Experts say one of the biggest challenges facing mental health in the country is stigmatisation, low level of knowledge and awareness regarding mental health. President, Resident Doctors’ Association at Neuro-Psychiatric Hospital, Yaba, Dr. Raliat Akerele in this chat with GERALDINE AKUTU, enlightens on mental health, treatment of mental disorders and how families can help their loved ones with mental illness.
What does it mean to have a mental health issues?
To understand mental health illness, we need to understand mental health first.
Mental Health is an individual’s ability to recognise his or her talents, use it to cope with everyday life stresses, while working productively and fruitfully and contributing to society.
Therefore, mental health disorder occurs, when an individual loses these functions.
It is an illness with psychological or behavioural manifestations in thoughts, emotions, beliefs, and behaviour of an individual.
This means the individual starts to think strange and unusual things and act out of character.
Who does mental illness affect?
It can affect anyone regardless of age, gender, tribe, religion or socio-economic status. Most mental illnesses start during adolescence and maintain a lifelong course.
What causes it and what are some of the warning signs?
There are numerous causes of mental illness but for ease, I’ll divide it into biological, psychological and social causes.
Biological factors like defective genes that form due to injury to the foetus in pregnancy can lead to a mental illness later in life.
These genes could also be inherited from parents or grand parents, meaning it’s a familial disorder.
Another biological cause of mental illness is long-standing medical conditions like hypertension, diabetes and sickle cell disease, among others.
Note that a gene is a very important part of the cells in our body, which controls our growth, development and our physical characteristics.
Psychological causes of mental illness include, personality traits, which can predispose an individual to develop a mental illness.
For example, there are people that require excess approval to function. They are more at risk of a depressive illness, if they don’t get the validation they need.
Another cause of mental illness is environmental/social factors. These are life events that can either be positive or negative e.g. parental neglect in childhood, pregnancy or delivery and loss of job, among others.
All these factors interact and exert their influences on the brain in a nature and nurture interplay, thereby, altering the way the gene is expressed.
The extent to which these factors are implicated depends on the individual’s level of resilience.
Visible warning signs of mental illness are persistent unusual thoughts and or behaviour that cause distress to the individual, society and affect the individual’s functioning.
I stress persistent, because we all behave out of character occasionally for one reason or the other.
Examples of these are talking to self, undue suspiciousness and decline in personal hygiene to name a few.
Can one have mental health condition and not know?
People who have mental illnesses usually are initially aware that there has been a change in their behaviour, or how they perceive things, but the stigma borne of ignorance that persists with mental health issues does not allow them to accept it. When the condition progresses, they lose that awareness.
More so culturally, Nigerians have a strong bias to label unusual phenomenon as spiritually caused and we are more comfortable with that option. However, not all mental illnesses cause loss of awareness about the condition.
Does stress lead to mental illness?
Stress is a very important precipitant of mental illness. Note that I said precipitant. T
his is because the individual would already have been predisposed to having the illness during pregnancy or childhood by some of the factors I mentioned earlier.
So, recent stressful events like infertility, loss of spouse and even financial constraints, which is a form of stress, can then precipitate the illness.
What treatment options are available?
We have come a long way from treating mental illnesses with exorcism, rituals, flagellations and bloodletting. Treatment options include medications, depending on the particular condition, psychotherapy (talk therapy), social therapy and other physical therapy.
Social therapy is targeted at resolving the life event that might have precipitated the breakdown, because if it persists, it’s an ingredient for delay in resolution of symptoms or future re-occurrence of symptoms.
Other physical treatments include use of electroconvulsive therapy and neurosurgical procedures that are usually not the first option.
How does one handle a mentally ill person before help arrives?
To ensure that a person suffering from mental illness is taken care of before he or she gets available treatment, the onus lies on the family and friends to be empathetic and supportive.
Let the individual know (s)he is not alone and reinforce this at every opportunity.
Then reach out to a specialist for more information on signs the family has noticed, so that useful information can be passed along to the sufferer, which will convince him/her to present in the hospital.
Despite this, some individuals would still be in denial and would have to be brought to the hospital via subterfuge.
Above all, always reassure them that their experiences though unusual can be managed, that there is hope and they are not alone.
It will be counter productive to deny the signs or encourage them to visit religious homes only, because early presentation in the hospital produces the best outcomes.
What is the role of family and society in managing mental illness?
The family and society have a huge role to play in mental health issues, because these are the people those with mental illness interact with daily.
Any stereotypical comment or discrimination can affect them adversely, causing a reoccurrence of symptoms.
This can lead to loss of productivity in the individual, which will ultimately affect the family and society.
Since the family and society are a large body of people compared to just an individual, there is the advantage of being able to pool resources, such as donation of funds for acquiring office space for clinics and residential treatments, training of staff, organisation of mental health awareness campaigns, subsidising mental health care (MH care isn’t under NHIS), so that those affected can afford treatment and providing motivation and support for those in recovery.
Volunteering in existing mental health institutions is also a way for the family to be involved in the care of these people.
Above all, government has to pass the mental health Act, which outlines a structure for promotion of mental health, prevention, treatment and rehabilitation of mental illnesses.