There’s a lot of stigma around mental health, but we’re turning the tide
Often the bigger challenge in addressing mental illness in Africa is not the illness itself but the false stories society has told us about mental health.
When I was a young teenager grappling with panic disorder and depression, I thought many times about going to the mental hospital in Kampala, Uganda. It was just two hours away and I know I could’ve got the support I needed to get there, whether from my school or people who loved me. But an intense shame prevented me from admitting I was struggling and asking for help.
It was only many years later that I found the word – one I had only previously heard in reference to HIV/AIDS – to sum up how I’d felt. I had been unable to seek help because I was afraid of the stigma I would face.
This stigma around mental health affects countless people worldwide, particularly in Africa. A couple of years ago, I met a young man who lost nine years of his life chained up in a small tin shed in his family’s backyard after he showed signs of schizophrenia and major depression disorder. The young man would have been locked up even longer if district officials hadn’t stumbled upon him and seen his haunted eyes through the shed’s rusty slants. Alarmed, they pulled him out and took him to a nearby health centre.
I cried when he shared his story. I could see the experience would like stay with him for a long time and how his family felt terrible about the part they’d played. His mother, speaking with tears heavy in her throat, said that locking him up had been the only way to appease their neighbours. The man himself worried that, even though he now looked clean, he wouldn’t be able to find a job and live as a member of his community. Or worse, that he would relapse and be taken back to the rusty shed.
His story and mine are far from isolated cases. There is still an incredible amount of stigma today. In fact, often the bigger challenge in addressing mental illness in Africa is not the illness itself but the stories that society has told us about mental health. These stories see mental health disorders as the result of demon possession, karma, payback for the sins of ancestors, or curses. Sometimes, even more damagingly, those struggling with mental illness are simply said to be pretending and not in need of genuine help.
These misconceptions are so established – and furthered through the media, television, films and books – that they even permeate health care facilities. I have heard medical professionals refuse to treat those seeking help for mental illness, preferring to skip them in the queue, saying: “you are all mad, let her come in first, we will call you when your time comes”.
We are not alone
One of the most harmful aspects of stigma is that is increases isolation, which leads us to believe we are suffering alone and facing unique conditions others cannot fathom. Instead of seeking help, this forces us to hide. Curable or manageable conditions become lifelong sentences, not only for sufferers but their families and friends.
Fortunately, the tide is slowly turning. From my lived experience, the best way to combat stigma is through information and thanks to the internet, people are increasingly able to have open conversations about mental health. This is normalising conditions and raising awareness, but much more needs to be done.
For instance, governments and key health organisations must work with communities to introduce mental illness education in schools. Early intervention leads to happier and healthier adults, and a better-informed next generation could decrease or even eliminate stigma for those after them. Governments should also increase funding for mental health programmes as Rwanda did by decentralising mental health care to the primary level. This not only made care more accessible to rural populations, but it sent the message that mental illnesses can be controlled or cured.
Those seeking to tackle mental health issues must also listen to young people. As part of Young Leaders for the Lancet Commission on Global Mental Health and Sustainable Development, I have worked with others to design the #MyMindOurHumanity campaign, write policy briefs, and attend key events to ensure our voices are heard. We are not even close to where we want to be, but the understanding and treatment of mental health in Africa is changing. And everywhere you look, young people in particular are making efforts to transform the conversation through different mediums.
In South Africa, the Empathy and Hope project, staffed by people with lived experience of mental health issues, is using art and music to raise awareness and showcase people’s shared humanity. In Kenya, the Unveiling the Mask initiative uses music, dance, poetry and personal stories to promote awareness among college and university students. In Senegal, the Safe Open Space (S.O.S.) project uses social media to promote conversations around mental health, engaging thousands of young people and normalising the seeking of mental health care through testimonies about therapy and psycho social support. In Zimbabwe, The Friendship Bench draws on the well-respected motherly figure to promote therapy and care. Here in Rwanda, I work with young women and girls who survived the 1994 genocide to share their stories through group therapy.
These are just a few examples but everywhere you look, young people are working to transform the mental health landscape in Africa and worldwide. There is still far to go, but if we all put our hands together and embrace our humanity, I believe we will change the conversation around stigma and promote mental wellbeing for all.
Thanks to Damian Juma for his help in shaping this article.