Dear Africa, Mental Health Is Not a Myth!
By Dasha Asienga, Copy Editor
During the past few years, the movement for mental health awareness has gained global momentum. From conversations about mental health disorders in workplaces and educational institutions becoming normalized to celebrities promoting the importance of self-care and speaking up about their own struggles, the world is slowly waking up to the importance of mental health. This, in turn, has helped reduce the social stigma that has historically accompanied discussions regarding mental illness. In Africa, though, there is still work to be done. While many are choosing to speak up, Africa’s acceptance of mental illness falls far behind that of the Western world.
It is crucial to prioritize conversations about mental health everywhere in the world, especially among the youth. The urgency of this matter is evident. According to the World Health Organization (WHO), about 800,000 people die of suicide each year, 79% of whom come from low-income and middle-income countries. All countries in Africa fall under this bracket. Similarly, one in five of the world’s children or adolescents suffer from a mental disorder, and 264 million people globally suffer from depression. Yet, in low-income countries like those in Africa there are only two mental health workers for every 100,000 people.
Even with these disturbing statistics, many Africans refuse to acknowledge the unfortunate reality of mental disorders. These disorders are often explained away with superstition, witchcraft, and weakness. In fact, in 2014 when American film actor Robin Williams committed suicide after battling depression, a Kenyan humor writer for a nationally-acclaimed newspaper made an impertinent comment, writing, “I can’t wrap my mind around the fact that depression is an illness … in fact, it is such a non-issue that African languages never bothered to create a word for it.”
Unfortunately, most Africans hold the same opinion. Dr. P. Maramba from the Ngomahuru Psychiatric Hospital in Zimbabwe even listed a number of derogatory terms used to describe mentally ill people. Maramba explained that mental illness is viewed as punishment from the “gods,” making others hesitant to associate with those who are struggling with mental disorders for fear of being punished as well.
Similarly, many African governments have neglected mental health in their health and developmental policy agendas. Though this oversight mainly stems from a lack of awareness, these countries are also faced with many challenges such as high levels of poverty, infectious diseases, natural calamities, and political conflicts that threaten daily life.
To make matters worse, a number of mental illnesses may actually be triggered as a result of repeated exposure to such adversities. For example, in 2018 at the Nduta refugee camp in Tanzania, the number of mental health cases per month doubled from 700 to 1,418 per month in just seven months, with some people attempting and committing suicide because of their perceived lack of a forseeable future. Additionally, in the East and Horn of Africa, experiences of conflict and violence make up 48% of the events and risk factors affecting people’s mental health.
The devastating truth beneath all of this, though, is that there are not enough resources for those with mental illnesses. Only about 25% of South Africans experiencing mental illness have some form of access to psychiatric or therapeutic care. Even more shockingly, according to a 2017 infographic by the World Health Organization, in a population of about 7 million in Sierra Leone, there was only one retired psychiatrist, one clinical psychologist, 20 mental health nurses, no psychiatric social worker support, and one psychiatric hospital with a maximum bed capacity of 250 patients. These numbers are quite alarming as an estimated 450,000 suffer from depression and 75,000 from schizophrenia in Sierra Leone — not to mention the countless other mental disorders.
Despite the dire situation, there is always light at the end of the tunnel. Mental Health Awareness Day is observed globally on October 10. In 2019, the theme was “Working Together to Prevent Suicide” and among other interventions aimed at addressing the issue of suicide, the Kenyan government resolved to prioritize suicide prevention as a key strategic action in the country’s mental health policy. Furthermore, the Kenya Ministry of Health initiated primary and community health worker training in order to better identify mental health problems in communities, especially those faced with adversity. The government also expanded the universal health care system to allow for access to mental health services. There have also been a series of new interventions and innovations in various African countries that have incorporated non-specialist health providers in local communities, reducing the cost of care. Examples include the use of group interpersonal therapy delivered by local non-specialist facilitators in northern Uganda and a counseling intervention delivered by lay health workers called “Friendship Bench” in Zimbabwe.
These changes are certainly steps in the right direction, but there is still a long way to go both on societal and governmental levels. Currently, Africa still lags behind in meeting the WHO’s Mental Health Action Plan for 2013 to 2030. As of October 2019, only 21% of African countries, as opposed to the global average of 40%, had recent mental health legislation, and only 27%, compared with 53% globally, had implemented policies. Nevertheless, with conferences such as the 2019 Mental Health in Africa: Innovation and Investment Conference facilitated by the Royal African Society and the London School of Hygiene and Tropical Medicine for discussion regarding the continent’s progress, there is hope for a better future.
Africa, home to a seventh of the world’s population, should not and cannot be left behind. Mental health is a human right and it is not something to be ashamed of — mental illness is not a myth.
References:
https://www.mhinnovation.net/blog/2019/oct/10/mental-health-africa-innovation-and-investment
https://www.health.go.ke/kenya-observes-world-mental-health-day-to-prevent-suicide-i/
https://www.msf.org/displaced-and-distressed-people’s-mental-health-east-africa
https://www.who.int/news-room/facts-in-pictures/detail/mental-health
https://www.afro.who.int/sites/default/files/2017-06/MH.pdf
https://www.who.int/news-room/fact-sheets/detail/suicide