Fundamentally, it is essential to take a holistic approach to health, whereby mental health is assessed alongside physical health. This is already common in many African countries, but needs to be integrated into primary health care provision. A bigger effort is needed to train health workers to recognise the symptoms of mental health problems and recommend appropriate treatment. The enormous range of mental health problems needs to be recognised, from relatively common conditions such as stress, anxiety and depression, to more serious conditions that can cause severe disability such as schizophrenia.
Having gone through the above explanation, which is basically an introduction into what our searchlight is focused on, today, let us look at the meaning of MENTAL HEALTH.
MENTAL HEALTH is a person’s condition with regard to their psychological and emotional well-being. It therefore means that, it is the cognitive, behavioral, and emotional well-being. That is, how people think, feel, and behave. People sometimes use the term “mental health” to mean the absence of a mental disorder.
Mental health can affect daily living, relationships, and physical health.
HISTORY OF MENTAL HEALTH PROBLEMS IN AFRICA
Mental health problems appear to be increasing in importance in Africa. Research shows that between 2000 and 2015 the continent’s population grew by 49%, yet the number of years lost to disability as a result of mental and substance use disorders increased by 52%. In 2015, 17·9 million years were lost to disability as a consequence of mental health problems. Such disorders were almost as important a cause of years lost to disability as were infectious and parasitic diseases, which accounted for 18·5 million years lost to disability.
As Africa’s population is expected to double over the next three decades, the pressures on young people in particular, who across the region are already struggling to earn a livelihood in highly competitive labour markets, are likely to ratchet up. Many will experience psychological problems as they fail to realise their ambitions, and some will turn to substance misuse as a means of alleviating their frustration.
Increased attention to mental health by governments, researchers, and journals is therefore essential. In 2013, the member states of the World Health Assembly committed to the Comprehensive Mental Health Action Plan, in which they pledged, among other national targets, to increase service coverage for severe mental health disorders by 20% by 2020 and to reduce suicide rates by 10%.7 The third goal of the Sustainable Development Goals adopted by all the world’s governments in 2016 also includes commitments to improve mental health and prevent and treat substance use disorders
A NEGLECTED PAST DUE TO STIGMATIZATION
In the early part of the 20th Century, mental asylums were built in British and other colonies, reflecting the prevailing practice in European psychiatry at the time, but even these were a tiny proportion of wider health policies and budgets. Until recent times, these outdated institutions have remained the sites for delivery of the majority of care in many African countries, reinforcing the fact of 100 years of neglect of the care of people with mental health problems.
One of the consequences of this neglect of mental health has been that in many parts of the world, mental health is far less resourced and developed than other parts of the health care system, despite the fact that mental health conditions are the single greatest cause of disability, and suicide is the second biggest killer of young people (15-29) globally.
Africa in particular struggles to meet a number of the key parameters. In many sub-Saharan countries, less than 1% of already small health budgets is spent on mental health, and much of this is used wastefully on institutional care. However, we see a similar picture at an international level, where about the same 1% of Official Development Assistance for health is spent on mental health.
The result is that many sub-Saharan African countries have only one psychiatrist per million population, and some countries have none. The few mental health professionals available tend to be located mostly in the large cities. Psychiatric nurses and psychologists exist in very small numbers, and primary care personnel do not treat mental health conditions, so that in many countries, 90% of people with mental illnesses have no access to treatment, especially in poor and in rural areas. The limited access to professional mental health care, in addition to prevailing cultural beliefs, means that there is frequent recourse to care by spiritual and traditional medicine practitioners, some of whom employ abusive practices such as chaining patients, physical abuse and food deprivation.
The limited number of mental health professionals is in part because of low investment, but also because mental ill health is so stigmatised that people do not consider working in mental health as a career option. To make the situation worse, because there is also a shortage of mental health personnel in high income countries, there is a very high level of brain drain in this sector.
Basically, the neglect was as a result of lack of proper understanding of what mental health entails. As at then, it was approached and perceived in a derogatory manner.
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Disclaimer
All statistical records were gleaned from World Health Organization, Regional Office for Africa, published in 2015. Accessed on 10th of June, 2021.