5 January 2014

Zimbabwe: Many Unaware of Their Mental Illness - Health Experts

Lack of awareness and understanding of mental illness has heightened stigma and created barriers to proper diagnosis and care of those suffering from the disease, experts have said.

In most African countries, Zimbabwe included, people suffering from mental illness have been largely ignored and ostracised by a society whose traditional beliefs dictate that they should be avoided like a plague.

It is commonly believed that a mentally challenged person is under some form of a spiritual attack/influence. Families with members suffering from this disease are ashamed to be associated with the patients who end up roaming the streets without getting the necessary medical attention.

Acting Director for the Zimbabwe National Association for Mental Health (Zimnamh) Ignatius Murambidze said most black people were not concerned with the welfare of the mentally sick as they believed that it was some form of payback for whatever "sins" they or their family had committed.

"It is widely believed that a mentally disturbed person is cursed for one reason or the other. This attitude has seen this disease being neglected and not being given the appropriate attention it deserves," he said.

Murambidze said there was also little information about the illness and many people were ignorant of the effects of the disorders.

"Many people think that only those people we see in the streets taking off their clothes and eating from the garbage bins are the sick ones. The reality however, is that there are many forms of the disease which manifest in different ways," he said.

"Research indicates that a lot of people are not mentally healthy but because they still go to work and do all the other things that 'normal' people do, they assume they are fine."

Murambidze said the seemingly minor mental illnesses like stress and anxiety, although ignored by many, can affect one's judgement causing adverse effects on one's performance.

"Within a global economy where productivity and competitiveness become increasingly important, employers are realising that they need to invest in the mental health of their employees," he said.

There are various factors that can trigger mental disorders and according to researchers key among them is poverty, poor public health services and trauma related to political violence.

The deputy director for the mental health department in the ministry of health, Dorcas Sithole concurred that the area receives little attention and funding.

"Mental health services are marginalised thus they receive poor and low considerations for funding from partners resulting in serious drug shortages," she said.

"Prevailing challenges like the economic situation in the country has resulted in mental health institutions and hospitals not being able to secure adequate drugs and other services. They do not receive priority when funding is being considered, leading to shortages of human and material resources."

The department received a paltry US$170 000 from treasury in the 2013 national budget.

Commenting on the upsurge of mental disorders, Sithole said the higher incidences of chronic diseases like cancer had heightened the problem.

"The high prevalence of chronic diseases like cancer, HIV and Aids, blood pressure and diabetics, gender-based violence and sexual abuses have resulted in many people manifesting anxiety disorders. These at times progress to depression and even suicide," she said.

Integration of mental health into the primary health system remains a challenge, and while other pressing issues like maternal health, HIV and Aids have been successfully mainstreamed; mental health has remained a stand-alone and is a disease largely ignored in public debates.

"Mental health is a cross-cutting issue just like gender but the current approach limits it to just a department in the ministry", said Murambidze.

Although there are several legal provisions to ensure that the mentally challenged are treated accordingly, these have not been enforced. There is the Mental Health Act of 1996 which largely spells out the caring, detention and after-care of people with mental disorders.

The policy's mandate is to harmonise mental disorder activities and provide a framework within which mental health programmes/activities are designed.

Where are the mentally ill treated?

Zimbabwe has poor public mental services with a myriad of challenges compounded by lack of drugs and qualified personnel to treat and monitor the patients. Currently there are only five public psychiatrists for the whole country and nine mental institutions.

The institutions, Ingutsheni (built by the Southern Rhodesia government in 1908), Ngomahuru, Parirenyatwa Anexxe, and psychiatric wards at Harare hospital, Sakubva, Gweru, Mutoko, Marondera and Chinhoyi hospital, are all centralised, denying access to many people.

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