High cost of therapy leaving Jamaicans struggling

For some Jamaicans, the price of a therapy session is the difference between getting help and giving up.

Clinical psychologist Dr Paul Smith has seen patients drop out of treatment not because they want to, but because they cannot afford to keep going.

"There are times when I know someone cannot afford another session, but I see them anyway, because a life is a life," said Smith, who is also president of the Jamaica Psychological Society.

September is Suicide Prevention Month, and while Jamaica's suicide rate is relatively low by global standards - about 2 to 2.3 per 100,000 - the count has climbed for four consecutive years, reaching 67 deaths in 2024, the highest since the early 2000s.

In Kingston, therapy typically runs from $5,500 with a practicum student, to $14,000 with a senior associate. With the national minimum wage currently at $16,000 for a 40-hour week, a single senior session costs nearly an entire week's pay. Even the cheapest option eats up more than a third of a worker's earnings.

Smith, who describes his own fees in Mandeville, Manchester as "cheese money" compared to Kingston, often steps in to help when patients cannot pay. Sometimes he checks in free of charge, leaving his phone line open for calls and texts. But not every professional can afford to do the same.

"When someone cannot afford the service, they stop showing up," he told THE STAR. "And that in itself deepens their depression."

Beyond the individual, the responsibility often shifts to relatives, and the financial and emotional toll on households can be overwhelming. Smith noted that while the Government provides some assistance through programmes such as PATH and community clinics, those supports rarely cover the full cost of ongoing therapy.

"Even people who are not poor, who have a TV and a fridge, struggle," Smith said. "Caring for someone with a mental illness is another stretch financially and emotionally."

He opined that Jamaica must treat mental health like chronic illnesses such as diabetes, and even cancer.

"It ought to be pronounced on insurance cards, not discretionary. Mental health must be featured as a matter of priority," he stressed.

While the government has rolled out policies and training, Smith said that the system is still falling short. Guidance counsellors, for example, are stretched thin, one often responsible for hundreds of students, leaving them drained themselves.

"We need an ecosystem where private practitioners and government services work together," he said. "It has to be a national campaign that is sustainable."

Support at home and in the community can be the difference between recovery and relapse, but it takes more than casual check-ins to truly reach someone in crisis.

"From a psychological perspective, telling people to check in is not sufficient," Smith said. "It's more than just opening a door and saying, 'You alright?' and then leaving. Friends and relatives need to know what to look for - if someone has stopped eating, [becomes] withdrawn, or seems unlike themselves. And when they open up, the best thing you can do is listen, encourage professional help, or even offer to accompany them."

For Smith, the fight against suicide and depression cannot rest on kind words alone. It demands a system that makes care reachable for everyone.

"It must be okay to get help and that means making help affordable," Smith said. "Because it's okay not to be okay."

If you or someone you know is struggling, call Jamaica's 24-hour Mental Health and Suicide Prevention Helpline at 888-NEW-LIFE (639-5433).