Tackling Mental Illness In Africa

This blog post was originally published here as part of a series of blog posts to tailor with the March's SpotOn NYC (#SoNYC) event.

What is mental health? It's perhaps not so easy to define. For one, there is a wide spectrum of mental disorders that has to be considered. Two, the link to societal well-being has to be acknowledged since being out of sync with one's entourage is generally miserable and stressful. Taking those factors into consideration, the World Health Organisation (WHO) relates mental health to the "promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders." And in 2005, the WHO endorsed mental health as a universal human right.

A universal human right it might be, yet millions around the world are still deprived of it, especially those who reside in the developing world. Many African countries in particular, are guilty of discriminating, marginalising and violating their people who suffer from mental disorders. When put in the light of the current regional African economic boom (Africa's economic growth is projected to overtake that of Asia soon), the African lackluster is even more troubling since it points to a lack of motivation or worse, willpower, rather than a lack of resources routinely brandished in its defence.

In October last year, Human Rights Watch released a damning report which documented the inhumane treatment of Ghanaian sufferers of mental illnesses. In a country where an estimated three million people live with mental disabilities, the report describes the overcrowding and unsanitary conditions of three public psychiatric hospitals. The report also sheds light on so-called spiritual healing centers, presided by independent faith healers. Nearly all patients in the eight centers inspected were chained to trees by their ankles and left to sleep, urinate, defecate and bathe in that same spot. Some of the patients had been chained as such for five months. Some of the patients were less than 10 years old.

South Sudan, Africa's newest state, has no mental health facilities. To deal with South Sudanese people who suffer from mental illness, its government appears to resort to putting them in jail. From mid-2011 to roughly mid-2012, 90 South Sudanese were in prison only because they appeared to have mental disabilities. The relatively more stable Uganda has, in some cases, adopted the same strategy. The Ugandan government is still keeping behind bars 11 people found not guilty of charges placed against them on the grounds of insanity. One of those prisoners has languished in prison for over 16 years.

The main barrier to preventing these violations is the stigma attached to mental disorders in most of Africa. A study conducted in Nigeria qualitatively illustrates this stigmatism. 250 people interviewed acknowledged that their primary response to mental illness was fear, avoidance and anger. In addition, a public surveyconducted in South Africa showed that most South Africans attributed mental illness to stress or lack of willpower rather than medical disorders. The stigma attached to mental illness sadly dissuades people from seeking treatment, leaving them alone and helpless with a limited hope of recovery. To bring down this barrier, governments, health institutions and professionals should not only work to change public attitudes but should also advocate the rights of people with mental disorders.

Governments and local authorities should also be more proactive. They should set up proper channels to monitor human rights in psychiatric institutions and other healing centers and must take action whenever such institutions are harming rather than aiding patients. Such actions should not necessarily be met with reprimands. Better training of the workforce, encouraging enhanced support from families and communities and adequate investment in mental health are actions which should definitely contribute to better healthcare. Investment is arguably a great barrier faced by the many low-income African countries. However, the WHO estimates that a modest $2 per person a year in low-income countries should cover adequate resources for mental health.

While the problem is tackled on a national level, international expertise provided by developed countries should also be more appropriate for their cultural needs. Too often, developed countries make recommendations that are based on Western ideas, without the culture of African countries or regions taken into consideration. For instance, while the West tends to deride traditional healers or faith leaders, it is those people who have a stronghold on much of the population and as such, those people have the potential to actually move things in the right direction on the ground. The African Association of Psychiatrists and Allied Professionals (AAPAP) recognised the importance of traditional healers and has developed partnerships with many of them in Kenya. By co-diplomatically conversing with those healers, the AAPAP has successfully convinced many to refer cases of mental illness to them. There is even an upward trend in the number of people referred to by such healers. Developed countries too should strive to make the most of such cultural potential and take cultural appropriateness into consideration as they provide expertise.

Africa, in the eyes of many, is a continent plagued by natural disasters and violent political regimes. While many African countries do indeed have to battle with such problems or are still scarred by them, many others are progressing and prospering at an impressive rate. These countries in particular have the ability, know-how and potential to care for their population's well-being and human rights. And since they can, they should care for their people who suffer from mental illness. As they do so, they may even, along the way, mobilise the African continent in its entirety.

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Image credit: UNAMID (from Flickr).