End mental health discrimination
On World Mental Health Day last week, challenges facing such patients came into sharper focus.
14 October 2020 | Health
A safe haven for Namibians suffering from mental illnesses, the Oshakati State Hospital psychiatric centre has changed the lives of about 26 000 people, and counting.
With a 70-bed capacity, in August, the facility admitted 71 patients.
On a warm Friday afternoon last week when Namibian Sun paid a visit, the centre had 110 in-patients.
According to the World Health Organisation, one in four people worldwide will be affected by mental or neurological disorders at some point in their lives, and Dr Benonia Sheetekela says no one should feel ashamed.
From genetic factors to trauma and stress, Dr Moges Admassu said there are several causes for mental illness, and because most people don't know about these causes or how to treat mental illness, they resort to stigmatisation.
In a deeply superstitious and religious society, mentally-ill people are sometimes seen as possessed, while many are dragged to exorcism sessions at charismatic churches, he said.
While not all churches try to pray away mental illness, he added that it is important for religious interventions to be packaged well.
“Churches tell them not to drink their medication. That is wrong. We do not stop patients from going to church, but they should take their medicine and not replace them with prayers,” he said.
Causes of mental illness
Having a family member with mental illness can increase your risk, “however, just because one family member has a mental illness doesn't mean that others will,” Admassu stressed.
Meanwhile, psychological trauma and stress caused by social isolation, domestic violence, relationship breakdowns and financial or work problems can increase the risk of mental illness.
He added that traumatic experiences such as living in a war zone can increase the risk of post-traumatic stress disorder.
Drug and alcohol abuse can also trigger manic episodes or psychosis.
Drugs such as cocaine and marijuana as well as excessive drinking can cause paranoia.
“Before lockdown, we would be admitting four or five people overnight from excessive drinking. Young people who abuse alcohol from an early age are likely to suffer from mental illness,” Admassu warned.
Negative childhood experiences such as abuse or neglect can increase also the risk of some mental illnesses, he added.
Seeing the person, not the illness
In conservative Namibia, getting people to open up about their mental health is a victory in itself, Sheetekela said.
Hilma Ndahangapo*, a 48-year-old unemployed mother of two who began therapy in 2004, suffers from schizophrenia and depression.
“In our culture, you are ridiculed for speaking about your mental health,” she said.
“I was desperate to find someone to talk to about my problems. When I speak to the doctors [at the psychiatric centre], I feel like a load is lifted off my heart.”
Sheetekela encourages people to share their experiences, saying this will help end the stigma attached to mental illness.
“To provide holistic care, you must see the person and not just their illness. You have to treat them as individuals with hopes and dreams. By sharing our experiences, together we can end the stigma.”
Support from families
When Ndahangapo first found her way to the hospital, she was surprised to find she was one of many with similar problems. Now she hates going back home as she feels that is when she gets sick, she said.
She mentioned that at the hospital, they have one-on-one sessions with social workers, who encourage them to speak about their problems and their mental illness.
“I like it here,” she said tearfully. “It makes me feel normal. At home, people treat me like I don't make sense.
While patients are often brought to the facility by family members, it is common for them to be abandoned when they are discharged, Sheetekela said.
“Family members get frustrated while the person recovers as most of them do not want the responsibility of looking after a mental ill patient. It's painful on both sides.”
Life after Covid
When it comes to life post-pandemic, what worries Sheetekela the most is the mental health repercussions.
“In general, stress behaviour for many, many people bring a lot of problems. Just the fact of someone wondering if he/she is positive for Covid-19 or might be retrenched as many people continue to lose their jobs, that affects, of course, one's behaviour,” she said.
“We know very well that panic leads to bad behaviour and to psychosomatic problems as well, and we have to be careful and delicate with how we handle this,” she said.
*Not her real name