“There is no health without Mental Health” ~ David Satcher
If you have been watching the local news lately, you have definitely seen an increase in the number of crimes of passion, cold-blood murders and cover ups to suicide. The reports can be mistaken for episodes from a popular series or scenes from a movie- most of which are unfathomable.
You may recall a few such cases that were recently reported by the media including that of a man who killed his girlfriend and her two children from a previous marriage but spared the last born whom he had sired with the lady; siblings who killed their parent because of land, a man who ran away after killing his whole family a student who committed suicide after failing his exams and many more.
These cases when taken to court usually require the defendant to undergo a medical check up to ascertain their mental stability. For most, when asked, they say they were tormented by evil spirits, while others say they were listening to a voice that told them to do those bad things, among other bizarre explanations.
The fact is, most people do not consider mental health illnesses as anything they, their friends or family members would suffer from. In fact, many think that mental illness is for those like patients admitted at Mathare Hospital who exhibit violent tendencies, a likelihood of hurting themselves and other behaviours such as undressing and talking to themselves in public. You are wrong.
According the World Health Organization (WHO) 2017 Global Health Estimates, 300 million people suffer globally from depression while 264 million people suffer from Anxiety disorders. The prevalence of a mental disorder globally ranges from 18.1% to 36.1% which means that a third of the world population has, or has previously suffered from, a mental disorder.
Depression is WHO’s single largest contributor to global disability and is also said to be the world’s major contributor of suicide deaths which are estimated at 800,000 every year. The report also reveals that Depression is higher in females at 5.5% than it is 3.6% in males. Prevalence of depression are higher in the African Region at 5.4%
Understanding Mental Health
Mental Health refers to a person’s psychological, emotional and social wellbeing that affects how we think, feel and act.
The World Health Organization (WHO) defines it as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to her or his community.
One is said to have a Mental disorder or illness when their state of well being affects how they relate to others, how they react to issues/challenges, how they react to stress which normally affects the choices they make.
Types of Mental disorders include; anger, anxiety and panic attacks, bipolar disorder, personality disorder, dysmorphic disorder, hearing voices, eating disorder, alcohol and drug abuse, psychosis, post-natal depression, post-traumatic stress disorder, schizophrenia, very high/ low self-esteem, self-harm, stress, sleep problems, suicidal problems.
Just from this, you can already tell that anyone can have a mental disorder. Perhaps, how we handle it is what matters and what determines whether we get better or not.
The Tanzanian perspective
According to a research paper ‘providing Sustainable Mental Health Care in Tanzania’ by Professor David Ndetei of University of Dar es salaam and Dr. Ana-Claire Meyer, Unipolar depression accounts for 45% of mental health disease burden in Tanzania, which is the highest among mental disorders. Neurological disorders on the other hand account for 11%.
The WHO also ranked Tanzania 6th globally with 1.9 million cases of depression.
Unfortunately, in Tanzania, people with mental health problems are often stigmatised and discriminated against. They are told to seek spiritual healing or traditional healing alternatives to ‘cure’ their problem.
Often, there are myths and misconceptions of mental illness where the affected are either told that they were possessed by an evil spirit hence the need for a traditional healer to perform exorcism or they have ‘lost’ their mind and cannot be helped hence they are either locked up alone to ensure they do not harm others and sometimes even disowned.
Despite the high numbers of mental illnesses, there is still an inadequate number of psychiatrics in Tanzania with only about 100 most of whom are based in Dar es salaam. There are also about 12 neurologists with most of them based in Dar es salaam, Mombasa and Kisumu.
Accessible and Affordable mental health services therefore remain a mere promise in the Mental Health Bill 2014 which is yet to be enacted into law. However, the Tanzania Health Act has adopted WHO’s Global Mental Health Action Plan 2013-2020. This adoption seeks to bring together the state sector, private sector, and civil sector together in developing policies aimed at improving mental health services, preventing mental health illness and promoting recovery.
Care and Support
With a basic understanding mental health and knowing that we can all become victims of mental health disorders, how do we care and support people with mental disorders and illnesses?
Understand the type of mental illness or disorder they have as one size does not fit all.
Be patient- They will not get better overnight, and it could take a while before they trust you.
Make a crisis or emergency plan especially if you live together. Have emergency numbers on a wall or fridge door, ensure you take them through safety measures as well.
Stop and Listen. Most people with mental illnesses feel out of place and alienated. Ensure you make them feel comfortable by letting them express themselves as you listen. Pay attention to what they say. Body language can tell if you are genuine or not.
Encourage them to be independent and to contribute to everyday life through education, working, etc.
It is important to also set limits on what you are willing to do and what you are not and communicating this to them.
Enroll them in a support group.
Remember, a carer also requires care. It is important that you also talk to someone about the kind of care you are offering. Take time off to do what you like and with other friends so that you also have a life and do not start feeling overburdened.
The big Question is, if your friend or family member had diabetes or cancer, would you tell them to be prayed for or to seek a traditional healer for the ‘evil’ spirits to be removed? Therefore, we should fight against stigma for people with mental illness. We should raise awareness that leads to action, then pursue action that pushes for reforms and always campaign for change.