Contemporary Reflections

By Di Levine

The MNS Guyana team has recently undertaken some analysis particularly focused on ‘juvenile’ experiences of prisons in Guyana between 1834 to the present (Warren et al. 2021). This blog post takes a moment to reflect on what our analysis might mean for how we work with children and young people right now.


Of course, none of the extensive work done with, for, and to, children and young people in contemporary times happens in a vacuum; rather it is rooted in the socio-cultural, political, and geographical frameworks and practices of the past. Here, I take a brief look at three key themes emerging from the team’s analysis through the lens of contemporary understandings of childhood and adolescence. I close with an invitation to build new conceptual frameworks for child and youth justice.


Theme 1: Representations and (re)presentations of childhood and youth
The ways in which childhood and adolescence are viewed and understood in any society has direct consequential relationships to the ways in which they are treated, not least in the justice system. Until relatively recently, children’s needs, presences and voices in both colonial and postcolonial justice contexts have been significantly under-represented (Ame, 2018) or dominated by the question of what is considered ‘juvenile’ (Abrams et al., 2018).


As the team discuss in their article (Warren et al. 2021), this lack of representation has also been present in their analysis of the youth incarceration context in Guyana. Pre-‘66 concerns surrounded ‘lawlessness’ amongst boys, and ‘immorality’ amongst girls, crucially and inextricably linked to harmful stereotypes regarding family formation (e.g. illegitimacy) and guidance, particularly towards the Afro-Creole population. Post-’66 they have found a broader consideration of ‘youth’ and ‘delinquency’ placed in the context of wider systemic change. Both of these trends reflect wider colonial and postcolonial representations of childhood and youth (Moruzi et al., 2019), and offer little surprise. What is surprising – and speaks to the problematic, deep embedding of colonial perceptions and practices on those colonised – is how little the processes of independence triggered debate in the justice system around opportunities to (re)present childhood and adolescence in ways that were rooted in local socio-cultural understandings of these life stages (e.g. Creole, Indigenous, African or Indian, or complex combinations of these).


I propose then, that the key learning from this theme for contemporary scholars of childhood and adolescence is the need to surface the myriad conceptualisations of these phases of the lifecourse in Guyana, in the same way that we would approach the intersectional challenges of any sub-group in a population, if we are to progress youth incarceration and justice systems that are both sustainable and effective into the future. We need to move from representations of childhood and adolescence, to (re)presentations of these life stages.


Theme 2: Deficit models and compound impact
The ‘deficit model’ linking aggression in childhood (and associated family risk factors) with later delinquency has dominated a significant proportion of the empirical literature and as the team show in their article (Warren et al., 2021) certainly speaks to the perceptions of both colonial and postcolonial administrators about child, parent and family relationships in Guyana. Recent research, however, suggests that both the directionality and nature of this model is incomplete, and that the deficit model may not be universally applicable (Renouf et al., 2010). Rather, there are multiple pathways through which aggressive behaviour may evolve (Hawley, 2014; Jambon et al., 2019).


There is a further challenge offered by the use of a deficit model in the Guyanese context: close to 90% of the evidence about childhood and adolescence is built on research in ‘high income’ (Minority World) countries (Blum & Boyden, 2018). The relevance of deficit models of delinquency to the Guyanese context is therefore highly questionable, compounded by the highly problematic stereotypes we have seen represented in archives and records, and demonstrated in Queenela Cameron’s recent study on the New Opportunity Corp (NOC) facility in Onderneeming (Cameron, 2019).


Contemporary evidence suggests that there are some aspects of youth development specifically that are universal. For example, the powerful neurological drive during adolescence leading to heightened effects of peer influences on perception of risk, reasoning surrounding risk, and risk-taking, and hypersensitivity to social exclusion (Foulkes & Blakemore, 2018). The team therefore saw recurring discussion of the problems of ‘gang’ cultures in their analysis, and the administrative urge to channel these neurobiological drivers into national service or corps in post-independence Guyana.
However, while there are characteristics of childhood and adolescence that are observed across cultures and histories (e.g. Blakemore, 2019), system-level interactions (e.g. between child/youth and health, education or indeed justice) can often be context-specific. Arguably the concatenation of these two circumstances the team has witnessed in archives and records, has contributed to the lack of sustained change in the youth incarceration system both in Guyana and elsewhere over long periods of time.


Theme 3: Work, educational reform and rehabilitation
The perceived close relationship between ‘work’ and ‘rehabilitation’ is a recurrent theme in our analysis since the colonial period. While much has been written on the definition and nature of child ‘work’ and ‘labour’ (e.g. Van Daalen & Mabillard, 2019; Rahikainen, 2017; Adonteng-Kissi, 2018), because child and youth voices are so absent from the evidence available to us in Guyana within the prison system, it is difficult build a picture of what aspects of this work could be considered rehabilitative, or even restorative, in the longer term. We cannot judge whether the highly-gendered educational opportunities afforded young Guyanese were sufficient to enable them to build a life for themselves beyond institutions, were barriers or facilitators of what limited social mobility might be available to them during these periods, or whether this work impacted on recidivism. The study by Cameron (Cameron, 2019) represents an initial step towards building a contemporary picture that centres the lived experience of young, incarcerated people now, which will provide new foundations for future scholarship.


Finally, we have reached the point where we understand that children and youth people are progressing through crucial periods of human development. This understanding enables us to reflect on what it means to ‘become’ an adult, and therefore what is means to be human. Significant physiological and psychosocial change (e.g. Sawyer et al., 2018), associated changes in attitudinal and behavioural appetites, influences from socio-cultural constructs, all point to complex multisystems of anthropometric, environmental and psychosocial change in which a young person navigating the justice system operates. The team’s analysis invites scholars to begin to conceptualise these multiple, interconnected systems (Theron & Ungar, 2020), some universal, some highly contextualised, all rooted on the past, in order to build more transformative pathways (Case & Hampson, 2019) in youth incarceration and justice system for Guyana’s future.

Dr Diane Levine is Deputy Director of the Leicester Institute for Advanced Studies.


(Warren et al. 2021) Warren, K., Moss, K., Kerrigan, D., Ayres, T., Anderson, A., Cameron, Q., Confronting Silences Haunting Guyana’s Juvenile Justice System, Caribbean Journal of Criminology, Vol 3:1 (2021), ISSN: 0799-3897, pp. 10-39.

Interviews and Understanding the GPS

By Emma Battell Lowman

Working through the 110 interviews conducted to date (20 prisoners, 30 community members, 30 prisoner family members, 30 prison officers) by or for this research team has been a key aspect of my work with this project. These interviews were intended to draw out details of individual experience and understanding to help develop a well-rounded and carefully evidenced understanding of the Guyana Prison Service (GPS) as it operates today. This work is in support of our efforts to understand the historical roots and present-day operations and challenges of the GPS and more broadly, and specifically, issues around MNS in these systems and spaces.

Some interviews were conducted by members of the project team, but the COVID-19 pandemic interrupted this work. We were lucky to connect with Fiona (Magda) Wills, the Director of SSYDR who took over the interviews in Guyana, with great success. All interview participants gave their consent to be interviewed and audio recorded, for their contributions to be used anonymously by the project team, and generously shared their time, experiences, and impressions of the GPS. Interviewees were thanked with a small cash gift (honorarium).

Interviewing for this project involved connecting with people whose lives are intimately connected – directly and indirectly – with Guyana’s prisons. These can be difficult stories to share, as people revisit sensitive subjects and delicate moments. The experience of deep listening as an interviewer also involves an intensity of experience and emotion. To better understand the experience of interviewing family members of prisoners, people who live near prisons, and prison officers, we asked Fiona to tell us about her experience and she generously agreed to sit down with Clare Anderson and Emma Battell Lowman earlier this year.

We were keen to learn whether prisons were something people were interested in discussing. Fiona explained, “People generally, people are always very willing to talk, I find! […] they want to talk more, and a lot of it isn’t necessarily related to the interviews but they’re just happy to talk.” In some cases, it seems, these interviews offered a space for people to feel heard about their concerns and experiences with the prison system.

What stood out for Fiona across the three groups she interviewed – family members of prisoners, people who live near prisons, and prison officers – was that “they are all stakeholders” and were invested in the prison spaces being well-maintained and tidy as an important aspect of these persons’ mental health. Many interviewees identified the purpose of prisons as being for the rehabilitation of prisoners as part of a shift from a penal to a correctional approach in the GPS. As Fiona identified, “if you really want to rehabilitate, my belief is that you have to make everybody’s space liveable” and that means attending to the physical spaces inside and outside the prison to benefit the diverse communities involved in and impacted by Guyana’s prisons.

It was something more personal that Fiona told us had the biggest impact on her over the course of conducting the interviews. The thing that “jolted” her was the number of mothers she interviewed who had sons – particularly sons in their 20s – in the prison system who were impacted by the incarceration of their child, and often maintained narratives of their innocence. Fiona said this “gripped” her, because she also has a young son, and this connection made these experiences stand out.

Fiona’s team transcribed the audio recordings of the interviews with great care and expertise (good transcription is not easy or fast!), these were then sent securely to the UK-based project team, and that’s where I come in. I’m the most recent addition to the project team and have come on board to help as the project nears completion. The project team is an excellent collaboration between the University of Leicester and Leicester Prison Service in the UK, and the University of Guyana and Guyana Prison Service, which allows us to combine specific skills and expertise from several areas of study with on-the-ground experience and expertise in the GPS. In turn, this means the work we are doing stays closely tied to the needs and priorities of those most impacted by the GPS while also seeking to make contributions and changes to global research on prisons, carcerality, and MNS (mental, neurological, and substance use disorders). By working to analyse and prepare the interview transcripts for use by the research team, I help to support the collaborative work of the project team to produce practical materials for use in the GPS and research articles for public and academic audiences.

My work with the interview transcripts took place thousands of miles from Guyana, but created a sense of proximity and intimacy as I worked carefully through each one to identify themes and information connected with the project’s key questions and concerns. The immediacy of frustration of family members and prisoners at the long delays in moving cases forward in the justice system, the evident strain on family members who have to provide support to prisoners in terms of food, toiletries, and money to ensure a reasonable level of health, and the fear of violence spilling over from the prisons into the streets and homes of people who live nearby all came through powerfully in the words and stories on the page.

The emotional experience of working with these stories is an important aspect of our work – it helps us find empathetic connections with people whose lives and our own are quite different, and it helps us understand from a personal perspective the direct impacts of the prison system as it operates today in Guyana. Taken together, these interviews present a powerful picture of a system whose impacts extend far beyond the prison walls and the strong case for investment and improvement.

Dr Emma Battell Lowman is a research associate on the ESRC GCRF project Mental Health, Neurological and Substance Abuse Disorders in Guyana’s Jails, 1825 to the present day.

Alcohol, Alcoholism and Mental Health in British Guiana, Part 2

By Deborah Toner

At the inaugural meeting of the Caribbean Conference for Mental Health (CCMH) in 1957, delegates described alcoholism as the single biggest mental health issue facing Aruba, where the conference was held, and amongst the biggest problems across the region. As part 1 of this post established, heavy alcohol use had featured prominently in psychiatric explanations of insanity during the late nineteenth-century period of asylum reform led by Dr Robert Grieve at the Public Lunatic Asylum in Berbice, British Guiana. Grieve and other physicians typically used the term ‘alcoholism’ to describe the physiological and neurological effects of alcohol consumption that led to different forms of insanity and used some combination of theories about inherent racial difference, the impact of social dislocation, and environmental factors to explain the varying prevalence of mental illnesses amongst the colony’s ethnically diverse population.

By the time the Caribbean Federation of Mental Health (CFMH) was formed in the 1950s, to spearhead the first cross-Caribbean project to improve mental health at a population level, medical and psychiatric professionals around the world increasingly viewed alcoholism as a mental illness or physiological disease in its own right. As a result of the influence of organisations like Alcoholics Anonymous (AA), the term had also become part of everyday language in discussing problem drinking, defining alcoholism as a particularly destructive, out-of-control pattern of drinking. The early conferences of the CFMH explored these ideas and adapted the AA model of alcoholism to incorporate, as part of alcoholism’s causation, the psychological and social legacies of colonialism and ongoing processes of rapid socio-economic change in the Caribbean.

The Emergence and Spread of the ‘Alcoholism Movement’

From the late nineteenth and up to the middle of the twentieth century, an increasingly global community of researchers, practitioners, temperance advocates and policy makers discussed the social, economic and health impacts of alcohol consumption at major international conferences known as anti-alcohol congresses. By the middle of the twentieth century, the “disease” model of alcoholism dominated medical, psychological, and social work approaches to understanding and treating problem drinking. Organisations like Alcoholics Anonymous, the Research Council on Problems of Alcohol and the Yale Centre for Alcohol Studies, all founded in the United States between 1935 and 1943, helped to popularise the idea that alcoholism was a sickness to which some individuals were more susceptible than others. There was ongoing debate about the aetiology of this susceptibility – as a physiological allergy to ethanol; as a psychosexual disorder; or as more environmentally influenced. But all agreed that alcoholism should be treated as a public health problem (Tracy 2021; Tracy 2005).

            Treating alcoholism as a public health problem, these organisations promoted mass public awareness campaigns, alongside new models for treating and rehabilitating the individual alcoholic. The most influential was the Alcoholics Anonymous Twelve Step programme, “a set of principles for achieving sobriety and personal transformation through self-reflection, mutual aid, good works, and surrender to a higher power” (Tracy 2021). The AA model for treating alcoholism spread around the world quite quickly, with branches opening in Mexico in 1940, Ireland in 1946, Scotland in 1848, France in 1960, and Japan in 1963 (Toner 2021, 18). In the Caribbean, a report commissioned by Aruba’s Department of Social Affairs in 1951, led to the foundation of an Alcoholics Anonymous group and the Aruba Society Against Alcoholism in 1955. Both these organisations fed into the establishment of the Aruba Society for Mental Health that hosted the first Caribbean Conference on Mental Health in 1957 (CCMH Proceedings 1957). While research into a wider range of records is needed to map the spread of AA across the Caribbean more systematically, proceedings of the 1959 Virgin Islands conference suggest that it quickly became established. In discussing tensions between different government departments about who should be involved in improving mental healthcare and how it should be funded, Trinidadian delegates commented that Alcoholics Anonymous ‘could be relied upon to go along’ without public funding, indicating that AA was already an established presence in the Caribbean by the end of the 1950s (CCMH Proceedings 1961). Certainly, delegates at later conferences reported that AA branches had been established in Grenada in 1961 and Antigua in 1962, and joining AA had become a formal part of the treatment programme operating in St Ann’s Hospital, Trinidad by 1963 (CCMH Proceedings 1965).

Alcoholism at the Caribbean Conferences for Mental Health: Definitions and Causation

American speakers were influential in moulding discussions of how to define alcoholism at the Caribbean Conferences for Mental Health. In 1957, Dorothy M. Johnson, Supervisor of Psychiatric Social Work at the State of Florida Alcoholic Rehabilitation Program, followed the Yale Center of Alcohol Studies in defining an alcoholic as a person who drinks ‘alcohol in an uncontrolled and self-destructive manner’, such that their drinking causes serious detrimental impact on their health, personal relationships and/or work. Johnson further highlighted that alcoholism was often linked to difficult transitions or traumas in a person’s life. Another colleague from the Florida Rehab Program implicitly defined alcoholism as a male condition, saying that wives often caused their husbands’ drinking problems by infantilising and emasculating them. The secretary of Aruba’s AA branch, comprised of 150 members at this time, defined an alcoholic as ‘a person who has a physical allergy to alcohol and is at the same time emotionally immature’, echoing the way in which AA as an organisation typically combined a specific physiological predisposition with the influence of social and psychological factors in explaining individuals’ alcoholism (CCMH Proceedings 1957).

However, in applying the AA definition and treatment model to rehabilitation programs in the Caribbean, mental health professionals typically emphasised broader sociological processes, some relatively recent, others with long historical roots, in explaining alcoholism in their communities. A social worker from the Aruba Department of Social Affairs, which had kickstarted sustained investigation into alcoholism in the early 1950s, highlighted as a central cause, the ‘mental tensions’ that had resulted from rapid development of the island’s oil industry, via American investment, in the previous two decades. In the capital port city, the higher wages and social influence of a large influx of ‘unsettled foreigners’ apparently led to increased incidence of alcoholism. In more rural regions, alcoholism was attributed to the longer-term pattern of young men from Aruba migrating to Cuba for work on sugar plantations, where they often developed habits of heavy rum consumption, combined with psychological feelings of inferiority stemming from intergenerational poverty (CCMH Proceedings 1957). The dislocating effects of rapid socio-economic change across the 1950s and 1960s, often as a result of migration and tourism, continued to be important themes in explaining the psychology of alcoholism, and mental health problems more broadly (CCMH Proceedings 1961; CCMH Proceedings 1965).

            Conference delegates often pointed to the psychological and social legacies of colonialism in producing the emotional immaturity, or feelings of emasculation and powerlessness, that organisations like AA posited as being central to the psychology of alcoholism (CCMH Proceedings 1965). Discussion following papers presented by personnel from the Florida Rehabilitation Program in 1957 highlighted that the Caribbean experience of alcoholism was bound to be different from that in the US because of the legacies of colonialism and slavery (of course, the US had its own legacies of slavery and colonialism, but the early alcoholism movement in America, and Alcoholics Anonymous in particular, overwhelmingly catered to white people). Delegates argued that instability of family life in the Caribbean was a source of emotional immaturity and emasculation, rooted in the ‘break up of family patterns among negroes when they were taken from Africa into slavery in the New World’ and that feelings of powerlessness were pervasive because of how colonial governments (still in control of most Caribbean countries at this time) meant that Caribbean people were ‘not master in [their] own home or own country’ (CCMH Proceedings 1957).

            Reports from both St Ann’s Hospital, Trinidad and Fort Canje Hospital, British Guiana in 1963 suggested that alcoholism was more common amongst patients of East Indian heritage. Heather Pinto, Senior Occupational Therapist at St Ann’s Hospital, stressed the psychological and social legacies of colonialism in explaining this. While she followed the AA disease model in stating that some predisposition in the individual was necessary for broader factors to lead to alcoholism, the main causes that explained a higher rate of alcoholism amongst East Indian people were: the psychological legacy of indenture and separation from a distant homeland; the trauma of marginalisation due to ethnic, linguistic and religious difference; and cultural traditions that embedded alcohol in social and family life. By contrast, she stated that Black people were ‘not so inclined to be bogged down by memories of slavery’, but where they did develop alcoholism this was because they used alcohol as a ‘tranquiliser’ for feelings of inferiority compared to Europeans they worked with in the oil and sugar industries. Europeans who developed alcoholism in the Caribbean, meanwhile, were likely to do so because of ‘too much money and lack of suitable activity which constitutes boredom and depression’. While Pinto concluded that alcoholism was fundamentally rooted in emotional immaturity, in line with a core tenet of AA’s definition of alcoholism, this emotional immaturity was understood to be the product of historical and social forces that shaped the experience of different ethnic groups in the Caribbean (CCMH Proceedings 1965).

This conclusion was broadly in line with the wider ethos of improving mental health at population level with which these CFMH conferences were imbued. Specific innovations in institutionalised and outpatient care were implemented to treat individuals, in the context of a broader understanding that it was really major social inequalities arising from Caribbean histories of colonialism that needed to be addressed. You can see our working paper, “Changing Approaches to Mental Healthcare in the Caribbean Conferences on Mental Health” for more on this broader context, and await publication of our article on the relationship between intoxication, insanity, migration and intoxication for more on how these relationships played out in British Guiana across the whole colonial period.

Deborah Toner is an Associate Lecturer in the school of History, Politics and International Relations, University of Leicester.

Mental Health and Covid-19 Protocols in Guyana’s Prisons

By Queenela Cameron

Interviews conducted at the Georgetown and Lusignan prisons in 2019 as part of a collaborative research on the topic of “Mental, Neurological and Substance Abuse disorders in Guyana’s Jails – 1825 to the Present Day” revealed that a number of mental health challenges (diagnosed and undiagnosed) are experienced by both prisoners and prison staff, with depression seeming to be the dominant one. Depression in the context of Guyana’s prisons, is exacerbated by several factors; limited recreational activities, poor or limited work and education rehabilitation programmes, and an absence of, or limited contact with family members to name a few.

Lusignan Prison 2019

The Covid-19 pandemic and the measures taken (from March 2020 to early January of this year) to prevent and manage its spread in the prison environment, played additional roles in further alienating prisoners from the already limited activities which aim to contribute to their rehabilitation. It stands to reason, that an absence/suspension of these activities and programs (for approximately two years) as well as the pandemic itself, likely intensified feelings of stress and depression amongst prisoners.  Prison staff who too were subjected to strict Covid-19 guidelines including prolonged periods of confinement in the prison environment likely experienced increased levels of stress on their mental well-being.

Among the measures taken was the suspension of all religious activities and training programs within the prison. One of the key findings unearthed during the interviews conducted in 2019, revealed that religion is one of the biggest coping mechanisms utilized by prisoners, as attending religious services gives them comfort and relieves feelings of stress, depression and hopelessness. These findings are not unique to Guyana’s prison environment, as several studies conducted in other jurisdictions point to the effectiveness of religion in positively impacting the mental health of prisoners. Bradshaw and Ellison 2010, and Ellison et al, 2008 for instance, note that “Participation in religious activities can impact inmate mental health by promoting social support. Attendance at religious services has consistently been shown to be protective against mental distress.” 

The suspension of this vital stress-reliever and depression-combatant implies that many prisoners were likely to become withdrawn, easily agitated, disruptive, fight amongst themselves, experience appetite loss, and harbour escape and/or suicidal thoughts.

Given that the number of daily Covid-19 positive cases, both outside of and inside of the prison contexts of Guyana has drastically reduced from its peak of 1,558 on January 17 of this year to 5 cases as at March 25, 2022 (WHO), and also given that there is already inadequate mental help support in the form of counselling and therapy for convicted prisoners and that no such service exists for prisoners on remand, it is recommended that religious activities should be resumed, albeit in the contexts of social-distancing, sanitizing and mask-wearing guidelines. Conscious of the limited spacing available for religious worship due to massive overcrowding, small groups could be accommodated at various intervals in order to fulfil the right of prisoners to religious engagements which is vital to prisoners’ mental well-being as well as their rehabilitation.

With respect to training activities, those too were suspended for approximately two-years. However, between January 12 and 15 of this year, all of the Guyana dailies and Newscasts reported that 861 prisoners housed at the various prisons graduated in what is being referred to as “ground-breaking” training courses offered at the various prisons. The programs, prison officials’ note, aim to prepare inmates for life outside of the prison and to assist with their reintegration into society. The inmates had the opportunity to participate in a number of different training areas such as entrepreneurship, anger management, carpentry and joinery, family reconciliation, tailoring, culinary arts, art and craft, cosmetology, barbering, crops husbandry and veterinary sciences. The courses were extended to all prisoners including those on remand and also those who were convicted with several high-profile and special watch inmates taking the opportunity to rehabilitate themselves with the courses. (HGP Nightly News. January 15, 2022). Further, the “Fresh-start” program launched just last month by the Guyana Prison Service with similar programs and more, are all aimed at preparing prisoners for productive life outside of prison. (Stabroek News. February 18, 2022)

These programs must be commended for their role in fostering prisoners’ rehabilitation and likely reducing rates of recidivism as “the impact of education goes well beyond the walls of the prisons themselves, extending into the home communities of the incarcerated.” (North Western University Prison Education Program). Their importance in assisting the mental health of prisoners whose time would have been more than likely spent on unproductive activities which contribute to depression, anxiety, stress and other mental ailments cannot be overstated. Further, the inclusion of these programs to prisoners on remand must also be applauded for its progressiveness given that the current laws do not extend those privileges to remand prisoners, many of whom sometimes spend several idle years behind bars before sentencing or release.

Another of the measures taken was the suspension of the (external) work rehabilitation program. Prior to the pandemic, some prisoners were able to capitalize on work rehabilitation programs which not only helped in the provision of financial resources for them to supplement their prison-provided supplies, but also contributed to their families’ upkeep, occupied their time, helped provide meaning in their lives by providing them with something to focus on, and prepared them for post-prison productive life. North Western University Prison Education Program notes that work rehabilitation aids in preparing prisoners for life outside of prison as “reentry is far smoother and more successful for those who took classes in prison, especially insofar as gainful employment is one of the defining features of successful reentry.” The suspension of this privilege likely impacted the mental health of prisoners in a negative way.  Existing literature suggests that “inmate boredom caused by the lack of work and absence of recreational activities could be linked to depression and aggressive behavior.” (Tartoro and Leaster, 2009). Such behaviors could spread among the prison population thereby leading to prison riots, fires etc., all of which could make the work more challenging for an already thinly-stretched and over-worked prison staff.

The suspension of family visits was another measure implemented to prevent and manage the Covid-19 pandemic in Guyana’s prison setting. During the interview sessions with prisoners in 2019, many bemoaned the lack of/limited visits form their family members, while others were in praise for supportive family members who visit often and supplement their supplies. The complete removal of this social support privilege (though replaced by electronic means using the “Google Hangouts app” and/or telephone) likely increased feelings of depression and other mental health issues amongst prisoners. De. Claire Dixon, 2015 notes that “Visits help offenders to maintain contact with the outside world, promoting successful reintegration back into society and reducing recidivism. This scarcity of social support might make adjustment to prison more difficult, risking the use of maladaptive coping strategies.”

A further measure taken was the suspension of actual (face-to-face) court hearings, and the establishment of virtual courtrooms. While this measure must be lauded for its role in respecting the rights of prisoners to a trial within a reasonable time period as well as the possible reduction of time spent on remand, the positive mental-health benefits of actually leaving the confines of the prison environment for a trip (however temporary), to be in a setting with non-prisoners, to perhaps have a moment to socially interact with family members and their attorney, cannot be ignored.

While most of these measures impacted prisoners, their impact on the mental-health of prison staff cannot be ignored. Prison Officers were already in-line due to the prolonged March 2020 elections and they were forced to remain in-line (for time frames as long as two weeks) as a precaution against bringing the virus into the prison environment.  Devoid of the vital social interaction of family, being forced to work long hours in an overcrowded setting in the face of a massive human resource deficit, fearful of contracting a deadly virus in the contexts of agitated, violent, dangerous and scared prisoners are all factors which likely intensified the stress levels of prison staff.

It should be recalled that a number of undiagnosed prisoners, specifically those on remand, complained of experiencing bouts of depression and anxiety as a result of their incarceration. They also bemoaned the absence of competent mental health personnel on whom they could unburden themselves. Similar sentiments were expressed by officers and other prison staff who, like most prisoners, also use religion as a coping mechanism.

In light of the foregoing, and in the context of the almost- completed “modern” prison and proposed new prison headquarters at Lusignan, it is hoped that this facility would be equipped with a modern mental health facility and staffed by competent metal-health personnel, including therapists and counselors to assist prisoners (including remand prisoners who do not benefit from existing arrangements) and prison staff.

Such facility would greatly augment prisoners’ rehabilitation, prepare them for life outside of prison and ultimately reduce the rates of recidivism. For Prisons Officers and other staff, working in both one-on-one and group sessions with a therapist could help them cope with the challenges associated with a highly stressful, time-consuming, low-paying, and sometimes under-valued profession.

Research during Covid: The three Rs (Reflexivity, Resilience and Rum)

By Members of the Research Team

Research never goes to plan. As academics, we all know this. It is also a fact we constantly share with our students as an expected part of academic research. Whether it is a failure to gain access, or find enough people willing to participate, we all face research challenges. Like most things however, Covid has added a new set of challenges to academic research (as well as opening up new opportunities), which our research team recently faced on a trip to collect data in Guyana. This reminded us all about the importance of the three Rs – Reflexivity, Resilience and Rum (rum is used to emphasise the importance of relaxation and researcher self-care as well as the importance of looking after each other when out in the field, something that is to commonly forgotten about in research). Subsequently, this blog outlines how Covid recently impacted upon our data collection plans and how we, the team of three (the three musketeers), responded to the challenges they faced, illustrating the importance not only of the team – its members, relationship, reflexivity, and resilience – but also of building the networks of support that became an invaluable source of help on this trip. Although often over-looked, networks of support – academic as well as practitioner – are invaluable as we travel the globe in person or virtually undertaking research and delivering research papers at conferences.

Covid-19: The Challenges

We have all had to face new challenges arising from the global Covid pandemic, and this includes research. The ever-changing requirements for travel alone can be a minefield especially when multiple destinations are involved. Do you need a PCR test? A lateral flow? A vaccine record? Although the team joked about the possibilities of Covid negatively affecting this research trip as we completed the usual research risk assessment form, we did not for one minute think that this would become our reality. As we navigated the various government requirements for travel to Guyana, and as transit passengers (currently there is no direct flight from London to Georgetown), we quickly became all too familiar with the challenges when these documents expire. Three days prior to travel our connecting flight was cancelled; due primarily to the knock-on effects of Covid the carrier was required to consolidate some of its existing flights. This delay in being able to fly to our final destination meant that our existing Covid PCR tests (taken in the UK before departure) became invalid while we were in transit. As a result, two hours before we were due to leave for the airport, we had to retest, and then found ourselves faced with the unenviable decision of whether to abandon the research trip as one of us tested positive. Despite the UK being only days away from dropping all restrictions the rules of quarantine in our transit destination, as in many areas of the Caribbean, remained in full force. After a frantic hour of rearranging hotel rooms, contacting our colleagues, updating the insurance provider, and ensuring the Covid patient had the basic necessities for a possible ten-day stay in isolation, the remaining two members of the team apprehensively continued on with the trip.

Reflexivity

We reflect on a daily basis in both our personal and professional lives, and the importance of being reflexive when undertaking research is well documented.  It facilitates self-awareness and allows researchers to respond to unexpected challenges and situations in appropriate and ethical ways. It also allows researchers to improve and build on instances of good practice as well as to learn from their mistakes. Thanks to Covid we had to revisit and alter our itinerary for the trip. This was mainly owing to the fact that as a team we were now lacking in the expertise required for certain elements of data collection, namely the interviewing of prisoners and a focus group with their families. The added scrutiny that this placed on our planned activities ensured that we worked together, albeit remotely, to create a workable plan. As a result, two of the most invaluable research tools on this trip quickly became Zoom and WhatsApp, as we adapted to the circumstances to ensure the trip was a success. This technology enabled us to further refine our research questions and aims as we prepared for the interviews with our colleague in isolation. Due to the circumstances, we also made the decision to employ a local researcher with experience of working with prisoners and their families. In addition to helping with the language barrier (many speak a variation of English known as Guyanese Creole) this also had the unexpected benefit of producing more in-depth data as the prisoners connected with the interviewer over their shared experiences of living in the same country. Furthermore, where possible one of our key activities – a session in which we co-created a new tool that will enable the Guyana Prison Service to gauge the experiences of prisoners and officers – was moved to an online session. This had the added benefit of enabling officers, and members of our team, from a wider geographical area to take part. This reflexivity not only ensured we were able to successfully carry out our designated activities, it also strengthened our relationships with our partners, both in Guyana and the UK, as we worked together to overcome difficulties.

Resilience 

Although not a fan of the word resilience – which seems to have become a contemporary buzz word – it best describes the reaction of the team members to the situation they found themselves in during this research trip. Instead of letting it get them down they did their best to make the best out of a bad situation (thanks to being reflective), which actually resulted not only in a very productive data collection trip, but also one that contained some genuine moments of comradery, good humour and bursts of hysterical laughter despite the adverse and at times disappointing situation that faced us. As Charles Darwin exclaimed/outlined: ‘It is not the strongest of the species that survive, not the most intelligent, but the one most responsive to change’. Sentiments that stand true for the recent predicament we, the research team, found themselves in and how we chose to respond to it.

We had always planned for Covid, in that we decided that three persons would go on this trip, so that in the event of sickness and isolation the others could complete the research activities. Despite our pact that if one of us tested positive for Covid then the team would carry on without them, like many plans in life, you never really expect them to happen so, the reality and its accompanying shock was somewhat overwhelming and definitely unexpected. In fact, the first 5 minutes after the initial news of the positive test was spent asking the medical team if they were joking, as is often the way in the Caribbean. It was however no joke. One of us had tested positive and was going to have to stay behind in transit and in quarantine in a different country on their own, while the remaining two went on to Guyana. This is when true teamwork and collegiality really come into play as everyone (bar the infected who had to stay outside) pulled together to rectify/address the situation in the 2-hour window before everyone was due to fly. A team member in the UK liaised with our travel agent. We called and discussed the situation with our partners, and later on the British High Commission in Guyana, with whom we have built excellent working relationship over the past few years.

Once the initial shock of one of us testing positive for Covid had worn off the team revisited their itinerary and data collection plans for the forthcoming week to ensure everyone was still involved where practically possible/needed. Despite the initial disappointment, and the frustration of not being able to go and collect data in Guyana, the Covid patient endeavoured to come up with an exit plan until they heard from the Ministry of Health. The idea was to rest up, clear the virus and follow the team on after 5-days. However, this was not to be. Instead, the Ministry made it quite clear that the minimum isolation period was 10-days, although the patient was given a hotline number to call. After a frustrating day with 7-hours spent just redialling but being unable to get through on the telephone number provided by the Ministry of Health, the Covid patient also explored other avenues of help/support to ascertain the situation. It was at this point that the importance of networks was emphasised: the team was in touch with the High Commission of Guyana, and it was willing to help. Once the Covid patient knew that they were quarantined for 10-days and the research team had created a new itinerary for the trip, it was easy to plan their time and make the best use of the situation both to recover but also to catch up on some of the background project reading, reading the interview transcripts and coding frames as well as numerous other tasks that often get postponed.

The team debriefed every morning and/ or evening where practicably possible not only to catch up on the day’s progress but also to relax, and jolly each other along. The daily debriefs with their colleagues in Guyana, including meetings where the Covid patient Zoomed in, also helped to ensure that they felt part of the project and part of the team. It also kept them busy and helped the time to pass quickly, with some days feeling quite busy despite not leaving the hotel room. We had a job to do, and Covid was not going to stop us. We just had to get on with it.

Rum

Undertaking research in the Caribbean is challenging. Although, Guyana is often seen by many as a desirable research location, many often fail to consider the subject matter of our project, the political/cultural sensitivities, and the fact that despite being a desirable destination, our time is often spent in old colonial prisons – some of which have been deemed to violate the United Nations Minimum Standards for the treatment of prisoners – talking to prisoners, staff, communities and families about often upsetting and traumatic experiences, which the research team then have to process and deal with. It is in this context that the importance of self-care and looking after each other comes into play. Although there are more formal channels of support offered to everyone working on the project, there are also informal support practices that have been an integral part of this research project, which is also reflected in the relationship of the team.

The research team on this project are very close, familial like even – but without much of the negativity associated with families. We all genuinely support each other. There are no egos. There is no competition. Instead, there is clear leadership, collegiality and care. Whether it is coffee and cake or catching up over a meal, regular debriefs, relaxation and humour have always been an important part of the team’s R and R, emphasising the importance of relaxation and researcher self-care as well as the importance of looking after each other when out in the field, something that is to commonly forgotten about in research. It was this which got us through what one of the researchers described as the most difficult situation in their 25-year career. With pride, we returned to the UK together, having completed all our planned activities and with our research team stronger than ever before.

Acknowledgements: The Covid patient would like to thank their two travel/research companions, as well as the team in Guyana, and everyone that looked after them, especially the High Commission in Georgetown in Guyana, and the Chief Medical Officer of the transit country, who went above and beyond in their support.

Resisting Carceral Confinement in Guyana: Legacies of a Colonial State

Kellie Moss & Kristy Warren

In July of 2017, a fire destroyed the majority of the buildings that stood in the compound of the Georgetown Prison in Guyana’s capital. Four prisoners escaped and one warden was killed. Over 1000 people were imprisoned at the time in a space meant to hold less than 600 people. Just over a year earlier, in March 2016, 17 prisoners died and eight were injured after a fire spread in the Capital A Block of the prison. The setting of this fire arose out of prisoner’s frustration with structural deficiencies within the prison which included overcrowding, poor sanitation, and an infestation of pests. Also of relevance was that the overcrowding was caused in large part by the length of time individuals were being held on remand before trial. However, these events did not occur in a vacuum. The issues of overcrowding and the numbers of prisoners being held on remand for extended periods of time have been linked to varying forms of prisoner resistance since British rule.

Historically, prisons in British Guiana were used by colonial administrators to control and confine the labouring population, namely the formerly enslaved and indentured immigrants, within the plantation society. As a result, those of African and Asian descent were disproportionately policed and punished to deter others from engaging in ‘criminal’ activities. Most notably this occurred for breaches of contract and misdemeanours under the immigration ordinance. Whilst some prisoners adapted to the substandard living conditions and overtly punitive environment of the prison system, many sought to test these institutional practices. Critically, therefore, prisons quickly became sites of resistance and challenge for the labouring population as they attempted to alter their legal, social, and political situations.


Since the mid-nineteenth century, government inquiries and the reports of colonial authorities have urged change in the provision of the colony’s prison system, citing concerns disturbingly similar to those identified by the Commissions of Enquiry into the 2016 and 2017 fires. This included, among others, poor infrastructure, overcrowding, and unsanitary conditions. As in recent years inquiries into these concerns were often a direct response to violent, every day, or official forms of prisoner’s resistance.


Due to the limited number of warders the prison system was often reliant on the compliance of prisoners to adhere to rules and regulations rather than force. As a result, when the prisoners felt powerless, they would often resort to uprisings as a way to challenge the system. Habitual offenders frequently took advantage of the lack of trained warders required to maintain discipline with the creation of gangs that threatened to overwhelm the balance of control. These groups included a range of differing classes, such as first offenders, juveniles, and those awaiting trial. Whilst attempts were made in the 1930s to alter certain aspects of the prison system, such as the separation of different classes of prisoners, these efforts were ultimately hampered due to budget constraints, and the need to manage and discipline the prison population. A lack of space, and facilities within Guyana’s prison system mean that those on remand continue to be held in close association with those imprisoned for committing violent crimes.


Rum, cannabis, and opium provided an escape from the hardships of labouring on plantations throughout much of the nineteenth century. And, having become firmly established within the culture of the labouring class the increased legislation introduced around the turn of the twentieth century unsurprisingly led to a significant rise in this form of resistance both inside and outside the prison walls. For many prisoners, substance use provides an escape from the anxieties of being imprisoned. Thus, unlike uprisings that involve acts of violence, most acts of resistance have involved everyday negotiations that have taken place between the prison population and the staff. This has included the consumption and trade of illicit substances, such as alcohol and drugs, the latter of which has mostly been trafficked by the prison staff for financial gain. Recently, much has been done to improve fencing, with the introduction of night-time surveillance, to help stem attempts by friends and family to throw contraband over the walls.


Hence, it can be seen that the use of alcohol and drugs within the prison is a trend that has continued into the twenty first century. Whilst the introduction of technology has led to a wider range of contraband in recent years (cell phones and sim cards), alcohol, and drugs continue to play an important role in helping to relieve the strictures of incarceration. In particular, cannabis remains a key drug within the prisons in connection to both escapism and resistance. Additionally, images and videos of participation in other illegal or banned activities, such as human ‘dog fights’, bring attention to the conditions in the prison system, both physical (the overcrowding) and mental (frustration and boredom).


As Guyana’s prison system continues to attract media attention and the concern of prison reform and human rights organisations (United Nations), history can be drawn on to highlight continuities in terms of the challenges of managing large numbers of prisoners with limited means. Despite some temporary successes for the prison population during the nineteenth and early twentieth century, resistance often led to additional or continued oppression. Yet, such acts of resistance continue. Since independence, a lack of resources and poor infrastructure has meant that the several commissions of enquiry have not resulted in systemic change. Further uprisings occurred in the summer of 2020 in response to continued deplorable conditions and worries that COVID-19 was spreading in the prison. It also provides a final sobering conclusion that little has changed in terms of the high rate of imprisonment in Guyana and the detrimental effects the system has had since the beginning of British rule in 1814.

The authors would like to thank Mellissa Ifill for her comments/feedback on an earlier draft of this blog.

Evaluation in a post-colonial context

By Diane Levine

In their 2020 chapter “The South against the destroying machine”, Lara Hofner takes an interdisciplinary approach to reflecting on the social realities of the Minority World, the ways in which they are hegemonic and violent, and the contrasting social realities of the Majority World,  considered ‘oppressed’ (see Hofner in Baumann & Bultmann, 2020). In this blog post I reflect on the challenges of evaluating the MNS Disorders in Guyana’s Jails project as we saw them at the outset, then share some of the key messages emerging from the mid-point evaluation, and consider some of the challenges we will face in the remainder of the project in ensuring evaluation does not become part of the “destroying machine”. [Note: I do not sit directly within the research team, which I hope has given me some small sense of distance and objectivity in delivering evaluative activity.]

What was

At the project launch stage the team’s planned evaluation and impact activities were founded on some shared key principles:

  1. We collaborate and align our efforts for the benefit of the project as a whole wherever possible,
  2. We ensure equity of access to data, including by considering gender, socio-economic and socio-cultural dimensions to our findings.
  3. Our research emerges from meaningful understandings of the complex environments in which we operate.
  4. We promote decolonising methods and perspectives.
  5. We learn continuously by analysing and reflecting on the specific and changing circumstances in which we operate.
  6. We harmonize with our colleagues outside the academy, committing to co-ordinating our efforts with others in the same space on their advice. 

The challenge ahead was not underestimated by team members. Impact and evaluation have already been problematized widely in the academy (e.g. Aguinis et al, 2014). With particular reference to this project were conceptualisations of impact that rely wholly on ideas of rationality and control that provide an unfortunately fantastical security in a context that does not in reality allow for non-linear ‘contradiction, complexity, or paradox’ (e.g. Shahjahan & Wagner, 2018, p.g.3). We all saw that this formulation made an incontrovertible link between the rational and the conqueror, and brought us dangerously into colonial practice: in this framing everything must be manageable, observable, knowable, and measurable, as the team sought to identify causal linkages between intersectional complexities and ‘impactful’ intervention.

As was expected across the funding landscape at the time (2018/19), the team intended to produce an evolutionary logical framework, and emergent classical Theory of Change goals that would: i) model pathways to impact, explaining the potential connection between activity, output, outcome, and impact, ii) provide rationales on how implemented activities and inputs are likely to lead to our desired outcomes, and iii) make assumptions and constraints explicit. The original logframe looked something like this:

Attempts to conceptualise impact in the context of a decolonial imperative have aimed to demonstrate multi-stratified perspectives of reality (e.g. Izutsu, 2008), and alternative ways of knowing that we cannot normally see through the common impact lenses of, say, policy citation (see Śūnyatā, as explicated in Shahjahan & Wagner, 2018). Change that might arise from our research activities as viewed through Śūnyatā’s lens is not change in itself. Rather, change depend for existence on everything else.

We realised that we would need to learn the lessons being taught to us by the limits and failures of tools such as logical frameworks and Theories of Change, whilst acknowledging our commitments to our funders, colleagues’ careers, institutional progression, and our partners. Following their first fieldtrip (March 2019) the team began to ask themselves some difficult questions:

  • Can we understand and evaluate in a pluriversal way that surfaces the interconnectedness between us all in the Guyanese context?
  • Can we accept the discomfort that our work may not ‘make a difference’ in the ways we conceptualise ‘difference-making’?

Alongside finding ways of addressing these questions, the team realised that parallel systems might need to be run for capturing the pragmatic requirements of funders and institutions. They wanted to formulate these new ways of evaluating and knowing without sacrificing their integrity. This seemed to me an excellent position from which to begin my observation (and learning) journey.

What is now

One of the parallel systems to which we had committed was a mid-point evaluation. Our original conceptualisation was of something that would be delivered in Guyana, with Guyanese stakeholders. Sadly, in March 2020 we had to rapidly re-formulate our approach with the onset of Covid-19. Fieldwork, workshops, focus groups and consultation would no longer be possible in the way we had envisaged. Not only that, but uncertainty within the Guyanese socio-political context, and associated significant workloads for everyone, meant that we could not in fairness ask people to give up their time for long virtual workshops.

In the interests of pragmatism we opted for a light touch mid-point evaluation comprising a content analysis of all meeting minutes to summer 2020, 1:1 interviews of all team members willing to speak, and a summary that would then be reflected to our Advisory Board for comment, critique, and critical friendship. Six key themes emerged.

What will be?

So what about next steps? Well, there are some practical things we need to do. For example, for large scale projects, we need to begin to consider costing/building in professional support for those gathering data in the field (including in archives), or possible training modules available to all teams in managing emotional responses to this kind of high-stakes work.

But the significant, intersectional task ahead for evaluation will be to continue to recognise that “evaluation is unavoidably and simultaneously in dialog with the prevailing contexts of colonization and decolonization vis-à-vis the location and moment in which it occurs” (Marama Cavino, 2013). We need to build a culturally-meaningful, Caribbean-aligned, model of evaluation that meets Guyanese needs, as well as our original commitments. Watch this space!

Dr Diane Levine is the Deputy Director and Manager of the Leicester Institute for Advanced Studies at the University of Leicester.

Guyana’s Prison Officers: A Stressful and Dangerous Job

By Tammy Ayres

Guyana’s prisons have been described as ‘potentially life-threatening’ and ‘not  fit  for human  habitation’. These life-threatening conditions can be attributed to systemic and historically derived deficiencies that continue to plague Guyana’s Prison Service (GPS) today. These include overcrowding, poor infrastructure, violence, physical abuse and unsanitary conditions, all of which have a detrimental impact on the staff and prisoners that live and work there. Prison officers are not only detrimentally impacted by the prison environment and its decaying infrastructure (e.g., which induces psychological distress, depression, burnout, post-traumatic stress disorder, substance use, violence, corruption, disorder, absenteeism and a high staff turnover) but their responsibilities often entail ‘physical exertion and mental anxiety’. This helps to explain why the international evidence shows prison officers are at a greater risk of mental ill-health than other occupational groups. In fact, being a prison officer is a dangerous and stressful job that involves daily intimidation and on occasion, actual physical violence. Nowhere is this truer than in Guyana. While the experience of prisoners in Guyana has been captured elsewhere (see Cameron, 2020; Sarsfield and Bergman, 2017), this blog focuses on the frequently forgotten prison staff who work across Guyana’s five prisons; three of which are colonial era prisons that were constructed and operated according to the needs of the colony (see Anderson et al. 2020); colonial legacies that are still evident today.

The post-colonial prison is shaped – haunted – by the colonial past and this is true for prison officers as well as the regimes, infrastructure and policies. Staff played a key role in the colonial prison as they were expected to use ‘their moral influence to encourage good behaviour’, provide educational classes and enforce labour, which often led to guards using ‘cart whips and cat o’ nine tails’ on prisoners to ensure compliance and productivity. The cruelty and mistreatment of prisoners by staff that plagued the colonial prison was attributable to a lack of regulation, which had created ‘a regime of fear and cruelty’ in some of Guyana’s jails. Although Regulations were finally introduced in the late 1800s outlining the duties of prison officers, which were implemented in line with British practices (e.g., CO 111/67, CO 116/207 and CO 111/384), it did not stop these abuses. Abuses that have not only been documented in the past but as the ensuing discussion will show, are still prevalent in Guyana’s prison service today.

The lack of penological resources characteristic of the contemporary Guyanese prison were also prevalent in the 1800s; prison guards were difficult to recruit, while overcrowding and poor conditions meant that many prison officers ‘left employment, or retired early, due to stress and overwork’. Historical records show that even the medical officers – employed to care for prisoners – were responsible for the death of inmates, as their role often revolved  ‘around diagnosis and discipline rather than treatment and care’. In fact, the decaying infrastructure and overcrowding has  a negative impact on staff and prisoners today as well as in the past: ‘J.  Brumel  noted  in  1875, that incarceration  caused  terror  to  convicts,  but  also had  a  depressing influence on officers’ and their families, ‘who often lived inside prison compounds’. This remains the case today, with many prison officers and their families living in close proximity to the prisons in which they work, particularly at Mazaruni where officer’s families live on the prison complex, which is only accessible via boat (see pictures below). 

Her Majesty’s Penal Service was changed to Guyana’s Prison Service in 1957 and was established by the Prison  Act  No.  26. Guyana’s Prison Service (GPS) aims ‘to provide a secure environment for Staff and Offenders’ and has just over 500 staff working in the service – 58% are men and 42% are women (GPS, 2017) – with the Director of Prisons having overall responsibility for all of the prisons in Guyana, while the Deputy Director holds responsibility for Operations. As nearly half of all GPS staff ‘are women and civilian staff who do not secure the majority of male prisoners’ there is a shortage of staff for the male estate – about 295 male prison personnel for around 2,074 male prisoners that comprise 96% of Guyana’s prison population – that results in a low staff to prisoner ratio, which has had ‘a significant impact on the personal security of inmates and guards alike’. Feelings of safety and security are integral to rehabilitation and building healthy prisons. Feeling safe is also the most important determinant of distress among prisoners and staff, illustrating that both safety and security are important issues that need to be addressed since the majority of prisoners (89%) felt less safe in prison than anywhere else they had lived (Sarsfield and Bergman, 2017). In fact, safety and security are basic human needs, which if unsatisfied can actually exacerbate levels of violence, disorder and rule-breaking in prison (see Hoke and Demory, 2014).  Although prisons have a dual role of public protection alongside the rehabilitation and reintegration of prisoners, it has been unable to adequately fulfil either since its inception (see Ifill, 2019) as many of the problems facing GPS today, were also prevalent in the past.


A Warder at HMPS, The Illustrated London News, 1888.

The contemporary prison service in Guyana is plagued by the same problems evident in the colonial prison, which according to the Director of Prisons (2020) rests on ‘the absence of physical infrastructure and human resource’. In fact, the physical infrastructure remains the same as in colonial times, particularly in the colonial era prisons that have not really changed. Internationally, it is well documented that the prison environment (conditions and culture) can adversely affect staff and prisoners, particularly prisons described as ‘not  fit  for human  habitation’ like those in Guyana. Such conditions also feed into and influence the way staff see and treat prisoners detained in these prisons. Research from the global north has continually shown that ‘the routine and bureaucratic denial of humanity in prison and the tendency to construct prisoners as the other ‘them’ creates spaces where inhumane treatment may occur…making brutality possible, even inevitable’ (Crawley, 2004). The use of violence by staff against inmates, the depersonalisation of prisoners (prisoners are merely bodies to be counted) and staff detachment are also well-documented techniques implemented by prison officers to cope with their job, which can also precipitate corruption.  In fact, the prison environment, its culture and the high concentration of criminals in confined spaces ‘not only makes those  deprived  of  their  liberty  prone  to  instigating  corruption;  it  may  equally  serve  as  a  catalyst  for  corrupt  practices  and  abuse  among  prison  service  officers,  particularly  if  coupled  with  a  lack  of  accountability  and  oversight’ (UNODC, 2017). Thus, safety and security are also compromised by ‘widespread corruption, mismanagement, bribery, favouritism and dishonesty in the GPS’ as the correlation between levels of corruption and ill-treatment in prisons globally is well documented (see UNODC, 2017). Although incidents of violence and corruption are sporadic in GPS, they still occur. Prison officers often have fewer qualifications, less training, low morale, low salaries, fewer career opportunities and are often held in lower regard than other officials leaving them susceptible to corruption (Ifill, 2019; UNODC, 2017). This has led to calls to increase the pay of prison officers in Guyana to compensate for the daily risks they face and in attempt to eliminate corruption.

Corruption occurs on a continuum and can vary from turning a blind eye to contraband in prison to aiding escapes and undertaking financial misdemeanours. Although levels of corruption vary across Guyana’s prisons, levels of corruption have been described as concerning, with ‘High-Levels of Corruption’ being evident at the overcrowded and heavily criticised Lusignan prison (also described as ‘not  fit  for human  habitation’). In fact, Minister Benn said, ‘we are losing more prison officers than we are getting due to corrupt practices.’ In Guyana in 2016, two hundred and thirty-nine prison officers – just under half of all officers (47%) employed by GPS – were charged and sanctioned with misconduct, that fell into two main areas; the possession of prohibited articles and assault on one another (GPS, 2017).

Possession of Prohibited Articles: Cigarettes, Cannabis and Rum: it is acknowledged that prisons are not closed and total institutions (if they ever were), which means contraband flows freely in and out of prisons via visitors, prisoners, civilians and delivery drivers, as well as prison staff. In fact, staff are one of the main supply routes for contraband, with 28% of inmates in Guyana reporting that staff brought drugs into prison (Sarsfield and Bergman, 2017), which is supported by several high profile incidents across all of Guyana’s prisons (e.g., in New Amsterdam, Camp Street, Mazaruni and Timehri). The trade in contraband, particularly illegal drugs in prison, namely cannabis, is facilitated by prison wardens and Police Officers because it is ‘big business’ and there is a lot of money to be made. However, it also indicates corruption, illegal earnings and criminality, which is often accompanied by violence, and is increasingly being associated with (organised) criminal gangs (see Owen and Grigsby, 2012). 

Violence and Assault: Shivs and Shanks: there are incidents of violence by staff against prisoners, by prisoners against staff and prisoners against prisoners, some of which have led to death. In fact, eight out of ten prisoners had witnessed inmates being beaten and a quarter said they had been attacked or beaten in the previous six months illustrating why prison was deemed to be an unsafe place (Sarsfield and Bergman, 2017). Not only have there been instances of prisoners overpowering staff and stealing their weapons, which includes guns, but prisoners also create makeshift weapons which are then used to attack fellow inmates and/or staff, which has on occasion resulted in death:

sharpened spoons…boring out your eye…a sharpened spoon up an officer’s nose…they also had sharpened wires, which they could push up under your ribs.’

However, staff also perpetrate violence against prisoners, and according to Minister Benn ‘some unfortunate persons, who perhaps [have] money or from whom money could be extorted…they [prison officers] will take a picture or a video and put knives to his throat and say ‘pay money to us…or else.’ While most prisons are violent, the State have been accused of creating the ‘conditions’ necessary for violence to occur in Guyana’s prisons. The overcrowding, poor infrastructure and staffing issues, when combined with the toxic mix of prisoners, including those with mental health issues who have always been, albeit inappropriately, sent to prison rather than a mental institution, has led to violence, unrest and murder. In fact, reports suggest that:

‘If they (prison authorities) know that a person is not well behaved, they deliberately transfer them to the Capital Section where you will be beaten. It’s a dog eat dog situation.’

Corruption and violence varies across Guyana’s prisons. However, corruption at Lusignan prison is said to have ‘significantly increased after prisoners were transferred there following the deadly fire at the Camp Street prison in March 2016’. In fact, the confiscation and seizure of contraband instigated the 2016 fire at Camp Street, which was described as ‘a war zone… full of burnt bodies’ where anyone in uniform was seen as the enemy. The more recent fire at Lusignan prison last July was also related  to the seizure of contraband as well as the beating of a prisoner by four prison officers, incidents which subsequently led to the prisoners setting ‘fire to the building, demanding that the drugs be returned’. While it is unclear how rife corruption is in Guyana’s Prison Service, contraband, particularly cell phones and drugs, help prisoners to cope with imprisonment; a sentiment also iterated by prisoners at the Camp Street Enquiry: ‘they have to get them cause it wouldn’t be comfortable for them to serve their prison time.’ Therefore, it is difficult to ascertain if corrupt prison officers who collude with prisoners do it to make money or do it out of compassion due to the harsh conditions’ prisoners are forced to endure in Guyana’s jails. This is particularly pertinent since many of the prison officers come from the same communities as their custodians, which is further compounded by a lack of research/knowledge in this area. Although GPS have tried to eliminate corruption, by offering financial incentives (e.g. the Guyana Prison Service offer $25,000 to expose criminal activities in the prison system), as well as recruiting new staff who are currently being trained ‘to manage prisons without corruption’, the demand for contraband will remain as it makes life easier for prisoners and staff alike. Drugs like cannabis have a calming effect on the jail, which makes the job easier for prison officers and may help to explain why some prison officers occasionally turn a blind-eye and/or facilitate its supply (see Cameron, 2020). Unfortunately, due to market dynamics, while demand exists there will always be someone willing to take the risk to ensure their supply, meaning that eliminating corruption and violence is an ongoing challenge facing GPS, particularly while the demand remains amongst prisoners that is largely driven by the poor and ‘potentially life-threatening’ conditions prisoners are forced to endure.

Discharged Convicts Waiting for the Boat, The Illustrated London News, 1885

Therefore, it can be seen that Guyana’s Prison Service continues to be haunted by its colonial past, and that includes its staff. During colonisation, the British blamed isolation, overcrowding and a lack of prospects on the low morale of prison officers. There were very few rules and regulations outlining their role, which meant violence and mistreatment were rife, but justified, as prisons, like the plantations contained dehumanised and often animalised bodies that led to an increase in the number of punishments being administered within the prisons. It is in this context that prison officers and prisoners occupy historical spaces of distress, decay and violence. In fact, the conditions and problems facing GPS today are similar to those in the colonial past despite the plethora of reports, commissions and recommendations that have been made over the years. All grades of prison personnel in the contemporary Guyanese Prison Service – as they did in the past – experience physical  and  mental exhaustion, poor health, stress, anxiety as well as being over worked and under paid, that has for some resulted in excessive alcohol use that according to Governor  P.E.  Wodehouse, could result in death. However, there is very little research on prison officers in Guyana, which is something the MNS in Guyana’s Jails project seeks to rectify. The dearth of research on the experience of prison officers in the global south means that research from the global north is often extrapolated and applied to explaining the experiences of prison personnel – as in this blog – despite its inapplicability and irrelevance, illustrating the need for research that captures the lived experiences of prison officers working in Guyana’s prisons. The role and impact of effective, well-trained and committed staff at all grades should not be underestimated since research – albeit from the global north – shows it can impact on staff motivation and retention; determine the success of a prison or new regime; impact on safety and security; everyone’s health and wellbeing; levels of distress, violence, drug use, self-harm and suicide; as well as recovery and rehabilitation. Although there have been calls for more professionalism and training in GPS, caution must be taken to ensure that the institutional reproduction and dominance of colonial practices does not take precedence and obscure the epistemologies and experiences of the global south that removes the colonised from their own history. An ‘erasure and forgetting’ known as colonial amnesia (see Kerrigan, 2020).  

Tammy Ayres is an Associate Professor in the School of Criminology, University of Leicester, UK.

The author would like to thank Clare Anderson, Kellie Moss and Queenela Cameron for their comments/input on an earlier draft of this blog. Thanks, must also go to Kellie Moss for the photographs.

Enhancing Mental Health Communications in Guyana

Martin Halliwell

Two of the trickiest aspects of mental health care to get right are psychiatric diagnosis and public health communications. The challenge for health providers around the world is to maintain consistent standards of classification for mental health and illness without imposing a rigid framework that overlooks social determinants and cultural specificities. Similarly, while public health education is part of the machinery of government – advising citizens about healthy behaviour or instructing them what to do in emergencies – this top-down model sometimes overlooks the importance of horizontal modes of communication within and between communities.

In this blog, I reflect on these two different types of health communications – the first directed towards health care providers, the second towards the public – to think through implications and challenges for developing a dynamic model of public health in Guyana, especially at the intersection of mental health and incarceration for a multicultural society.

Mental Health Diagnostics

Guyana, like the Caribbean as a whole, uses the International Statistical Classification of Diseases and Related Health Problems (ICD) for its diagnostics. This is a globally held standard for both physical and mental health, except for in the United States and parts of Canada, where the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM) has more specifically informed psychiatric classification since the early 1950s. First established in Paris in 1900, the ICD has gone through 11 editions in the 120 years since and is closely wedded to health standards upheld by the World Health Organization (WHO). This compares to the DSM, established by the American Psychiatric Association in 1952 to provide consistency to the hitherto psychiatric categories deployed in the medical department of the US Armed Forces. DSM has expanded dramatically through five editions, moving away from psychoanalytic language in the third edition of 1980 to develop an organic framework for describing psychiatric disorders and, since 1994, a multi-axial system for understanding the various causes and components of mental illness.

The most obvious commonality between ICD and DSM is the word ‘disorder’ for describing a group of conditions that includes mood disorders, neurotic disorders, schizophrenia, personality disorders, neurodevelopmental disorders, and mental and behavioural disorders due to using psychoactive substances. As well as variance in scope, there also some key differences between the two systems. In a July 2014 article, Peter Tyrer points to the global reach of ICD and its attention to primary care in low and middle-income countries, in contrast to DSM’s focus on high-income countries and its specificity as a psychiatric manual. The ICD also stands apart from DSM’s links to health insurance, which determines whether a patient in the US with a diagnosed condition is eligible for co-pays, Medicare or Medicaid. Given its global reach and flexibility as a system, researchers like Cary Kogan and Peter Tyrer hope that ICD will eventually replace DSM in Canada and the US. Published in June 2018, for adoption by member states from January 2022, ICD-11 has moved away from a categorical to a dimensional approach to mental, behavioural and neurological disorders, offering a more nuanced account of a patient’s changes over time and seeking to integrate traditional medicine.

The main problem about both diagnostic models is that psychiatrists deem ‘disorder’ to be a neutral term referring to a disequilibrium or impairment within the human organism, yet from an analytical sociological lens it is a heavily coded word shaped by social determinants and cultural experiences. In clinical terms, diagnosing a disorder can sometimes lead to relief for a patient. Just as often, though, it can lead to the medicalization of a person who might be experiencing a temporary fluctuation in mood and behaviour; or who needs interpersonal support rather than medical treatment; or whose environment is not conducive to the best of health.  Crucially, sometimes the diagnosis of a major disorder can be stigmatizing and can resonate more forcibly within certain demographic groups. For example, there were numerous studies in the post-World War II period that linked ‘disorder’ to the perceived behaviour of Black males, with discourses commonly slipping fluidly between health, home and society. It is easy to see how the term becomes mired in ideology if a disorder in or of the self mirrors a breakdown in family or social order. This insight has led critics like Daryl Michael Scott in Contempt and Pity (1997) and Jonathan Metzl in The Protest Psychosis (2010) to critique what they see as the invidious racial coding of this kind of psychiatric language.

This does not mean that we should dismiss ICD and DSM as being part of the micropolitics of the state, especially as ICD seeks to cross borders and promote health access globally. Through their numerous revisions, the two manuals have attempted to balance questions of scale and duration and take into account multiple factors before reaching a diagnosis. However, even if we embrace the progressive spirit of ICD, the consequences of a clinical diagnosis for treatment and operational practice are subject to significant variations in national health infrastructures across global regions. This is especially the case if we think about the availability and cost of certain therapeutic drugs, if and how comorbidities are treated, and to what kind of interpersonal care a patient has access – whether it is in a state or private facility or within an outpatient setting. Used crudely, an ICD or DSM diagnosis can be life transforming in the wrong way. A diagnosis of a major disorder, particularly among some demographics, can lead to custodial care or a course of drugs that might not be in the patient’s best interest, leaving social determinants largely untouched.  

Public Health Communications

In contrast to diagnostics, public health communications seem to be, on the surface, less controversial. Surely, the balancing of official communications at state level and a sensitivity to the needs of a particular community offers a balanced way forward for health officials. This balancing of vertical and horizontal approaches is one that Chelsea Clinton and Devi Shridar uphold in their 2017 book Governing Global Health, aligned with WHO’s view that health is a right and not a privilege. The Pan American Health Organization, established in 1902, embodies the views of the WHO within the Americas, and in 2018 it mapped out a sustainable health model through to 2030, which places as much emphasis on human resources and crisis response as it does on access to medicine and the resilience of health systems. On this view, the most effective kinds of public health communication are less about the balancing of vertical and horizontal axes, and more about promoting a holisitic understanding of physical and mental health as part of an ecosystem of well-being.

This PAHO model shares with a ‘One Health’ approach a recognition of the interconnected nature of human health and animal and planetary health. Yet, this does not necessarily provide public health workers with easily distributable public health information. This is especially true when budgets are tight, or where there are barriers of language and literacy, or where some communities are hard to reach. This last factor is true of Guyana, which centres its state health apparatus on Georgetown and the seaboard, leaving a number of rural regions and localities (in the interior and close to the borders with Venezuela, Brazil and Surinam) underserved in terms of access to well-staffed health services, instead relying on sparse health units operating on a part-time basis.

On visiting all of Guyana’s prisons in April 2019, in collaboration with the Guyana Prison Service and Guyana’s Ministry of Public Health, members of our research team were struck with how patchy and out-dated health information was, and in some prisons was lacking altogether. Where we did see posters or leaflets in the prison system, or in allied medical facilities, they focused almost entirely on physical health and disease, such as malaria, anaemia or HIV/AIDS.

Only occasionally did we see very basic information on mental health. At the National Psychiatric Hospital near New Amsterdam Prison we saw three versions of the 2017 PAHO World Mental Health Day poster ‘Depression: Let’s Talk’, representing different ethnicities and genders (as illustrated here), despite the conditions of the hospital ward being almost unbearable and not conducive to talk therapy. We also saw a ‘Break the Silence’ poster on domestic sexual violence in the prison hospital at Mazaruni (a men’s prison), with an emphasis on abused women speaking up against hidden crimes that are often covered over, and with the tagline at the bottom of the poster: ‘A real man can control himself’.

Recommendations for a Dynamic Public Health Model

Whether or not health information in communities and prisons are improved and updated, it may still overlook the WHO’s view that health is a dynamic process that needs underpinning by care-oriented facilities, not simply a textbook issue to diagnose and treat. The implications of the WHO and PAHO model are that public health communications should not just be offered to a community as a service, but be embedded in that community in a co-owned space in which prevention is prioritized over treatment. We saw an example of this co-ownership in Georgetown, with the participation of many students in a World Suicide Prevention Day march on 10 October 2019 (see my December 2019 blog), alongside the Ministry of Education’s efforts to integrate classes on health and family life into school curricula from age 5 upwards. Nevertheless, there are three key aspects of an integrated public health model that might be usefully adopted.

The most obvious aspect is for an updated and more nuanced set of posters, leaflets and online resources about the signs and symptoms of mental distress that might help to deepen social views of mental health and would support the work of health officials in terms of education and outreach. It presents an opportunity, for example, to ensure health education among male prisoners does not simply skew towards anger management, as is the case in Guyanese prisons. This opportunity might link to a broader programme of prisoner rehabilitation classes, including sociological, historical and literary topics, in order to help inmates better understand their behaviour and to learn about harm prevention from a wider frame of reference.

Secondly, we could point to the need to ensure that public health literature brackets off discourses of ‘right behaviour’ understood in moralistic, religious or legalistic terms – which is particularly tricky when it comes to countries that criminalize recreational drug use across a broad spectrum. Such a move needs to be carefully considered and managed, in order to focus less on punitive discourses and more clearly on self-care, care of others, and how to access health services. The independent Drug Policy Alliance in the US, established in 2000, offers a model of this, given that one of its key values focuses on ‘empowering youth, parents and educators with honest, reality-based drug education’ that moves beyond ‘fear-based messages and zero-tolerance policies’.

A third important area would be to ensure that prisoners, as well as patients treated for lengthy periods in inpatient facilities, have broader access to two-way communications beyond the institution. Within the US prison system, one example is the Restorative Radio Project, run by Sylvia Ryerson, a researcher at Yale University. This project enables families of prisoners in Appalachia to share ‘audio postcards’ and music with imprisoned family members via toll-free public radio – and there is potential for inmates to reciprocate with their own audio postcards. Such an opportunity can help alleviate loneliness, isolation and a loss of self-esteem among prisoners, as well as what Johanna Crane and Kelsey Pascoe call the ‘chronic health condition’ of incarceration itself.

This radio-facilitated model can be linked to larger step changes, such as Yale University’s efforts to expand prisoner education via for-credit courses with the aim of imagining ‘a future beyond mass incarceration’ and ensuring that prisoners and empowered and educated rather than being treated or managed. The fact that this is an elite Ivy League institution with a $1.5 million Mellon grant to develop an educational initiative that dovetails with criminal justice reform takes us back to structural questions about capacity, economics and racism which are never easy to resolve. However, the initiative also speaks to other national models, such as in Norway in which all prisoners have a right to education and a commitment to rehabilitation through positive experiences.

Concluding Thoughts

There is much promise at state level in Guyana of meeting the challenge of tackling the burden of mental illness, as the development expert Ramesh Gampat recommended at the end of his two-volume 2015 book Guyana: From Slavery to the Present. In addition to the aim of the Ministry of Public Health to reduce suicide rates and destigmatize mental illness with the aid of WHO’s mhGAP Intervention Guide for use in non-clinical settings, we saw evidence of art therapy practised at Mazaruni Prison, alongside (patchy) library material and outdoor recreational facilities in most of Guyana’s prisons. This reveals a growing awareness that health and well-being are multifaceted.

The challenge remains for us, though, across the intersecting global communities of the early twenty-first century, to imagine a future where public health information is a shared resource rather than an arm of government that flourishes or withers on the strength of budgetary priorities.

Martin Halliwell is Professor of American Studies in the School of Arts and a research expert at the University of Leicester. His new book American Health Crisis: One Hundred Years of Panic, Planning, and Politicsis published by the University of California Press. He would like to thank Clare Anderson, Queenela Cameron, Dylan Kerrigan and Kellie Moss for their valuable help in developing this blog.

Alcohol, Alcoholism and Mental Health in British Guiana, Part 1.

Deborah Toner

As previous posts have highlighted, the use of alcohol, cannabis and other substances form a major part of ongoing discussions about mental health and mental illness in Guyana in the twenty-first century. Concepts relating to the problematic use of substances also shaped historical understandings of mental health issues in British Guiana and the Caribbean. In two linked posts, I aim to explore how alcoholism in particular was understood during two key junctures in the development of mental health infrastructure in the region: the late nineteenth-century period of asylum reform led by Dr Robert Grieve in British Guiana (part I); and the foundational conferences of the Caribbean Federation for Mental Health in the mid-twentieth century (part II).

While the terms alcoholism and alcoholic are still widely used and familiar today, in both lay and therapeutic contexts, clinical diagnoses of problem drinking have long been moving away from these terms. The fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published in 1994, included alcohol abuse and alcohol dependence as two distinct disorders, while the more recent DSM-V of 2013, integrated the diagnostic criteria for both into one “alcohol use disorder”, with gradations in terms of its severity. Public health bodies such as the WHO have increasingly shifted to the language of harmful drinking and alcohol-related harm instead of alcoholism. There are multiple reasons for these developments; an important one to highlight here is that alcoholism as a concept has, since its inception, been a moveable feast.

The Asylum Journal for 1882. Berbice, British Guiana: printed for the Asylum Press.

By exploring the development and application of the alcoholism concept through the history of mental health in British Guiana, these two linked posts constitute a preliminary attempt to write British Guiana into a major aspect of the global historiography of alcohol in the nineteenth and twentieth centuries. The emergence and spread of medicalized understandings of problem drinking and associated concerns about public health have been a major focus of this historiography (Levine 1985; Sournia 1990; Piccato 1997; Tracy 2005; Toner 2015). Until the nineteenth century, habitual drunkenness was largely understood as a moral failing. Across the nineteenth century, new terms like inebriety, dipsomania, addiction and alcoholism diagnosed certain drinking patterns and practices as medical or psychiatric problems. Moral judgements and social prejudices were still embedded within these new concepts, and they varied in their definitions and applications from place to place. In British Guiana, Robert Grieve devoted many pages of the Asylum Journal (1881-86),produced while he was Medical Superintendent of the Public Lunatic Asylum in Berbice, to analysing the connection between alcoholism and insanity. His interpretation combined analysis of the physiological and neurological effects of alcohol with theories about racial difference, degeneration and the impact of social dislocation. By the 1950s and 1960s, Alcoholics Anonymous, formed in the United States in 1935, had established a significant presence in the Caribbean. The “disease” concept of alcoholism, which Alcoholics Anonymous helped to popularise in lay terms around the world, featured in the early conferences of the Caribbean Federation for Mental Health, alongside broader interpretations of problem drinking that considered the psychological and social legacies of colonialism and ongoing processes of rapid socio-economic change.

Part I: Intemperance, Alcoholism and Insanity in the late Nineteenth Century

Rather than using alcoholism to denote particular patterns of alcohol use, late nineteenth century medical practitioners in Europe, North America and elsewhere typically used the terms alcoholism or chronic alcoholism to describe the range of physiological, neurological and psychological conditions that alcohol consumption could cause. Physicians in British Guiana followed a similar pattern. They made few and only vague attempts to describe an “alcoholic” pattern of drinking behaviour and more consistently employed the terms “drunkards”, with “intemperate” or “vicious” habits in the use of alcohol to convey prolonged or excessive patterns of consumption. In quantifying excess, Robert Grieve ventured some specific observations. In discussing the importance of good diet for general physical and mental health, he stated that the quantity of alcohol consumption “within which safety lies is very limited, not more than a wineglassful of ordinary spirits or its equivalent in the twenty-four hours” (Asylum Journal, 1881). Case histories presented in the journal sometimes described heavy drinking patterns that led to specific symptoms as alcoholism. A 41 year old migrant from Barbados, diagnosed with syphilitic insanity, reported that “he had been drinking freely for some time and he rather proudly declared that he could take a bottle of strong rum without staggering”. Grieve subsequently noted that he had been suffering hallucinations upon his admission to the asylum, “no doubt dependent upon the alcoholism under which he then laboured” (Asylum Journal, 1882). Dr Godfrey, in Georgetown Hospital, was initially stymied in treating a patient suffering from shooting pains and paralysis of the arm, which the doctor suspected had been caused by excessive drinking. The patient, a 39 year old sugar distiller, claimed to drink only “a glass or two of alcohol during the day”, but his wife subsequently informed Godfrey of a “clear and exact history of alcoholism which had been going on for some time”. On giving up drinking altogether, the patient slowly recovered over a period of several months (Transactions of the British Guiana Branch of the British Medical Association, 1891).

Medical and psychiatric experts more consistently attributed to intemperance in the use of alcohol, various physiological and neurological imbalances that caused different forms of mental illness. Writing in the Journal of Mental Sciences, James S. Donald described intemperance as “one of the most fertile causes” of “lunacy” in British Guiana, singling out the consumption of high-strength rum, known as “high wine”, for producing “cerebral lesions” over time (1876). Grieve wrote quite extensively in the Asylum Journal about the prevalence of Bright’s disease (an out-of-use term for various kidney diseases) amongst patients of the Berbice asylum, where it was a leading cause of death over several years. He attributed the comparatively high rate of Bright’s disease within the asylum to the long term effects of malaria, poor diet, and intemperance in the use of alcohol, and also argued that drinking alcohol compounded the negative effects of malaria and malnutrition on the kidneys. Further, he postulated a causal link between Bright’s disease and neurological changes that led to insanity and hence, admission to the asylum. For example, in a case history of a 50 year old female patient, “said to be of intemperate” habits, Grieve traced a causal link between her kidney disease and her “cerebral excitement”, which manifested on admission in symptoms such as incoherence, delusions, violent and erotic outbursts, severe head pains and memory loss, and ultimately led to her death via a brain haemorrhage. He concluded the case history: “we have therefore a case of insanity arising directly from Bright’s disease and remotely from intemperance” (Asylum Journal, 1881).

Finally, in exploring the causes of mental illness, Grieve pondered connections between intemperance and theories of racial difference, degeneration and social dislocation. Grieve sometimes attributed an inherited predisposition greater causal weight to mental illness than environmental or lifestyle factors, but all three could be linked through the theory of degeneration. “Proclivity to any disease is influenced by all the previous conditions of life not only of the patient but of his ancestors”, he argued, and that insanity as a disease could often be understood as the last step in the “evolution of degeneration of which too often overindulgence in drink forms the starting point” (Asylum Journal, 1881). Assessing the numbers of patients admitted to the asylum in Berbice up to 1880, Grieve explained that there was a considerably higher proportion of migrants than creoles – a distinction based on being born outside or within British Guiana – likely as a result of having less of a family support network to provide care during periods of mental distress. Within the category of migrants, Grieve further attributed a disproportionate number of African patients in the asylum population to racial difference, in two senses. First, the disorientation of being displaced from a “savage” lifestyle in Africa to the comparatively high “civilisation” of a British colony. And second, as a “race which possesses less of civilisation than any other seen in the Colony”, he argued Africans were unlikely to suffer mental illness because of “mental strain”, a common explanation of insanity in Europe at the time. Instead, the high rate of Africans being admitted to the asylum in British Guiana was taken as evidence that “vice”, especially in the use of alcohol, was a “more active agent in the manufacture of the insane” than “mental strain” (Journal of Mental Sciences, 1880). While so-called ‘moral causes’ of insanity – including anxiety, domestic strife, the strains of modern life – predominated in English cases of insanity, Grieve suggested that in British Guiana such problems weighed little on the minds of people of either African or East Indian descent. Amongst these groups in the colony, alcohol and cannabis (or gange) were respectively considered the leading causes of insanity (Asylum Journal, 1882). The close connection Grieve drew between African asylum patients and alcohol use was also linked to their higher fatality rate as patients compared to other ethnic groups, as a consequence of co-morbidities between cerebral abnormalities, chronic heart disease and Bright’s disease (Asylum Journal, 1883).

By the time the Caribbean Federation of Mental Health was formed in the 1950s, medical and psychiatric professionals around the world increasingly viewed alcoholism as a mental illness or physiological disease in its own right, and the term had become a familiar part of everyday language in discussing problem drinking. Come back to the blog for Part II of this post to find out how such ideas were debated at the Caribbean Conferences for Mental Health in the 1950s and 1960s.

Deborah Toner is an Associate Lecturer in the school of History, Politics and International Relations, University of Leicester.