Tochukwu Chukwu
Mental health is the state of complete awareness of the mental and physical faculties by a person. A mentally stable person understands the abilities and capabilities of his being, acknowledging the General wellbeing of his physical and social status.
Every 11th October of every year has been dedicated to the Awareness of Mental health to the populace, this year’s theme was “MENTAL HEALTH FOR ALL: GREATER INVESTMENTS, GREATER ACCESS”.
Joining UGAMATV’S Chidinma Madu the program “Spotlight” was Dr. Onyekachi Ugwuonye, a Mental health specialist and the Chairman Nigerian Medical Association Enugu East Zone.
He explains explicitly the need to maintain and ensure mental stability, as well as the role of the government in the Sensitization and creation of Awareness about Mental health through the endorsement of bills and laws as well as Investing greatly in the mental health Sector to create easy access for the rural and urban dwellers of the Nation.
WHAT IS MENTAL HEALTH
Before delving into mental health, I’ll love to explain the meaning of health, Health is the state of complete physical, mental and social wellbeing, it is not merely the absence of infirmity and diseases. Now, Further into mental health, is the state of wellbeing, where an individual realises, his or her abilities or capabilities. This individual is able to cope with the normal stress of daily life without breaking down mentally.
HOW CAN MENTAL ILL HEALTH BE DETERMINED IN A PERSON?
There are various ways of classifying and determining mental ill health in a person, things we call symptoms. Once a person deviates from the definition of mental health, he/ she already has a mental illness.
For instance, if one is unable to cope with the several stresses of the life, this person is not being productive and contributing meaningfully to the society, even if the person dresses completely and talks coherently, such a person can be said to lack mental health, invariably, some degree of mental illness.
Another symptoms can be with experiences, example, someone feeling depressed, is a common feeling we all pass through in our lives from time to time, when we encounter difficulties in our lives, but when this feeling of depression persists from a long time, and becomes a problem, hindering this persons ability to function or contribute meaningfully to the society, you’ll start tagging it “Depression”, the feeling however, is a normal thing, but it lingering, becomes a mental illness. It is similar to Phobias, anxiety, one is allowed to feel anxious and have fear from time to time, but when it becomes recurrent and out of the norm and extraordinary, it becomes a problem, it is now affecting this person’s ability.
These are Neurotic illnesses, like psychosis, when someone is hearing strange voices in clear consciousness, that nobody else can hear, or maybe having this belief that the whole world is against him without obvious reasons, you are not the world leader and everyone is against you.
These are some of the different ways you can see mental illness from time to time, you know, when you talk about mental illness, people usually see the psychotics on the streets, as the only people with mental illness, they are actually the extreme cases, that was not cared for, the reason why they are on the streets is because they were not cared for in the meantime.
IS IT IDEAL FOR A PERSON WHO IS BEING DIAGNOSED WITH MENTAL ILL HEALTH TO BE ISOLATED?
Well, saying Isolated, this was practiced in the olden days, at least in Nigeria, when we had an asylum, the first was in Calabar and Lagos in 1903 and 1907 respectively, that was the practice then, now, we have the integration of persons with Mental illnesses with other members of the Society, so people can actually be treated in their communities, so it is not ideal that when people have mental illnesses, they would be Isolated.
HOW DO WE MAKE MENTAL HEALTH A REALITY ESPECIALLY HERE IN NIGERIA?
The theme for world mental health day which says “Mental health for all: greater investments, greater access”. Before now, there existed what is called Mental health gap, trying to look at the gap between those who have mental illnesses and those who actually access care, it was discovered that there’s actually a gap between those who need it and those who get it, this common in middle and low income countries, which Nigeria is one of them, it was found that about 80% gap exists between the two parties, so they are strategies actually put forward to be able to breach this gap. That is what this year’s mental health day’s theme came to tell us.
We need to invest more on mental health, so the care can get across to more persons who need it, there are four basic things,
1. Bringing mental health care down to community health centers, health posts, General hospitals, closer to the people in the rural communities, that’s the primary thing that needs to be done, in that way, you are training the health workers, nurses who will be able to render some level of care for mental health issues, before it gets too difficult to be referred to a specialist.
The next thing that should be done especially in this time of pandemic, where people are encouraged not to travel unnecessarily, avoid unnecessary gatherings, is to do what is called, Telemedicine, have a way for people to access medical and health care from the hinterlands without actually coming to the hospital, at the same time, they have what they could have gotten in the hospitals and get the care needed. If it’s something that should be treated in the community, it will be done. If it’s something that a specialist needs to interface, with the community health care workers it will be done as well.
The next thing is to harness and make sure there’s a mental health facility in the Cities and the community, so that there will be a bilateral way of referral system. You refer from the community hospital to the City for things that could not be handled there, and when the person is better and stabilized, he is referred back, there will be a to and fro communication between the health care workers and the specialist in the City, to be able to stabilize and maintain a stable mental health.
The government should invest a whole lot of Fund in the System, to be able to increase mental health awareness in the communities and reducing the Stigma that people have which prevent people from presenting themselves for assessment and possible care.
These are few to be done, if you also go further, you will realize that care for mental illnesses, are out of pockets. For instance, mental health care is not in National health insurance Scheme, appropriately, but now, it’s actually being incorporated little by little.
This mental health’s bill has been in the National assembly for quite sometime, there have been Bottlenecks, we hope that government should expedite actions and have these mental health laws passed, that way, the people that have mental health issues will have some right to access care, to some level, that other health conditions are actually treated.
For instance, if you look at the COVID-19, task force that was formed by Mr. President, it took a long time before they could consider mental health as a component of that task force, even when World Federation of Mental health, had said that 450 million persons in the world have mental issues, they further said that one out of every four will have mental illness in their life time, if you take that to Nigeria, it means 25%, taken out population to be 200 million, that means about 50 million Nigerians, will have mental health issues in their lifetime and we are not considering it as important in this country.
WHAT ARE THOSE THINGS THAT IMPROVE MENTAL HEALTH SERVICES?
It is a collaborative effort to pass the mental health laws in Nigeria, to Gazette the bill is actually the role of the stakeholders in mental health. I give thumbs up to the association of psychiatrists in Nigeria, they have actually put up this bill and followed it up, but you know, there are unit political power, you also the need the collaboration of several other sectors in order to do this, it has passed first and second reading currently and you know the National assembly is very Pivotal in accelerating this bill, if they think it’s important. Now, when it is done, you need Executive power to give accent to this bill to be a law. Beyond that the General public have got some role to play because if we agitate and find it important, we will draw it into the ears of our Various representatives at the National level.
HOW MUCH IS DONE TO CREATE AWARENESS OF MENTAL HEALTH AMONGST THE POPULACE?
Efforts are being made here and there, individual and organizational efforts, just like I commended the Association of Psychiatrists in Nigeria.
The government needs to encourage the efforts of the organizations, despite the efforts made already, it is still not near what is expected to be able to achieve this awareness.
DO YOU THINK THAT THE PANDEMIC AFFECTED PEOPLE MENTALLY ESPECIALLY DURING THE ERA OF LOCKDOWN?
Yes, there’s a place of Stressors, we pass through stress daily, some persons are Vulnerable, people are already on the edge of tipping over to the other side, when you increase stresses in their lives, you most likely going to tip them over. Now, when you look at this COVID-19 pandemic, ravaging the globe, it has affected people in diverse ways, people have lost their Jobs because of this COVID-19, people have lost their Freedom, Money, lives because of COVID-19 pandemic. I know a lot of persons who could not access medical care during this pandemic, due to fear of contacting the disease, this thing has worsened situations.
Again, when you look at it, you no longer have the freedom to associate with others as you used to, you know, there is what is called Social network and social capital, these things have been breached because of this COVID-19 pandemic. So it hinges on the mental health of the citizens of the country and globally, hence, worsening the situation of those that already have it and those at the verge of developing it. Even those you think are stable, could actually have issues when tipped off in the mental angle.
WHAT ROLES CAN AN INDIVIDUAL PLAY TO MAINTAIN A HEALTHY MENTAL STATE, ALSO HOW DOES ONE PREVENT THE DEVELOPMENT OF ANY MENTAL ISSUE?
We should understand that mental health is a part of health and that we should take care of our health, if we understand that, we should make deliberate efforts to reduce stressors in our lives, as much as possible, what matters is not what comes to you but how you handle it, you may not be able to change circumstances that comes to you but your perception and appreciation of the situation is actually your responsibility to design the way you want it. Even in the midst of this pandemic people should take it easy and understand that it has a lifespan beyond which we may get back to our lives and things will move on.
Beyond that people should also understand that you can access mental health and mental care if you have issues bordering on your mental health, such things like becoming unnecessarily anxious without obvious reasons beyond what others surrounding you experience, becoming unnecessarily moody, being weak and losing interest in things that ordinarily would have been of joy, then you start having Strange Experiences that you can’t understand, walking up to a mental service care centre like a psychiatric hospital or a psychiatric department of a hospital, as the case maybe, does not make you a mentally ill patient, in fact you are actually preventing yourself from having a mental sickness, if you take care of that. Beyond that it takes care of things that you cannot get, there are basic things is that you know that when there is life there is Hope, take it little at a time, the quest for enormous wealth, Riches can actually be a big stressor which is tipping people over hence mental illnesses.
Before now what Africans were known for is our extended family relationship, it has its own therapeutic effects when you have to check on your brothers and sisters your extended family members, you may not know that the person you are asking how are you hasn’t heard that question in the last 48 hours, it may actually be a thing of joy to say that I’m fine and remember that somebody cares, yes you can’t go to see the person but most people have phone numbers, you can call them, send messages, send someone to go and tell them something, you do not have to travel. That way people feel connected and then remain stable. These are the things an individual can do to maintain a stable mental health.
what are the complications of mental health?
We have the economic complications, in the sense that someone who has a mental illness that is not attended to, will most likely not be productive, the person may not have employment, the person may lack financial stability.
Now in terms of health, first of all, it actually endangers the life, some what a disaster, someone might get suicidal. Suicide has been linked a lot to mental health mental illnesses, I mean, this does not mean that anybody who commits suicide has a mental illness but up to 80% of them have mental sicknesses.
Suicide is any act that is willfully done with the intentions of ending someone’s life bye himself. WHO and World Federation of mental health have actually proceeded that every 40 second one person dies by suicide which is equivalent to 800000 persons per year. This is said to be more than the number of people that die by War and Homicide put together. So if you look at it, you will understand that it’s actually a disaster. Suicide is the second leading cause of death between people of 15 to 29 years, which is the youthful age, when we have issues with the youth, can you imagine the future of any nation. That is to understand that for each completed suicide, there are about 20 attempted suicides. When you have a case of a completed suicide, you should understand that there are 20 attempted cases within that same time.
Are you saying that the highest rate of mental illness is within the 15-29 years of age?
No, I said Suicide. Now, if we look at mental illness such as disorders, neurological disorders, substance use disorders, which have contributed to 30 to 40% of the Global body of the disease, this age is the age that is ripe for substance abuse, which can lead to mental sicknesses, again, neurological problems, so coupled with the fact that people want to do what others are doing without really understanding it, so it becomes a problem for them, they need to be taken care of, the extremes on the streets becomes a problem for himself and the others, there’s a possibility of running into a moving vehicle, now he might get killed, thereby bringing problem for the driver that killed him, now the police is involved, the court is involved. Efforts are to be made to stop them. They need to be cared for, Measures are to be taken to stop these youngsters from driving into any manner of mental disorder, since they are somewhat the future of any nation.
Chidiogo asuke
