Gender Gender

Mental health vis-à-vis family support

Gender Focus with EMELDA MWITWA
BARELY three months after Zambia held a mammoth conference on mental health where stakeholders voiced out on the need to de-stigmatise mental illness and improve mental health services, the abandonment of mentally disordered persons continues at Chainama Hills Hospital.
Just last Saturday, this newspaper reported that 37 mental patients have been dumped at the hospital by their relatives for as long as 11 years.
Information from Chainama Hills Hospital public relations officer George Tafuna indicates that the relatives in question took the patients to the health facility on the pretext of seeking medical services, but eventually they disappeared in thin air.
Efforts to trace these relatives have proved futile because they deliberately gave the hospital fake home addresses, and perhaps phone numbers too.
Normally when we take our loved ones to the hospital, we mean well because we want them to recover from their illnesses so that they could reunite with the family later on.
This is why relatives flock to the hospitals with food and drinks to share with their ailing kin because caring for the sick is our moral obligation, especially for us Africans who hold the extended family close to our hearts.
When I go to the hospital to visit the sick, I often observe how health personnel struggle to send droves of relatives and friends away when the visiting hour comes to an end.
Well, this is not the case for people with mental disorders because the path to recovery is a long and lonely one since one’s condition may persist for a longer period than one experiencing physical health challenges.
To make it worse, society confers low status on people with mental health conditions and subjects them to cruel and degrading treatment.
Generally, persons with mental health needs don’t have it easy in our communities – the name-calling, discrimination and stigma – for suffering mental disorders, which anyone of us is prone to.
The Mental Disorders Act of 1951, which is being reviewed, makes the labelling of mental patients worse with such offensive labels as ‘idiots’, ‘imbeciles’, ‘moral imbecile’, ‘feeble-minded person’, and ‘mentally defective person’.
Unfortunately, family members who are the primary caregivers for people with chronic mental conditions, are also cited for abusing and torturing them.
Despite society’s hostility towards people with mental health challenges, risk factors for mental illness such as depression, alcohol dependence and substance abuse are common in our country, making many people potential mental patients.
Common mental disorders found in Zambia are alcohol and substance abuse-related disorders, mood disorders, acute psychotic episodes, schizophrenia and organic brain syndromes, mainly due to HIV and AIDS.
However, there are no readily available statistics on the prevalence of mental illnesses in Zambia.
The World Health Organisation (WHO) defines mental health as a state of well-being, enabling individuals to realise their abilities, cope with the normal stresses of life, work productively and fruitfully, and make a contribution to their communities.
Anyone of us is vulnerable to developing mental disorders, whether rich or poor; educated or non-educated; young or old; well-nourished and malnourished.
However, WHO findings indicate that the risk is higher among the poor, homeless, unemployed, persons with low education, victims of violence, migrants and refugees, children and adolescents, the neglected elderly and abused women.
Among abused women who experience mental disorders are victims of gender-based violence – physical and emotional – and those suffering from depression.
Depression affects more females than males, and some of the common causes are traumatic divorce experiences, infidelity in marriage and heart-breaking break-up with an intimate partner.
On a global scale, mental illness presents a serious challenge and costs countries in millions of dollars in terms of disease burden and productivity loss.
WHO states that about 450 million people in the world suffer from a mental or behavioural disorder, whereas one in four families has at least one member with a mental disorder.
And arising from depression and other mental disorders, about 1 million people commit suicide every year, according to WHO statistics.
Furthermore, it says four of the six leading causes of years lived with disability globally are due to neuropsychiatric disorders such as depression, alcohol-use disorders, schizophrenia and bipolar disorder.
Role of the family
Taking care of people with mental disorders and providing them the necessary support that could help them recover, works for the good of all us and society at large.
For your own information, mental illness has a telling effect on affected individuals, their families and caregivers, as well as the country’s economy.
Much as prolonged mental ill-health of individuals culminates into loss of productive hours, there is also productivity loss to the nation arising from low economic output by mental patients and their caregivers.
And in most communities, it is the family that provides primary care to people with mental disorders and helps them to get back on their feet.
But when families neglect mental patients, as the case is at Chainama Hills Hospital in Lusaka, chances of rejected persons recovering from their illnesses become very slim.
Nevertheless, there are people that stand out as role models in terms of providing that material and emotional support that their spouses, children, parents or siblings with mental disorders need.
Much as it may not be easy for families to bear the responsibility of meeting medical costs and providing primary care to mentally disordered persons, morality demands that they shoulder this burden.
Alienating patients from their loved ones and confining them to psychiatric institutions is unfair and inhuman.
Like other citizens of Zambia, persons with mental disorders deserve to enjoy their right to liberty in their communities, and, where possible, participate in community activities.
In my view, if a mentally challenged person can manage themselves outside a health institution, perhaps with regular medication, the family and community need to embrace them and give them all the necessary support.
And if one does not pose a danger to himself and other people, they should have the liberty to live in the community.
It is wrong for caregivers to refuse to take their kith and kin home if psychiatrists feel they have to be discharged from hospital.
It is the responsibility of the family to protect people with mental health needs from the callous and degrading treatment that society subjects them to.
But with what is happening, it’s like there is no safe haven for some of our brothers and sisters with mental health issues.
For example, in society they are vulnerable to physical and emotional abuse, including sexual and physical violence.
Sexual abuse of people with mental health challenges is particularly common among women who are sometimes left with children they cannot properly take care of because of their condition.
Oftentimes, we see some of our affected sisters having babies, and sometimes raising them on the streets, but the fathers of those children are nowhere to be seen.
But one would expect the family unit to protect their kin from such kind of abuses, by first of all accepting them the way they are and, secondly, giving them a safe place to stay.
Alas, some families are also guilty of subjecting their kinsfolk to callous and degrading treatment.
The confinement of mental patients in psychiatric institutions, and therefore making it difficult for them to recover fully, is one of those inhuman treatments.
Other reported common forms of maltreatment of mental patients by relatives include whipping and chaining them in the name of containing their excesses, and also depriving them of food and the much-needed mental health services.
Some families opt to consult witchdoctors, instead of seeking professional medical services.
Let me end by urging people who are guilty of mistreating and neglecting relatives with mental conditions to show them some love and give them the necessary emotional and material support.
Sometimes, being there for your loved ones in times of need is all what matters. The psychiatrist may provide all that is medically possible, but the lack of moral support from one’s family could negate all those good efforts.

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