Mental health neglected in Namibia

Namibia lacks facilities and specialised staff to care for mental patients. The Ministry of Health and Social Services has only four consultant psychiatrists in the country. The private sector is contributing towards improving the lives of people with mental disorders, but only five psychiatrists are practising in Namibia. The number of psychologists is slightly higher, with 32 practitioners. Namibian universities do not offer any specialised courses for psychiatry but mental health forms part of the School of Medicine curriculum for most of its courses. More than 50 000 new psychiatric patients visited various healthcare facilities between 2008 and 2013. The country is also experiencing a general shortage of mental health facilities. All district hospitals have emergency mental health services as part of outpatient services. These hospitals have no specialised staff although a limited range of psychotropic medications are available at some of the hospitals and clinics. Ministry spokesman Ester Paulus says the Oshakati psychiatric unit has 80 beds but the unit admits up to 100 hundred patients. “The unit has one psychiatrist but does not have a clinical psychologist. The specialised staff is therefore very limited,” she added. The facility in the Oshana Region is the only mental healthcare facility in northern Namibia. More than 19 000 mental patients visited the psychiatric unit in 2013. The Windhoek Mental Health Care Centre has a full range of professionals but their numbers are limited. This centre has a bed capacity of 112 and provides outpatient and inpatient services. The centre also houses the Forensic Service Unit with 99 beds. This facility is the only one in central Namibia. Private practitioners also refer patients to this facility. Eileen Rakow of the Ombudsman’s office, addressing delegates at a World Mental Health Day event on Friday, said mental health seldom features on the long-term or short-term agendas of countries and Namibia is no exception. The problem in Namibia might be larger since there is a stigma associated with mental disorders and some of the conditions go unnoticed. In a speech read on his behalf, Health Minister Richard Kamwi said discrimination against families and persons with mental disorders prevents them from seeking treatment. “There are now a number of different treatments available which are effective to manage the mental conditions of people. But because of stigma and other reasons, many people do not receive the care they need,” the minister said. A consulting psychiatrist for the health ministry, Dr Gerhard Marx, supported the minister’s views and added that the stigma of mental illness is not unique to Namibia. He said there is a lack of awareness about mental illness and an effective campaign is needed to curb discrimination against people with mental illness. The ministry has made plans to improve mental healthcare in Namibia. By 2018, the Windhoek Mental Health Care Centre and the psychiatric units at the Oshakati and Nankudu hospitals will be established as mental health referral hospitals. By 2023, Keetmanshoop should have a mental health referral hospital and it is hoped that every district hospital will have a psychiatric wing. But Rakow added that even in settings where mental health has attracted attention and services have undergone reform, resources are still scarce, inequitably distributed and inefficiently deployed. “Social inclusion of those with psychosocial disabilities languishes as a distant ideal,” she said. Paulus said the conditions of patients who have access to mental healthcare have improved and those who do not have access to health services will be reached by the future developments. WINDHOEK THEODOR UUKONGO