By Sir Ronald Sanders
Mental health is no longer hidden in the margins of public life, whether in Europe, North America, or the Caribbean. It is a growing global reality that costs lives and livelihoods, and prevents social cohesion and economic inclusion.
Yet, while the problem is no longer a secret, its treatment in the Caribbean too often remains one of embarrassed secrecy. Elderly people are institutionalised; younger people are locked away at home or in institutions. Dedicated practitioners do their best, but they lack equipment and medications. And there are not enough trained mental-health doctors and nurses.
The World Health Organization WHO) estimates that more than one billion people live with mental-health conditions, and the trend is upward. The latest official global count is that 727,000 people died by suicide in 2021. In 2023, in the United States alone, 49,316 people died by suicide. Caribbean record-keeping is weak. What little exists often reflects only institutionalised patients, but anyone working in schools, clinics, or courts knows the cases are rising.
Social media is part of this picture, particularly for the young. It is near-universal among teens: roughly 95 percent of 13–17-year-olds use it. Frequent users are more likely to report bullying (in school and online), persistent sadness or hopelessness, and suicide risk. Spending more than three hours a day on social media is associated with roughly double the risk of anxiety and depressive symptoms, and teens now average about 4.8 hours daily online.
In the Caribbean, accurate records are thin, but the pattern is unmistakable. In The Bahamas, a 2023 survey of 1,563 grade-nine students found two-thirds spending 3+ hours/day on social media; 46 percent had experienced cyberbullying; 62% reported depressed mood; and 48 percent had seriously considered suicide. Girls reported more cyberbullying (55% vs 37% for boys), and cyberbullying or sexting roughly doubled the odds of depression and suicidal ideation.
Jamaica shows similar strain: UNICEF reports six in ten students have been bullied at some point, and a U-Report poll found about 39% of youth had experienced cyberbullying. However, this data is not comprehensive because the problem is not being tackled fully. The pattern is the same throughout the region.
Climate stress is compounding the problem. The mental pressure of Hurricanes does not end with the chaos they wreak before moving on. They leave behind anxiety, grief, and trauma that surface months later in classrooms, clinics, and workplaces.
Against this backdrop, Antigua and Barbuda has chosen to act. Prime Minister Gaston Browne has kept mental health squarely on the national, hemispheric, and international agenda. At the 55th Regular Session of the General Assembly of the Organization of American States in June 2025, member states adopted the Resolution, “Addressing the Critical Mental Health Crisis in the Americas.” As Antigua and Barbuda’s Ambassador to the OAS, I advanced this initiative to move the issue from sympathy to structure: a working group open to all states, and a partnership with the Pan American Health Organization (PAHO) to explore a regional fund to address the problem.
The mental health problem is real worldwide and worsening. Wealthy countries have the means to address their domestic needs. The Caribbean must do the same. Resources must be allocated, country by country, based on clear plans and measurable objectives. But first, we must acknowledge the scale of the challenge, stop hiding it in families or locking it away in institutions that were never designed to heal, and commit to care that is close to daily life: in primary clinics, in schools, in communities, and at moments of crisis.
This September, world leaders will meet in New York for the United Nations high-level meeting on noncommunicable diseases and the promotion of mental health and well-being. The Caribbean should arrive not with rhetoric, but with clear objectives they want to achieve.
In the margins of that meeting, there will be a private roundtable on “Political action and investment for mental health equity,” organised by the Clinton Global Initiative, co-hosted by prime minister Browne and PAHO, to spotlight recent progress and identify practical pathways to accelerate investment. The goal is simple: turn high-level words into financed, measurable delivery.
But the Caribbean should not rely on external support for addressing its worsening mental health problem. Across the world, nations are confronted with their own challenges. Therefore, the Caribbean should collectively design and finance a roadmap for mental health—owned by CARICOM, budgeted by our governments, and delivered through our clinics, schools, and communities.
Governments should not wait for the outside world to underwrite their national responsibilities. If we put real policy on paper and real money in our budgets -however limited – then implement a timetable the public can see, partners will come. That is how small states show seriousness: we start with our own resources, prove momentum, and invite the world to match what we are already doing, not to do it for us.
It is in the region’s interest not to depend on handouts to end its critical challenges, including worsening mental health.
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