Understanding mental illness in the African context

A mentally ill man at his "residence" in Manzini, Swaziland

On the 10^th of this month, the world commemorated Mental Health Day. I have decided to also add my little voice to raise awareness as I really don’t think enough noise is made in Africa regarding issues of mental health. They are among the least understood conditions on the continent. In the countries that I’ve resided in – Zimbabwe, South Africa and Swaziland, the trend is almost similar. People believe that mental illness is not a medical, but spiritual condition. Where there is mental illness, there has to be an enemy involved, a dark-hearted aunt who doesn’t want to see his brother’s children progress, a jealous neighbour or an ugly witching grandmother. Alternatively, the illness is attributed to avenging spirits. Sometimes there are tales of an ancestor that murdered someone whose spirit is not at peace and is now manifesting in the form of mental illness in the affected individual.

In my mother language, Shona, there is no distinction among different forms of mental health conditions. There are various ways of describing it, which are largely derogatory without being distinctive. While in English there are names for mental conditions such as depression, bipolar disorder, schizophrenia, and eating, anxiety, obsessive-compulsive and post-traumatic stress disorders as well as neurodevelopmental conditions such as autism and Down Syndrome, in Shona, anyone with a mental condition is simply called benzi (mad person) or “sascam”, (derived from Salisbury Association for the Care of the African Mentally Handicapped, an organisation in pre-independent Zimbabwe) if they have a mild disorder or learning difficulties. Those who throw such terms around might not realise how terrible they are, until someone in their circle is affected. Poking fun at mental conditions or any condition that afflicts other people for that matter, while targeted at demeaning those affected actually makes the offending person stand out for their ignorance. I’m really convinced that people are not educated enough on mental health, which results in people who might be mentally ill or depressed avoiding seeing psychiatrist because thereof the vile stigma attached to mental illnesses, with very adverse consequences sometimes.

The belief that mental illnesses are only spiritual attacks is what has resulted in many mentally ill people sometimes getting neglected and roaming around the streets because some people believe they cannot be helped in hospitals. In some cases, mentally ill people pose a danger to themselves and the community, which is why it is essential for them to get help. Dr Violet Mwanjali, a Psychiatrist and Mental Health Specialist, said the majority of mental illnesses, among them depression and suicide, could be totally treated if those affected consulted mental health professionals. Those illnesses that cannot be treated can be managed, the same way ailments like diabetes and hypertension can. People with mental illness can lead normal, fulfilling lives if they get the correct help and take their medication as prescribed. There is, however, a disturbing trend of people neglecting to take their medication whenever they feel better. They would hate to take the medication because once people know that you take medication for a mental illness, song and dance will be made out of it. Asthmatics and diabetics fall short of sticking their inhalers and insulin injections on their foreheads because they are not ashamed of their ailments. Mental illness, however, has to be hidden at all costs because it’s regarded as shameful and evil. My friend, Sihle, was telling me a nurse told her most people ended up not taking medication because pastors or spiritual healers encouraged them to do so believing they were healed by the holy spirit. I’ve seen that happen a lot.  Some people say if you believe in Jesus don’t take medication. But I believe it is God that leads me to the right places so that I can get the help I need. It would be folly to reject that help because doctors were created by Him so that they could help us.

I really pray that more is done to enlighten people on mental conditions so that they can be supportive to affected individuals, who with the right support, can also be contributing members of society.