How lack of awareness, stigma fuel mental health challenges

Dar es Salaam. Stories about suicide, passion killings, and domestic violence have in recent years dominated news on social media and other sources of information in Tanzania.

But one big question on what could be the reasons behind the rise in such incidents remains unanswered.

“Have you taken your time and read the comment section for such incidents reported on social media?

Those who do so must have realised that most of the comments are either making fun of the situation or discriminating, condemning, or blaming victims for making ‘bad or stupid’ decisions.

The comments represent a lack of awareness of mental health challenges and the stigma surrounding them among Tanzanians.

Mental health experts associate the incidents with mental health challenges, as personality disorders or emotional outbursts in some people can result in such scenarios if not treated early.

As the nation prepares to join the rest of the world to commemorate Global Mental Health Day on October 10th, experts are calling for more efforts to raise awareness on the matter and fight stigma.

With this year’s theme, ‘Mental Health is a Universal Human Right, experts are calling for efforts to raise awareness on the matter and fight stigma.

The World Mental Health Report (2022) issued by the World Health Organisation (WHO) shows that 1 in 1,000 deaths globally are due to suicide, and more than 50 percent of the cases occurred before the age of 50.

The report further shows that suicide is the fourth most prominent cause of mortality among 15- to 29-year-olds.

Again, in the very same year, one in eight people out of 1,000 had a mental disorder globally, making it approximately 970 million people.

A survey conducted recently by The Citizen in Mwanza, Morogoro, and Dodoma shows that drug and alcohol abuse, long-term stress, poverty, unemployment, losing a job, debts, challenges, and loss of employment were the main causes of mental health challenges.

Several interventions are being made to reduce the number of people with mental health challenges.

A psychiatry and mental health specialist at the Mwanza Referral Sekou Toure Hospital in Mwanza, Dr Meshack Samwel, says mental health is the state of being able to deal with life challenges without being affected by other life challenges.

He says not being able to deal with other life challenges, living in isolation, thinking of suicide, and being depressed are signs of mental health challenges.

According to him, stigma about mental health challenges is due to the name-calling by society when one has a mental challenge.

Names like chizi, kichaa, and dish limeyumba silently contribute to the suffering of people with mental health challenges who are afraid to be lebelled with such names.

“The name-calling and discriminatory comments on social media regarding those with mental health problems to suffering in silence as people shun away from looking for help in hospitals or even expressing how they feel. As a result, the mental health challenge grows without treatment, thus resulting in killings,” says Dr Samwel.

To address the lack of awareness and stigma, the hospital conducts a special clinic on mental health at least three times a week.

“Six months ago, our hospital got an expert. We used to refer patients to Bugando Medical Centre in Mwanza Region.

The clinics were once a week. We also visit schools, universities, churches, and mosques to educate them on how to deal with mental health challenges and how to prevent getting into the mental health challenge trap,” Dr Samwel says.

Apart from raising awareness, other ways to help society deal with the problem are good parenting, which involves protecting children from the use of alcohol and weed and maintaining family values to create a generation with good morals.

He says the stigma around mental health challenges is very high, as the majority of them are burdens on their families because they cannot produce.

Medication for mental health challenges is expensive, and treatment normally takes a long time. Some take nine years to be treated.

“One pill costs up to Sh500. So Sh500 times 30 days times nine months The government has subsidised the medicine, but that amount is still expensive for someone who is not working or depends on their relatives; it’s really a big challenge,” he says.

He says he attends up to 150 patients per month, with an average of 10 to 15 new cases. The hospital receives up to 3,000 people with mental health challenges.

The director of Mirembe National Mental Health Hospital (MNMH), Dr Paul Lawala, says the levels of stigma for mental health patients are still a big challenge.

“Once the patient is here, his or her family will never make time to come back and see how they are doing. They believe the hospital is the only place these people belong. This is very wrong, and it needs to be addressed to reduce the burden on the hospital,” says Mr. Lawala.

He says the hospital has a lot of patients neglected by their relatives. This contributes to the hospital spending money on taking care of the bills of these patients even after they have been completely treated.

A clinical psychiatry specialist at the Morogoro Regional Referral Hospital, Martin Andrea, says the majority of mental health patients and relatives cannot easily detect the problem until it reaches the worst stage of a patient starting to attack people around them.

“Reaching out to society through the media to communicate the importance of visiting the hospital at an early stage is part of the strategy to raise awareness about mental health challenges and fight stigma around them,” says Andrea.

More awareness of mental health problems is needed to help with early detection so that patients are brought to the hospital in the early stages of the disease. Commenting on the numbers of people reaching out for treatment at the hospital, he says that in 2021–2023, a total of 2,361 outpatients with mental health challenges were treated at the hospital, and 1,071 were admitted.

A mental health specialist at the Bugando Medical Centre, Dr Catherine Magwiza, says the cost of treating people with mental illness varies depending on the type and stage of the disease.

She says outpatients pay between Sh20,000 and Sh30,000 (for patients on the cost-sharing scheme). The cost includes the doctor’s consultation fee and a one-month prescription of medications.

She says that for in-patients (non-insured), average admission costs around Sh150,000.

Supported by Bill & Melinda Gates Foundation