RMI emergency covid-19 - project name: republic of the marshall islands emergency covid-19 there is a need to enhance the current mental health/substance use disorders system of care and the…

RMI emergency covid-19 - project name: republic of the marshall islands emergency covid-19 there is a need to enhance the current mental health/substance use disorders system of care and the covid-19 pandemic absolutely puts the republic of the marshall islands (RMI) at great risk. There is no firm evidence based data set available for the number of persons with severe mental illnesses (SMI), SUD or CO-occurring in either of these populations of focus. However, there is anecdotal evidence that there are numerous persons with MH/SUD less severe than SMI. This anecdotal evidence is available through police records, hospital mental health division clinical records of engagement with persons, community organizations activity records etc. The current system is still hampered by: a) long geographic distances leading to lack of access to information and services; B) impairments to communication due to limited technology; C) limited access to outreach services and resources for people with MH and SUD such as problem identification and referral; and D) limited local workforce development opportunities. Currently the division of mental health serves around 300 people with SMI and reports that about 20 of them continue to roam the streets of majuro atoll. The marshall islands' society and culture is immensely different from the USA. The norms and topics of communication vary greatly. Familial communication mores and taboos are a notable element of this society. There are widespread blood or clan relations in a relatively small but dispersed population. IT is necessary that mental health related intervention activities and personnel be sensitive and consistent with at the least the major elements of these conditions and norms. Further, reading materials are not widespread in the local language kajin majol nor is reading in the english language a widespread activity. Film or video is a very effective way of transmitting knowledge- IT defers a direct face to face contact-in the first instance. However, in order to eliminate the personalization of characters in an educational film an alternative form of characterization- cartoon or explainer videos may be used effectively. There is need to develop explainer videos that address substance abuse and mental health in relation to the COVID19 pandemic and other triggers that are peculiarly relevant to the marshall islands, e.g. climate change, urbanization, rapid migration to the USA where covid-19 related conditions are very different, etc. The MH & SUD treatment services are already very limited and this project aims to continue to develop and strengthen existing services that have been able to provide culturally relevant and appropriate care. During this COVID19 crisis, there needs to be greater attention givent to people with severe mental illnesses and substance use disorders. There needs to be educational materials and inormation developed for this population group based on their special needs. There needs to be lockdown facilities for the patients with severe mental illnesses who continue to roam the streets not realizing what's happening around them. There needs to be continued cross-training between behavioral health specialists and medical staff to implement evidence based screening, assessments and treatment services. These are the goals and objectives of this RMI project for preparation, response and recovery to COVID19.