‘Sorrow looks back, worry looks around, faith looks up’ − Ralph Waldo Emerson

The WHO defines mental health as "a state of well-being in which an individual realizes his or her own abilities, can cope with normal stresses of life, can work productively and is able to make a contribution to his or her community". The prevalence of mental health issues is established world-wide at one person out of every four, therefore one of the leading causes of ill-health and disability worldwide.

The COVID-19 pandemic has brought with it challenges the likes of which we have never seen before, including mental stress issues. Mental health is a human experience and a normal part of being alive. Conditions, symptoms and circumstances that surround mental health are complex, come in a myriad of variations and need to be addressed with the same vigour as physical health. The stigma associated with mental health is a challenge that is being addressed vigorously by this Government, in a number of ways.

The situation in Gozo

Well before the current pandemic, my belief in a holistic approach to physical and mental health have led me, over the years, to be a push for reforms in the way mental health is tackled within the community, particularly in Gozo. There is no data with regard to the prevalence of mental health issues in Gozo. But on the basis of the above yardstick set by the WHO, it is assumed that given Gozo's population of 31,445 individuals (2015), there are around 7,800 persons who at some point experience mental health problems.

Furthermore, given Gozo's unique characteristics, its smallness and insularity which result in a higher level of inter-marriage, it is reasonable to conclude that the number of persons suffering from mental illness on the island is in the region of 6,000 individuals.

Considering Malta’s physical and soft infrastructure for the provision of mental health care, the state of play in Gozo lags well behind. The situation is further compounded by the fact that NGOs, which are very active in this sector in Malta are, as yet, barely present in Gozo, were it not for the excellent and sterling work of the Mental Health Association Gozo.

Avoiding stigmatisation

Gozo's unique social fabric leads me to find innovative ways of addressing mental health issues in a different way to that on mainland Malta. The treatment of mental illness on the island requires careful design because stigmatisation is still very high. An approach to establish an institutionalisation framework in Gozo will not work. A mentally ill person and his or her family will maintain their distance from such a healthcare model. Given Gozo’s size and small community, the stigmatisation of a person as being mentally unwell is likely to have a negative effect on the social and economic interactions of that person and his or her family.

It is my firm belief that the best successful solution is an outreach approach to health care provision based on the least restrictive environment and with the minimum disruption to their lives. This is why together with The Mental Health Association Gozo and other professionals we worked on a community-based project entitled Tgħanniqa.

Our first step in Għarb

A house in Għarb was rented through the Housing Authority with the aim of creating an outreach environment that targeted carer involvement and community partnership and development. Services addressing areas in an individual's life that are important to him or her, a recovery plan, service-user involvement at all levels and social inclusion were also factored into this project.

The property in Għarb will in essence serve as a Crisis and Respite house and a way of addressing mental health issues in a community outreach environment. The house is appropriately equipped to act as an alternative to hospital care in a safe, supportive and family-like environment for users in crisis. The respite aspect will provide for a short period of rest in a stress-free environment for the person under treatment and / or his or her family. The Crisis and Respite House is also meant to be an office for an Assertive Outreach Team.

As Allen Frances aptly put it: “The power to label is the power to destroy.”  With this in mind, The Crisis and Respite House was carefully chosen and is in a secluded and stress-free environment, in the picturesque rural village of Għarb. This project should, in the years to come, provide a breakthrough and a way forward in the treatment and recovery of persons suffering from mental health issues within the community. It is a hands-on practical approach that will pave the way for individuals to lead a productive and integrated life.

Stress and anxiety

The current situation carries with it psycho-social considerations. Stress and anxiety within our communities is a natural response to fear of the unknown. It is important that persons who contracted the virus are not stigmatised. During this time it is important that we follow all the advice given by the health authorities. Pulling one rope is the key – solidarity is the biggest weapon in our fight against the virus.

We are however a resilient and adaptable nation with the intrinsic capability of transforming obstacles into opportunities in a short span of time. We rose above the challenge. Proof of this is our ability to communicate with family, friends and workplace and actively participate in religious and social activities through virtual means, while staying safe and adhering to the health authority's instructions. As a mother of two children, I cannot but laud the efforts and innovative ways our teachers have tackled ways in which our children can continue to cover this year's syllabus in a practical way via internet.

Serving our community

On a regional and national level, opportunities are there for us to seize and implement together! I am now more determined than ever to continue serving the Gozitan community in particular. I am proud to chair the Parliamentary Committee for Gozo affairs and am looking forward to continued high level dialogue with the Gozitan constituted bodies and entities.

The aim of this Committee is to evaluate and bring forward measures tailor-made for us Gozitans, in our own setting and focused on creating a socio-economic environment, conductive of sustainability for this and future generations. I note with satisfaction that in the two meetings that I have already chaired, the response and interest were overwhelming. The enthusiasm and collaboration shown by the members and constituted bodies, have strengthened my resolve to ensure that solid solutions are found and implemented in as short a time as possible. For the love of our island, this is how I have and always will tackle challenges!

This is what I have always aimed for − rather than merely scrutinising and providing for Gozo from behind the desks in mainland Malta. Parliament has an established platform, where Gozitan stakeholders are directly involved in the legislative process concerning their island. Despite the current emergency, we have forged ahead with the opportunity to overcome challenges and look up to the future.