small island. It is typically the work of “obeah” or “voodoo” consultants, and to Jamaicans, it is the reason many of the “mad” people invade Jamaica’s rocky pavements in the first place. It goes without saying that one of the many associations attributed to Jamaican culture is the daily consumption and readily accessible mounts of “ganja,” or marijuana. What these tourists don’t see is the self-medication buried beneath the frequent party goers, heavy smokers and lively alcoholic drinkers. None of these things are in the brochures.

As Jamaica works to blend in and enjoy the American comforts, steadily progressing to make its attractions more Americanized, the overall health services are far from reaching the advances evident throughout the United States. To citizens suffering from mental illness and, quite frankly, many of the average people, Jamaica is far from a walk on the beach. Jamaican artists, politicians and its government work to bring superficial awareness to the island. Yes, you may find your favorite brands at local retail stores, and knock-offs for just about the same prices we offer for the authentic products offered throughout the U.S., but the awareness on both sides seem to stop there. There are people who once held promising futures, but lacked the luxury of quality and effective care.

Nonetheless, Jamaicans seems to take these realities, as just that—reality. A noncommittal shrug and a dismissive headshake tend come right before the common response of the only explanation they have, “A juss suh it go.”

“Ah Juss Bad Mind”

“It’s just bad mind” that causes the worst of circumstances to many Jamaicans, especially in the case of Michael Davis. They call him “Motto” as in “Motor” and he’s fast, as his name implies. His steady, swift pace that once glided across skating arenas in the U.S is now practiced whenever he perceives danger. This danger typically comes in the form of an approaching and unspecified injection administered by members of Jamaica’s psychiatric services. Michael Davis, 40, was once a member of Jamaica’s Olympic Ice Skating team in the late 80’s, but it’s been more than two decades since he’s skated, and though mentally ill, he remembers it fondly. He begins each day the same. His mother, Hermalin Darvy, prepares breakfast for him in their modest zinc-sheet-clad home, and then he’s off—off to walk along the importing train’s railroad in search of weed.

He lives in a small and impoverished community in Ewarton, St. Catherine, where the roads are outlined by streams of polluted water. Here, there are no paved driveways, and the houses are yards apart. The streams of water spring from the outside faucets used to clean many of the residents as well as the slaughtered produce they cultivate themselves. Most days, Motto holds no regard for a shirt, and the sun has blackened him considerably since his days in the ring. The crown of his head is bald yet natural hair crowds its circumference, and when asked for a photo, Motto considers his mouth first. Both lips bend inward to conceal his rotting teeth. After all, appearances still do matter. It is believed by Darvy’s mother, family members and Darvy himself, that marijuana is what ended it all for him almost 25 years ago.

March 28, 1991 was the last time he traveled with his Olympic team to the U.S.— specifically Alaska. After returning home, his mother soon realized some changes in Motto. The family thinks that a neighboring friend meticulously and inconspicuously sliced up a lizard’s tail and sprinkled it inside a marijuana joint that was then given to

Motto. That is the only explanation they have, even if it is just suspicion, as to why the promising athlete can no longer take care of himself. “Ah juss bad mind,” his mother said. It is a phrase used to describe the physical manifestations of envious thoughts in Jamaica. This means, to those closest to Motto, it seems he was just a victim of sheer jealousy. The phrase “bad mind” coincidently correlates with Motto’s mental health. His exact condition is unknown to him and his family, but they confidently resolve that “him head juss nuh good.” Again we are exposed to the aforementioned perception, because he is mentally ill his mind is bad.

For his “bad mind,” he is instructed to take 5 milligrams of an anti-psychotic phenothiazine named Stelazine two times daily after meals. He is then instructed to take 2 milligrams of Artane: a medication typically used for patients with Parkinson’s disease. He takes both only as needed, and sometimes not at all. When his “mind tek him” or when he’s showing progressively worse symptoms, his behavior becomes unmanageable to those who help to take care of him. He becomes violent and restless. After the Bog Walk clinic located in Spanish Town is contacted, he is typically visited by Dr. Henry, who administers the injections that terrify him. By that time, he is in flight mode as he understands the injections will sedate him.

According to the a World Health Organization assessment of mental health services in Jamaica published in 2009,iii for every 100,000 Jamaicans, there are only six authorized medical professionals, usually nurses, able to provide mental health services. There is also only one psychiatrist available for every 100,000 people.

The assessment continues: “There is a dearth of psychologists, social workers and occupational therapists in the island due to the unattractive remuneration in the public sector. Most psychiatrists provide both public and private services...There is no legislative, financial provision for person with mental disorders and only one percent of persons with a mental disability receive social welfare benefits.”

This means that for persons like Motto, they do receive home visits and services offered in the comfort of his own home, but if he’d like to receive services at the clinic, while most medications are offered for free, the travel and the services are typically paid out of pocket. His mother and caretaker don’t have much. She is what you call a “road-side higgler” in Jamaica. This just means she sells goods on the streets, just as you would see a man or woman “hustling” with less than authentic products alongside the sidewalks of New York City’s bustling traffic.

“Sometimes, I think they should have more doctors,” Darvy said. “They have the doctors that come and go, yes, but they don’t show much interest. They don’t examine them right through.” When things are really bad, the house-visits are delayed and Motto rejects the mind-numbing medication, he becomes violent. He threatens to kill his loved ones and he becomes uncontrollable.

A 2015 assessment released by the Bureau of Diplomatic Security of the U.S. State Department describes Jamaica’s overall crime statusiv: “In 2014, Jamaica saw 1,005 murders (the lowest figure in a decade, 195 less than 2013, which is a 16.6 percent decline over the past year to date), 1,227 shootings, 580 aggravated assaults, 792 rapes,

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2,631 robberies, 2,443 break-ins recorded. With a population of 2.8 million people, Jamaica continues to have a high homicide rate (36/100,000), which places it among the highest (per capita) national homicide rates in the world.” (However, in comparison, New York City’s homicide rate is about 2.2 people per 100,000, although just 25 years ago, the rate was comparable to Jamaica’s.) While Jamaica is progressing toward the advances of the luxuries offered all over the world, primarily in America, the homicide rates are continuing to increase as well. With this in mind, one must consider just how much “progress” is being made all around.

The numbers say a lot for this small island. Nonetheless, what seems to be even more interesting aren’t the sources these crimes are attributed to, but instead the underlying contributing factors that are reported. In WHO’s assessment, it reveals that out of 100 authority figures, only 1-20 of them are actually trained to understand mental illness and be prepared to work with those suffering from it. “The percentage of prisoners with psychosis is 11-15 percent, while 2 percent are mentally retarded. 81-100 percent of prisons have at least one prisoner per month in treatment contact with a mental health professional.” While the numbers are recorded, there are still many mentally ill civilians who don’t seek professional help. It then becomes the job of the limitedly trained percentage of authority figures to determine who needs help.

The report also reveals that 91 percent of all admissions to community-based inpatient psychiatric units, and 95 percent of all admissions to a mental hospital are involuntary. Which means, while Jamaica is working to keep a record of crimes attributed to mental health, for the most part, they can’t determine which crimes were premeditated and which were senseless acts by those who don’t truly understand the idea of right and wrong.

The possibility of this is not mentioned at all, but how can one not question the possibility that these growing displays of violence are being exhibited by people who have a mental illness and don’t know it, nor care to find out? Are people choosing to be mentally-ill or ignorant to the possibility, or is effective care not being offered?

“Obeah”

This, I had to see. Psychics, palm readers, and voodoo can all describe the practice of obeah workers. You can’t find these people on the streets unless you know the right people. They don’t have huge “Psychic” displays as you often see throughout the streets of New York City. No, you’re likely to be referred to one from a friend who knows a friend. When the citizens are suddenly struck with unfortunate circumstances or unexplained mental breakdowns, more often than not, they seek the help of “reader- men/woman” or simply put “Obeah workers.”

Deep in the heart of Montego Bay, Jamaica, a “reader-woman” lives in an inconspicuous comfortable home. They don’t introduce themselves by name, they just perform. The roads leading to her home are rocky, and after several suspicious turns, you are sure to find her home at the bottom of a hill or “deep inna di gully.” Her veranda is occupied by two people as they await their turns. There are a set of instructions you must follow before she sees you. First, you must wrap your waist with a scarf. This notion indicates a Biblical reference sporadically mentioned throughout the Bible but most famously noted in the book of Jeremiah chapter 1:17, “Thou therefore gird up thy loins, and arise, and speak unto them all that I command thee: be not dismayed at them, lest I dismay thee before them.” With that, I girded my loins and was prompted to begin step two: walk around a fountain located just before the veranda and recite the 23rd Psalm seven times. This became a deeply spiritual process as the number seven is noted as God’s number or the number of completion.

I began the process, “The Lord is my Shepherd...” Seven turns and biblical recitations later, I was then told to wash my hands in the fountain when I was promptly welcomed into the small room. There were no lights, but the door remained ajar leaving room for the sunlight to stream in. She donned a white scarf on her head, a tradition typically practiced in revivalist churches. She wore a long white dress, which flowed just large enough to hide the shape of her body. She sat down and looked directly in my eyes. “What is your name? (I assumed, she’d already know that), she continued to scribble words in an open composition notebook, and tried to gather remnants of my past, present and future. I was told that people were after me, and more specifically, these people were after my mind. “Before you leave, I’m going to have to give you a bath and something to take every day. The cost is 10,000 [JMD].” It suddenly all made sense. Those who were mentally ill would go to these reader people in an attempt to rid themselves of the bad forces. The cleansing bath is what would get rid of them, and the unspecified liquid one is instructed to take cleanses the body from the inside out, all the while maintaining one’s protection.

Still, there was the “obeah-man” who seemed more popular than the average “obeah” woman. After an extensive “who knows who search,” I was finally able to track one down. Just as the woman, his home is hard to spot. He lives in an area called Red Road and it becomes evident just why the area is deemed as such. The pavement leading to his driveway is filled with broken and splintered red stones, so the driver steers both slowly and carefully. Before heading to his home, I was cautioned to wear “yard” shoes, or shoes one would typically throw on and wear anywhere—they had to be both comfortable and unloved. The drive there seemed long, and with the amount of turns driven upon nondescript roads was enough to make me both dizzy and unaware of my surroundings. He seemed to be a big deal. His more than modest-sized home was gated, and separate from that home was a smaller house he used to practice his work. There was a lengthy wait period, as he took time to pray and prepare before welcoming anyone in. Once I was summoned, I took a seat in yet another small, cramped room. The first thing I noticed was the worn Bible left sitting upon the table. Just as the woman before, he declined to offer his name. He pulled out an empty bowl. A small pot of water sat beside it. I was then instructed to pour that water inside the bowl and wash my hands with the contents. The man then pulled out a stack of tarot cards, right after he told me to open up the Bible. Then my life, past, present and future was revealed to me. Of course, I was then told that if I want to ensure good life and prosperity, it would cost me. While he was considerably less expensive in his demands, the concept remained the same. If one wants to get better, one must pay for the fight against spiritual attacks.

“It’s much different here then it is there,” Karen Smith told me. She is a Jamaican-born behavioral health therapist at the Southwest Community Health Center in Bridegport, CT. She explained that there isn’t much awareness of psychological approaches to situations. “If you’re worried, they tell you to stop. If you’re sick, they tell you to drink tea. They only know what they know, and feelings aren’t talked about.” I could see evidence of that even within my own family. Born to first-generation immigrants, I realized the tougher skin I developed over the years. In my household, and in the homes of my Jamaican friends, there was a strict order to things—know your God, know how to do for yourself, and if you’re in pain, drink one of the curing “bush teas”. It’s nature’s way of helping with any cause. The concepts were simple, but anything larger than them were just as easily dismissed as a “when it rains, it pours” circumstance. As the stories of hardship and corruption in Jamaica began to unfold by the different members of the Jamaican diaspora in the U.S., the realization hit me—the problem may not be corruption within the Jamaican governmental system at all. The problem may be simpler than I initially considered—money, and the lack of it.

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