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[Excerpt] from an Mental Health & Well Being Open Consultation; United Kingdom

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May 19, 2022 – “Approximately 1 in 6 people aged 16 and over in England were identified as having a common mental health condition in 2014, according to survey data.  In 2020 to 2021, there were around half a million people with more severe mental illness such as schizophrenia or bipolar disorder. We have seen worrying trends for children and young people, with rates of probable mental health disorders in 6 to 16-year-olds rising from 11.6% in 2017 to 17.4% in 2021. More people than ever are receiving support for a mental health crisis and, tragically, the numbers of those ending their life through suicide have broadly increased over the past decade. We know that two-thirds of people who end their life by suicide are not in contact with NHS mental health services.

For many of us, the experience of the coronavirus (COVID-19) pandemic – and its wide-ranging impacts on individuals, families, society and the economy – have brought these issues into sharper focus. Around 1 in 5 adults in Britain experienced some form of depression in the first 3 months of 2021, over double pre-pandemic figures.

These problems aren’t felt equally by all of us. We know there is an uneven distribution of mental ill-health across society. People facing social and economic disadvantage are at a much higher risk of developing mental health conditions. They are also more likely to receive care and support much later as their conditions escalate to crisis point. In 2020 to 2021, people living in the most deprived areas of England were twice as likely to be in contact with mental health services than those living in the least deprived areas.

There are also disparities by ethnicity, age, sexuality, and sex, and for people with learning disabilities, neurodiversity, and long-term physical health conditions. Risks of mental ill-health are also higher for people who are unemployed, people in problem debt, people who have experienced displacement, including refugees and asylum seekers, people who have experienced trauma as the result of violence or abuse, children in care and care leavers, people in contact with the criminal justice system (both victims and offenders), people who sleep rough or are homeless, people with substance misuse or gambling problems, people who live alone, and unpaid carers. People may belong to several disadvantaged groups at once, which is likely to compound the risk of experiencing mental ill-health. Addressing these disparities is critical to deliver the government’s ambition to level up the country and tackle disparities in health. We will set out more detail on our plans to reduce the gap in health outcomes between different places and communities across the country in our forthcoming health disparities white paper. See Annex A below on mental health disparities for more detail, which can be used as a point of reference when responding to our questions.

The impacts of mental ill-health on individuals, communities, society and the economy are substantial. Children and young people’s mental health conditions incur annual short-term costs estimated at £1.58 billion and annual long-term costs estimated at £2.35 billion.

Around 50% of mental health conditions are established by the time a child reaches the age of 14, and 75% by age 24.

Adults with mental health conditions are much more likely to be out of work, to have lower incomes, increased problems with their physical health, and increased involvement in the criminal justice system, both as victims and perpetrators.

The total annual cost of mental ill-health in the workplace to government has been estimated at between £24 billion and £27 billion. The overall annual loss to the economy has been estimated at between £70 billion and £100 billion. Losses are greater in places and among groups that experience mental health disparities.

Health is essential to a stable and functioning economy.

Our strong economic foundation going into the pandemic and the support provided throughout means we have made good economic progress.

However, we must continue to build back better as we begin to rebuild the economy. By improving mental health across the country, we can improve lives and livelihoods whilst reducing the demand on the NHS and pressure on other public services, and at the same time supporting economic growth.

A healthier and happier population is also more likely to access employment opportunities, which will reduce inactivity and improve productivity.

Reducing disparities in mental health between local areas is therefore critical to ensuring more equal access to opportunities and supporting the government’s Levelling Up agenda.”

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Health

Dengue Getting Worst

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Rashaed Esson

Staff Writer

#Dengue#Caribbean#CentralandSouthAmerica, April 25, 2024 – New data from the Pan American Organisation(PAHO), indicates that dengue in the region may hit an all time high now over 4 million cases, a 260 percent increase from 2023 with over 1700 deaths registered since mid April. In fact, since April, reports say Brazil has reported the most cases. As a result of the surge in cases, the U.S. Centers for Disease Control and Prevention (CDC), reissued its Level 1 Travel Health Advisory for the Americas on April 18, 2024 and the countries listed include the Turks and Caicos, Guadeloupe and French Guiana, as they have been seeing higher than usual levels of infection.

 

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Health

Increased cases of Chicken Pox Prompts Ministry of Health and Human Services Response

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PRESS RELEASE

MINISTRY OF HEALTH & HUMAN SERVICES

Providenciales, Turks and Caicos Islands, 25 April 2024 – The Ministry of Health and Human Services is issuing a public advisory regarding a recent increase in chicken pox cases, particularly within school communities in the regions of Grand Turk and Providenciales. The Ministry is actively monitoring the situation and is working closely with affected schools to provide support and education aimed at preventing further spread of the virus.

Chicken pox, caused by the varicella-zoster virus, is a highly contagious infection characterized by a distinctive rash of itchy red spots or blisters. Transmission occurs via droplets, aerosols, or direct contact with respiratory secretions, and almost always produces clinical disease in susceptible individuals. While mostly a mild disorder in childhood, varicella tends to be more severe in adults. It may be fatal, especially in neonates and in immunocompromised persons. The Ministry urges parents, teachers, and the general public to remain vigilant and familiarize themselves with the signs and symptoms of chicken pox, which may include:

  • Rash: The primary symptom of chicken pox is a rash that typically begins as small red spots, which then develop into fluid-filled blisters over several days.
  • Fever: Children with chicken pox may experience a mild to moderate fever, often preceding the appearance of the rash.
  • Fatigue: Some individuals may feel generally unwell, tired, or lethargic.
  • Loss of Appetite: A decreased desire to eat may accompany other symptoms of chicken pox.

Management aims to relieve symptoms and reduce the risk of complications and may include:

  • drinking plenty of fluid (try popsicles if your child is not drinking) to avoid dehydration.
  • taking paracetamol to help with pain and discomfort.
  • cut your child’s fingernails and put socks on their hands at night to stop them scratching.
  • use cooling creams or gels e.g. Calamine lotion
  • speak to your health care provider about using antihistamine medicine to help itching.
  • bathe in cool water and pat the skin dry (do not rub)
  • dress in loose clothes.

 

  • do not use ibuprofen unless advised to do so by a doctor, as it may cause serious skin infections.
  • do not give aspirin to children under 16.
  • do not go near newborn babies, or anyone who is pregnant or has a weakened immune system, as chickenpox can be dangerous for them.
  • do not scratch the spots, as scratching can cause scarring.

To mitigate the spread of chicken pox within schools and communities, the Ministry emphasizes the importance of practicing good hygiene habits, including frequent handwashing with soap and water, covering coughs and sneezes with a tissue or elbow, and avoiding close contact with infected individuals.

In the event that a child exhibits symptoms of chicken pox, parents and caregivers are advised to keep them at home and seek medical attention promptly. A sick leave for a period of 14 days is usually given. After the 14 day sick leave period, the individual must return to the physician or the public health nurse at one of the primary care clinics to obtain a fit for work or school certificate allowing them re-entry back into school or work. Anyone returning earlier than this time or without this certificate should not be allowed in school so as to prevent spread to other children. Additionally, it is crucial to inform school authorities to prevent further transmission among classmates and staff.

The Ministry of Health and Human Services is committed to ensuring the health and well-being of all citizens, and will continue to work diligently to address this current situation. For further information and guidance on chicken pox prevention and management, please visit Turks and Caicos Islands Ministry of Health and Human Services Facebook page at https://www.facebook.com/tciministryofhealth/.

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Caribbean News

CARPHA Supports Antigua and Barbuda in Building Capacity for upcoming Mass Gathering Events

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St. John’s, Antigua and Barbuda. April 17th  2024. The Caribbean Public Health Agency (CARPHA) is conducting an integrated mission to Antigua and Barbuda (ANU) during April 15-19th  to build capacity in surveillance, early warning and response systems, laboratory capacity, competence in health and food safety, and prepare for the launch of  the CARPHA Regional Tourism and Health Program (THP), ahead of the 4th International Conference of Small Developing Island States (SIDS), Sailing Week, the ICC Men’s T20 World Cup, and other major upcoming mass gathering(MG) events.

The CARPHA mission, led by Dr. Lisa Indar, Director, Surveillance, Disease Prevention and Control Division (SDPC), comprises  persons from several CARPHA departments: Dr. Laura-Lee Boodram, Head, Caribbean Regional Field Epidemiology and Laboratory Training Programme, Dr. Michelle Hamilton, Head of Laboratory Services and Networks (LSN), Dr. Jarelle Branford and Ms Sheena DeSilva  from  Health Information Communicable Diseases and Emergency Response (HCE), Ms Neeta Oudit (LSN), Mr. Keston Daniel and Dr. Anushka Bissoon-Pustam  of the Regional Tourism and Health Program (THP), and Mr Mohammed Elsherbiny, Senior Technical Advisor to the THP from the UKHSA.

Dr. Kamaria De Castro, Acting Chief Medical Officer, remarked “The partnership is timely as it helps to improve capacity as it assists in developing a sustainable future. We want to protect our local population as well as our visitors and let them know that we are aware of public health threats and we are preparing, building capacity, training and procuring resources that will be put in place to effectively prevent major spread of diseases. She extended her gratitude to CARPHA for the continued support and partnership.”

Dr. Lisa Indar indicated, “It is important to prevent public health threats to stop them from becoming emergencies as visitors are coming in from many different countries for Cricket World Cup, SIDS, Sailing Week and we want to make sure our visitors as well as our people are safe. We want to put systems in place and strengthen existing systems to be able to identify risks early and begin immediate and more timely responses to mitigate the potential spread of diseases.”

Key outcomes and activities of this mission include:

  • High level endorsements for the capacity building missions from the Ministers of Health, and Tourism
  • Formation of an Antigua and Barbuda THP Steering Committee for promoting healthier safer tourism
  • Communicable Diseases Surveillance workshop for Health Workers across the health sector to understand case definitions and timely reporting to the central level.
  • National Risk Assessment for mass gatherings, using the WHO/PAHO Mass Gathering Risk Assessment Tool, the results of which will be used to guide preparation and response for the upcoming MGs.
  • Desktop simulation exercises with doctors, public health nurses, Emergency Medical Services, law enforcement, National Office of Disaster Services, Red Cross and laboratory workers to assess how participants will respond  to  multiple public health  scenarios during mass gathering events and identify gaps/challenges of the same.
  • Rapid response training for public health professionals, including persons from the security/defense force and  the National Office of Disaster Services and partners. The training will review scenarios that  necessitate  mounting a response to a public health emergency by rapidly dispatching a multidisciplinary team to investigate and implement mitigating measures to contain the situation.
  • Mass gatherings surveillance training for surveillance team, public health nurses and other members within the health sector. An all-hands-on-deck approach will be taken to emphasize the need for daily and real-time reporting, monitoring, response, coordination, and communication. CARPHA’s regional mass gathering syndromic surveillance system (MGSS) is detailed,  including  national surveillance, tourism-based surveillance and the new module developed for mass gatherings . Doctors, nurses, and surveillance officers to be present at the health stations for the 4th UN SIDS Conference will also be trained and registered on MGSS.
  • Engagement with the health, tourism, and port authority teams to discuss ways to bolster disease surveillance of cruise ships for Antigua and Barbuda as a large number of the transient population for the country is through cruises, especially as Antigua and Barbuda is a homeport for many cruise ships.
  • Conduct field visits to major hotels (including the ones hosting the players and officials for the T20 games) to get them registered on the confidential early warning THiS system.
  • Training on Food and Environmental Health safety during mass gatherings for food handlers and restaurants, including those who will be providing the catering services for the SIDS Conference. The training focuses on ensuring all food handlers are equipped with the appropriate knowledge and tools to prepare, cook, store and serve food to guests at the establishments and in a Mass Gathering setting.
  • Training in Prevention and Control of Infectious Diseases, for the hospitality sector with an additional focus on Mass Gatherings. The session aims to build capacity to quickly identify and respond to cases of infectious diseases and will include participants from the hotel, food and beverage sectors some of which will be working closely with the SIDS Conference and will be working with the upcoming Cricket World Cup.
  • Assessments of the laboratory network of Antigua and Barbuda for optimization of laboratory services available in-country. Training in testing for priority pathogens during an emergency response and/or mass gathering will be conducted.

As a highly tourism-dependent country, Antigua welcomes as much as 20,000 visitors daily, further highlighting the need for robust visitor-based surveillance. These workshops will provide instruments in identifying and addressing various challenges of Antigua and Barbuda in preparing for mass gatherings. This joint mission aims to strengthen Antigua and Barbuda’s surveillance and response capacity and preparedness to effectively anticipate and manage potential challenges, ensuring a seamless and secure SIDS conference, T20 CWC tournament, Sailing Week and Carnival experience for all.

CARPHA and Antigua and Barbuda continue to work toward supporting Antigua and Barbuda’s preparation for these large-scale mass gathering events and for the large number of tourists visiting the islands on a daily and weekly basis. CARPHA stands ready to continue supporting Antigua and Barbuda.

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