PHILIPSBURG:--- Sint Maarten, just like the rest of the world is currently facing a mental healthcare crisis, while already burdened with the community wide impact of the aftermath of hurricane Irma and more recently the impact of the Covid pandemic. Recently, the Association for Psychologists and Allied Professionals Sint Maarten (APAP SXM) met with the Minister of Health, Social Welfare and Labour (VSA), the Honourable Omar Ottley and his team regarding the state of mental health needs and licensed services available on Sint Maarten. APAP was represented by their board and its members, psychologists Alexandra van Luijken, Miranda Veltman and Islaya Streefkerk, and counselor Lisa Wilson-Gittens.
Manpower planning and preventive care
APAP requested Minister Ottley to revisit the findings of the manpower planning, whereby the applied model of the system of referring, the number of professionals considered and the effective use of affiliated professionals in the field, and other factors are not in agreement with the proposals from APAP in the last years. APAP has several points that its members would like to be considered in the upcoming evaluation.
OZR and SZV payments
Added to the workload, licensed mental health caregivers are forced to maintain their business operations out-of-pocket for extended periods while they await reimbursement from SZV for insured clients. APAP has been lobbying for the timely payment of insurance claims, though the situation is becoming increasingly burdensome. These delays are ultimately jeopardizing the continuity of available quality mental healthcare. Minister Ottley assured the association that this matter has his full attention and he will be working assiduously with SZV to have the payments regulated.
Adjustment tariffs and need for exemption ToT
APAP is pleased that in 2021 the milestone of adjustment of the outdated tariffs was finally reached with the final approval of Minister Ottley and looks forward to continuing to solve the other urgent and pressing matters which have been brought forward in the meeting.
Since 2016, APAP has been bringing forward to ministers and parliamentarians their opinion that an administrative error occurred with the transfers of 10-10-10 ToT laws, where the exemption for ToT for psychologists was overlooked. This resulted in the private practices being incorrectly taxed until this day. Minister Ottley extended his assistance to APAP by following up on the correction with his fellow ministers and parliamentarians.
Procedures on licensing
While agreeing with the need to guard the quality and update the ability of each mental health care provider, the current procedures of short two-year agreements are counter-productive for the established psychologists on Sint Maarten. The frequency of administration and paperwork is a challenge compounded by the uncertainty of long-term arrangements for employment on the island. This discourages professionals from committing to Sint Maarten.
Working towards solutions
APAP understands that Minister Ottley is currently working on mental health reform for Sint Maarten and has reached out to the stakeholders of each sector for their contribution. APAP has been working for many years to bring attention to the several challenges of working within the mental healthcare sector. This is a good moment to give further and structured follow-up to this initial meeting. APAP looks forward to partnering with Government and other stakeholders, and continuing contributions to bring St. Maarten’s mental health care to a higher level.
APAP finds it important to stress again that Mental health must take priority for the overall development of our community. APAP commended Minister Ottley for the work he has been doing with his efforts to reach the youth for violence prevention. “In the same light, mental health must be placed at the forefront of our recovery as the limited availability of service providers leads to unattended mental health issues for adults, in the labour market. This carries over to the home, affecting our youth who in turn transfer it to the education system. Ultimately, the breakdown of the social fabric results in crime and judicial issues. Therefore, an integrative approach to preventive mental health care is vital,” Wilson-Gittens shared. Van Luijken stated, “I believe in the power of a healthy community. Let’s all work towards a well-organized and professional mental healthcare system to keep our community healthy and safe. Then everything else will follow.”
Minister Ottley was very receptive towards the information and the sharing of several issues and confirmed the importance of mental healthcare on his agenda. Minister Ottley expressed his concerns about the mental health issues that he sees in the community and the matters that are brought before him as minister. He finds that too often the regulations are limiting the assistance that he can render. This fuels his passion to bring about change for the betterment of Sint Maarten by way of mental health reform. The Minister VSA has requested a follow-up meeting with APAP by early July.
For the last several years, APAP has been working diligently on improving the work conditions and the quality of mental health care for the psychologists and affiliated professionals in the field. Especially the licensed psychologists working in their private practices have been experiencing serious challenges. These difficulties are ultimately threatening their existence, while not willing to give up because of the importance of their work and not wanting to transfer the burden to their clients in need. Experience in the past has shown that the Government when discussing issues in mental healthcare, has mostly focused on the Mental Health Foundation. APAP would like to stress the importance of the existing licensed private practices which are doing great work as well.
APAP SXM has been established in 2016 to promote the practice and professional development of psychology and related fields and to serve the social and professional interests of psychologists and related professions in Sint Maarten (Dutch side).