“I decided to seek help because I was hearing voices and seeing people who were not there. Finding it difficult to distinguish what was real and what was not. I told my parents and they decided I go to church and see our Pastor, you know seek divine help, hoping I was still in shock over a nightmare”- “I am not Crazy!”: Diary of a Bipolar Menace.
The issue of mental health is yet to be fully addressed in the various nations of Africa. Individuals with mental illness are often viewed as having demonic possession or they are stigmatized and ostracized from their families. For those that seek medical care, there are usually little or no available services. However, various events and current research show that there is an increased need for mental health services in Africa especially in conflict and post-conflict areas. A recent report by Voice of America (VOA) illustrates the great need for mental health services and the lack of adequate capacity to address mental health concerns in the region. VOA reports that former combatants in South Sudan exhibit symptoms of Post Traumatic Stress Disorder (PTSD) which could lead to suicide and various forms of violence including maiming and killing others. South Sudan has psychologists but not a single psychiatrist nor adequate mental health facilities and psychiatric medication. As a result, these psychologists have no option but to sedate mental health suffers and if that does not work, they are sent to prison in the capital city, Juba. The same story holds for Liberia and the Democratic Republic of Congo.
But can we do something about it? Vikram Patel, the Co-director of the Centre for Global Mental Health says yes. In his talk seen below, Dr. Patel describes a model of care which trains ordinary people in resource-poor areas with the aim of empowering them to protect the health of their communities. He has also published a book titled “Where There is No Psychiatrist”, which provides readers with a guide to problem-solve various clinical disorders.
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This article is much needed. Some parts of Africa, mental illness is still invisible. Once African states address the problems of poverty, social stigma, they can better address mental health issues. It’s like the old saying, you must crawl before walking. First, states must address the biggest issues, which is poverty that triggers other severe problems, such as mental illnesses, poor health, etc…. I am glad that you are shedding light on these issues.
Thanks for your comment Shannon. You make some good points.
This is a profound problem in Africa and many cultures of the world. I watched with helpless sadness as my mother succumbed to depression at a tender age, all because she living in a culture that has no appreciation of mental health problems or ways to alleviate them. Sadly, many decades later, this picture is just as rife today as it was then. I have been following your work Dr Vikram, and I dare say, I have enrolled in the mission of Daring to Care.
Thanks for sharing something so personal! People like you inspire us to continue to create awareness of these issues in order to create solutions
A recent report on the mental health issue in Liberia can be seen here http://allafrica.com/stories/201209030413.html
Thanks for sharing. I am working with persons with mental health problems in Kenya. We have over the past five years come along way in creating awareness and opening public debate about mental health. I am very happy to say that mental health in Kenya is now openly discussed by the media, in public forums, in the communities and on social media. The stigma is still perverse but there’s hope . We are working with 11,986 people living in poor rural and urban slum neighborhoods. Training families, care givers, health workers and everyone around the person with the illness is a very promising strategy of building support and sustainable care. A Lot remains to be done but i appreciate the openness that is emerging in Kenya and the good response from the civil society , the government and all Kenyans.
Wow!! I am happy to hear this Joyce! I have read about your organization-Basic Needs. You are doing great work! Congratulations Kenya!
Thank you for your post! The more we talk about these things, the more likely we are to get things done. Mental healthcare provision is desperately poor in Africa – there are social and stigma issues as mentioned above coupled with a lack of recognition both from countries themselves and the global health community as a whole that mental health is a cornerstone of good health.
Having said that, I think two of the most important things to remember are the diversity of mental illness and the diversity of Africa. It’s so easy to see mental illness as monolithic with universally good or universally bad responses and/or treatment by one’s society or medical establishment. Likewise with Africa, it’s all too often seen as a homogeneous continent with certain attributes either being universally dominant or universally absent. I say this because there are also things we can learn from Africa in dealing with mental illness. For example, some African communities seem to be able to produce much better outcomes for people with severe mental illness such as schizophrenia (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472257/). It is absolutely key that resource-rich and resource-poor countries work together in partnership to improve mental health globally rather than imposing a “Western” model of healthcare.
I hope you don’t mind me posting these here, but I’ve written a couple of articles very relevant to this: the first on the neglect of mental health by the global health community http://globalhealthinterestforum.wordpress.com/2012/02/17/what-were-not-talking-about/ and the second on suicide as a global health issue http://globalhealthinterestforum.wordpress.com/2012/06/01/suicide-as-a-global-health-issue/ I hope the more we keep going on these issues, the more notice will be taken.
Thank you for your comment Paul, you make some interesting points about understanding the diversity of mental health issues on the continent and I agree that there is need to investigate this and fostering solutions that are tailored for the continent.I am glad you are adding your voice to create awareness of these issues. Thanks again
South to South Resource Exchange as in the field of eye care ( righttosight.com) and in HIV/AIDS ( VHS – SHARED ) are forerunners for Collaborations in Mental Health too !
Thanks for letting us know Narayanan!