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A Moment in Mental Health



My Q&A with Dr. Alicia Malcolm


  1. How many clients are you serving at this time or how many mentally challenged individuals are registered with the Department?

The Department of Mental Health and Substance Dependence sees an average of 1,100 persons in our clinics per year. This number has steadily increased as persons become more aware of the importance of taking care of their mental health.

  1. What are the top three or five leading mental health issues for TCI?

The leading cause for consultations are for Anxiety/ stress related disorders and Mood Disorders such as Depression.

  1. How many do you believe are going undiagnosed and therefore unsupported?

Based on psychological research, there does not appear to be a significant difference in the overall prevalence of mental health disorders between the genders. However, there are some noticeable differences in the types of mental illnesses that men and women struggle with.  Some more common mental disorders in men include:

  1. Do you think or do we have stats to show if mental health is a larger issue for men or women?

Antisocial personality disorders. For women, common mental disorders include: Depression, Anxiety and PTSD.

Women present more frequently in our clinics than men. However, this does not mean that mental health issues are larger in females. Typically across the globe you’ll find that men are less likely than women to seek help for a mental health condition.

  1. How many are getting treatment/care/support?

It is unclear exactly how many people across the nation have undiagnosed mental health conditions. However, our encouragement is that anyone who is experiencing any sort of mental or emotional issues that create impairment in their daily functioning contact us so that we can assess and provide the necessary intervention. On average we provide treatment and care for about 15- 20 in our treatment abroad program and as mentioned previously an average of 1,100 in country per year.

  1. What is the status of the Mental Health Facility; seems it has been stagnant for many years now?

The mental health facility project is ongoing and it is anticipated to open early next year (2022). Recruitment of staff is actively being done while remaining construction works are being completed.

  1. I notice that your budget has nearly doubled in 10 years; what does this mean for Mental Health in TCI?

The increase in the budget reflects a number of things but in essence it means that there will be additional mental health professionals available to provide care and treatment for clients. In addition, new and improved forms of medication are being utilized with patients who may have become treatment resistant.

  1. How many mental health doctors do we have country wide?  What is your team size?

The mental health team is currently comprised of  eight clinicians: 4 doctors and 4 therapists. There are 12 new positions that have been added and recruitment is being done to fill them.

  1. How many children with mental health issues; and what kind?

On average 30 – 40 children are seen in our clinics per year. The top three mental health issues are Depression, Oppositional Defiant Disorder and Trauma Related- Sexual Abuse.

  1. What step would make the biggest impact on an improved delivery of care/service to mental health in Turks and Caicos from your experience?

Some steps that will assist in the continued improvement of mental health care delivery in TCI include: building local capacity through ongoing training of general practitioners; completion of mental health facility to serve persons with acute and chronic mental health conditions; ensuring greater access to services e.g through the continued use of telehealth services and strengthening community outreach and educational programs.


Dr. Alicia B. Malcolm (Psy.D.) became Director of the Department of Mental Health & Substance Dependence of the Turks and Caicos Islands in 2013.


Bahamas News

Guys, Have 2 Minutes? Here’s How to Check Yourself for Testicular Cancer



Testicular cancer is a rare form of cancer for men in The Bahamas.  It is highly curable — if you know it’s there!


November 30, 2021 – Men…how often do you perform a self-exam to check yourselves for testicular cancer?

While it’s a relatively rare form of cancer, young men aren’t exempt – in fact, testicular cancer occurs most often in young and middle-aged men. The good news is, it can usually be treated successfully.

The most common symptom of testicular cancer is a lump on your testicle. But that’s not the only sign of this disease.

Men who have testicular cancer may experience several different kinds of symptoms, says oncologist Timothy Gilligan, MD, a Medical Oncologist at Cleveland Clinic who specializes in treating testicular cancer.

Testicular cancer most frequently strikes men younger than age 44, and is the most commonly diagnosed cancer for men ages 15 to 34. It is almost always curable if found early, Dr. Gilligan says, and it is usually curable even when at a later stage. So it’s important to know signs and symptoms.

Here, Dr. Gilligan says, are five possible signs of testicular cancer you might not know about:

5 Testicular Cancer Symptoms That Aren’t a Lump  – Know what to look for and catch it early

  1. A feeling of heaviness or pressure in your scrotum.
  2. Change in testicle size or firmness.Certain types of testicular tumors can reduce testosterone or increase estrogen in the body, which can result in a change in testicle size or firmness.
  3. Swollen legs.When a tumor spreads to the lymph node, it can constrict blood flow in the veins and result in a blood clot. The clots often occur in the legs, which causes them to swell. You might even experience blood clot symptoms such as pain and difficulty breathing.
  4. Lower back pain and shortness of breath.These are symptoms of advanced testicular cancer, meaning the cancer has spread to lymph nodes behind your stomach. Shortness of breath also may signal that the cancer has spread to your lungs, which may make it harder for air to move in and out.
  5. Breast growth or tenderness.In rare cases, hormone changes also can cause breast tenderness or growth of breast tissue. Some tumors can secrete high levels of a hormone called human chorionic gonadotropin (HCG), which stimulates breast development.

If you experience any of these symptoms, make an appointment with your doctor right away, Dr. Gilligan says. If your physician diagnoses you with epididymitis or orchitis and the symptoms do not resolve quickly with antibiotics, request an ultrasound to evaluate for a testicular tumor.

“While up to 95 percent of men with testicular cancer are cured, it’s important to get care quickly if you’re experiencing symptoms because testicular cancers usually grow fast,” Dr. Gilligan says. “If there is disease, the earlier it is treated, the greater than chance for success.”


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Dental Digits; Health Minister gives Update on Great Shape Inc & Sandals Foundation partnership



By Sherrica Thompson

Staff Writer


#TurksandCaicos, November 30, 2021 – Minister of Health and Human Services, Honorable Jamell Robinson, announced in the House of Assembly on Monday November 22 that three thousand six hundred and sixty-eight persons in Providenciales benefited from the 1000 Smiles Dental Clinic’s two weeks project.

The programme, which was started on October 15, by Great Shape! Inc., a non-profit based in the United States and facilitated by the Sandals Foundation Beaches Resorts, provided free dental care and education to citizens.

Minister Robinson said the project was valued at $1,1400,701, and 5,431procedures were provided. These included cleanings, extractions, sealants, and fluorides that involved three dentures and 18 root canals.

He said that 103 volunteers, including 45 dentists and hygienists, visited and worked with the Department of Dental Staff.

The Oral Health Education team visited most schools in Providenciales, where 400 children were impacted. The team provided interactive sessions and lessons on nutrition, home care prevention and professional dental care. Most children were also given a toothbrush, floss, and toothpaste.

Minister Robinson thanked Joseph Wright and the volunteers for the visit that he described as impactful and said he looks forward to similar partnerships in the future.


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US Deaths to COVID higher, Dr. Fauci floundering on Fully Vaccinated definition



#UnitedStatesofAmerica, November 24, 2021 – Vaccine manufacturers are predicting that booster shots for Covid 19 will be needed every six months for years to come, and Dr. Anthony Fauci, US infectious disease expert and advisor to the president has gone on record with the hope that this will not be the case.  But anytime Dr. Fauci says he hopes something won’t happen in relation to the vaccines… it always certainly does.

“We’ll continue to follow the data, because right now when we’re boosting people, what we’re doing is following them,” Fauci said. “We’re going to see what the durability of that protection is, and as we always do, you just follow and let the data guide your policy and let the data guide your recommendations.”

The vaccine is not working to keep Covid-19 deaths lower; more Americans have died in 2021 due to Covid 19, than in 2020.  CDC data says 14,700 more people have died in 2021 than last year due to COVID-19 — and there’s still more than a month left in the year for that number to grow.

Overall, the US has lost 770,000 people to the coronavirus.

Dr. Fauci is also floundering on the definition of fully vaccinated; saying people who have taken the third shot are being monitored to see how long efficacy holds up; he simply does not know if it will wear off again in six months.

“…fully vaccinated right now, by definition, is the original two doses… of the Pfizer and Moderna and a single dose of J and J.”

Media reports indicate there are plans to redefine fully vaccinated as having received three shots, evidence however could prove that in six months, the inoculated are back to square one.

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