Widespread traditional beliefs that mental health is caused by ancestors or bewitchment has influenced people’s knowledge and attitudes, so those suffering from mental illness are rejected by their relatives, hidden to avoid embarrassing the family, or kept in chains.
In some communities, talking about mental health problems is even taboo.
“Some cultures believe that if a person is struggling with their mental health, it is more likely there are evil spirits involved and must go to the traditional doctor or witch doctor to have them cleansed. There is this whole misunderstanding about it,” said Darryll Viljoen, regional mental health advisor at SOS Children’s Villages in East and South Africa.
“These misconceptions have been a barrier towards people looking at mental health from a positive as opposed to a negative perspective,” said Teresa Ngigi, a mental health and psychosocial support advisor at SOS Children’s Villages.
“People think it is negative and destructive. I have been in countries especially in West Africa where the slightest mental health challenge is associated with a curse or witchcraft and families are ostracized for it. Yet anytime we talk about mental wellbeing, we are talking about health.”
Against this backdrop, experts in mental health from eight non-governmental organizations met in Nairobi, Kenya’s capital, for a three-day conference themed, “Debunking mental health taboos in Africa” to deliberate ways to counter these myths. The conference was organized by SOS Children’s Villages.
People should feel safe and free to speak up about how they feel without the fear of being labelled “crazy” or “mad”.
“In Africa, and especially in Eastern and Southern Africa where we work, people avoid mental health conversations at all costs,” said Darryll.
“We never admit that we are stressed, we do not talk about depression. People are under enormous amounts of stress, depressed even, but they are not talking about it, afraid they might lose their jobs.”
Suicide rates on the rise
The taboo on addressing mental health has serious, even deadly consequences. In Kenya, for example, young people aged 10-24 years make up 60 percent of the country’s population of 55 million. Ten percent of these young people suffer from mental health difficulties, according to the ministry of health.
Seven people in every 100,000 die by suicide in Kenya. Data by World Population Review places Kenya at 114 out of 175 countries with escalating suicidal rates. Most young people have reported feeling judged when they express their feelings.
Without mental health being adequately addressed at the community level, families are unable to detect their loved one’s cry for help until it is too late.
“If we deal with it before it becomes a severe problem, we can mitigate the issue,” said Darryll.
Support is not easy to find
However, a shortage of mental health professionals makes it difficult for people to access help. Nigeria has 200 psychiatrists for a population of 200 million people, while Kenya has 100 psychiatrists serving a population of 55 million, according to official figures.
To fill the gap, countries like Nigeria are providing online counselling and psychosocial support. Online therapy has helped destigmatize and anonymize mental care which has encouraged more young people to seek treatment for depression, stress, and anxiety.
Julian Onyango the youth engagement officer with Basic Needs Basic Rights Kenya says he educates young people about mental wellbeing. He encourages them to share their struggles with mental health to break the stigma and taboos surrounding it.
“I have seen young people cry out for help on social media, and instead of receiving help they have been accused of seeking attention and being childish,” said Julian. “Debunking the taboos will be easier if we normalize conversations about mental health. If we increase attitudes that are pro-help seeking, then we will see the number of suicide cases going down and depression cases going down.”
The mental health experts agreed that a key element to the success of debunking myths in mental health is advocacy; to create sustained awareness about mental care in schools, in workplaces, communities, and families with a focus on knowledge, attitudes, and practice.
Decision and policy makers in government also need to learn about the impact of mental health.
SOS Children’s Villages works with children and young people who have been impacted by adverse childhood experiences due to neglect, poverty, violence, and substance abuse. Exposure to these adversities severely affects their mental wellbeing.
Mental health and psychosocial support (MHPSS) is central to the work of SOS Children’s Villages, and includes activities that protect and promote mental health as well as treat mental disorders.
Positive change toward mental health will protect children from harmful situations that expose them to mental health challenges, prevent family breakdown and end the mistreatment of people with mental health problems.
“We say there is no health without mental health and people are starting to acknowledge that,” said Teresa. “And when we debunk the myth around mental health then it will become part of us and that is our aim. To really make people understand that mental health is part and parcel of our lives.”
After lengthy discussions, the eight organizations resolved to work together and complement each other’s services.
A five-member task force was formed to guarantee the conversation between the potential partners stays active. By collaborating, they believe they can break down barriers to mental health.
“This will be impactful and it is a win for all of us in the process,” said Julian.
“I am also looking to see best practices shared beyond the training where probably learning visits can happen to see what works best. We have heard the voices of young people on climate change and in sexual reproductive health and in other issues. Why can we not bring that voice to mental health and make it a normal conversation?”
Darryll said there must be a paradigm shift in the region on mental health after the conference. “All the organizations should start working in one direction and not in ten directions trying to achieve one thing.
“It is almost like throwing one stone into water. The stone creates a ripple effect in the whole water system. If we can make a change with the group that we have here, we could make a change within the whole region over time. We could create new mindsets and change how people are handling mental health.”