Proactive steps towards mental health care for the youth

Casandra* shares a dark period in her life when she suffered a mental breakdown in college. It came as a result of a betrayal she experienced when she discovered that her boyfriend was cheating on her with her best friend.

“I suffered from depression and anxiety for over a year once I found out how I was betrayed by people who I dearly loved and trusted. I lost weight, I looked slim. I had no hope to live for and did not see my worth living. I don’t know what would have happened to me, were it not for my family. They stood by my side with unconditional love to make sure that I got stable once again from the therapy sessions that I received. I am now mentally matured enough to handle emotional and social issues that come along my way,” she said.

Mental health issues have been causing undeniable threats amongst people whether spoken or otherwise. People have been struggling to deal with mental health issues individually rather than visiting mental health centres out of the fear of being stigmatized if seen at a place believed to be meant for the retarded.

There is a line between insanity and mental health issues even though the two have often been put in one basket. On the contrary, insanity is the severe stage of mental illness where an individual develops psycho behaviours marked as symptoms of madness. Having mental health issues does not imply that a person is insane, it is an illness like any other.

Research by mental experts

It has been disclosed that people under the age of 24 are at a higher risk of developing mental health issues. Dr Suluma Aslan, a medical expert on mental health at Mirembe National Mental hospital said that 1 in 7 children and adolescents in Sub-Saharan countries struggle with mental health issues.

According to 2019 data from the World Health Organization (WHO), 1 in every 8 people in the world has mental health issues. In Tanzania, 5 out of 100,000 people have committed suicide out of mental health problems such as anxiety, depression, anger and drug abuse in the last five years, statistics have shown. Dr Aslan mentioned the youth to be at greater risk of being exposed to it as marked by several symptoms of mental breakdown.

“This age group is of greater risk since it is when a child develops cognitive and behavioural awareness as well as response to the environment. People who grew up under strict parental rule tend to develop anxiety as they lack the necessary self-esteem and self-confidence needed to speak before people,” she said.

Speaking to Your Health, Dr Suluma explained some of the symptoms that can be used to identify a person with mental health challenges including self-isolation, poor social relation skills and low-grade depression. It is when the situation worsens that a person starts to develop psycho behaviours of mental illness such as delusions, hallucinations and mumbling.

Roselyne Malenya, a psychologist from Mirembe National Hospital explained how poor parental guidance has triggered an increase in mental breakdowns, especially among children. This has exposed children to experience brutal abuse from those who they spend a lot of time with.

“The current society is more exposed to hardworking parents with great success records in their careers but with loosened family ties with children. Many children nowadays are being raised by house girls and nannies, they lack attention and affection from their parents which makes them become bitter and aggressive,’ she said,

“It gets scarier as children experience beatings, sexual harassment and sodomy from those who have been entrusted with them. Most of them are close friends, relatives and trusted neighbours which makes it hard for the victim to speak out and be believed. They often swallow the painful experiences in silence, this leads to serial development of mental health issues in individuals,” says Roselyne.

As a person grows physically on the outside, so do the emotional wounds from childhood trauma that one experienced. It makes them develop advanced symptoms such as extreme anxiety in daily activities such as examinations and interviews leading to poor performance.

Depression, self-isolation and attention disorders are other symptoms developed in a person with mental disorders as explained by Teddy John, a psychologist at Inspire Better Education in Tanzania Psychologists organization.

“Youth with mental breakdowns tend to isolate themselves from people as a defensive mechanism from being emotionally hurt further. They tend to block people out of their lives and opt for solitude as a way to redeem themselves from being questioned or judged by others,” she said.

Teddy listed the environment as a contributing factor to mental health disorders by 75 percent as it is where children imitate the behaviours they practice. Schools, religious institutes and streets which are highly populated consist of interactions where a child can adapt to any behaviour.

“A child who grew up in a calm environment is more likely to develop better mental stability than the one who has gone through many places which makes it difficult to cope and maintain character. A good character is built out of good guidance and proper morals but preserved by the consistency of maintaining environmental stability as a child grows,” she said.

She further elaborated on the implications brought along by mental health issues in society from an individual level to nationwide. Teddy pointed out how mental health problems were dragging back socio-economic developments if serious measures were not undertaken to deal with them.

“People with mental breakdowns are likely to have poor work production and low academic performances at school. Once this person gets married, there are low chances of having a healthy relationship with their spouse due to the trauma experienced in childhood. A leader who has mental disorders can hardly level up to guide through and accomplish the goals designed. Mental disorder creates gaps in multiple aspects of life,” she added.

“It gets worse for a person with mental stability as they are at risk when associated with people who have mental health challenges. Getting in a relationship with a person dealing with mental issues who has not yet healed exposes the other spouse to developing similar mental challenges. If two individuals with mental issues have children, they are to become innocent victims of unhealed trauma of their parent’s issues,” she said.

Teddy says mental breakdowns create a generational rundown of mental problems from one generation to the next. “As people seek medical advice on how to control hereditary health disorders to break the chain, it is also important to do the same for their mental health,” Teddy says with more emphasis.

“As a person takes time to treat and heal from physical wounds on the outside, it is also important for a person with mental disorders to make time for treatment. The medical assistance provided by specialists such as psychotherapists will help a person heal for individual wellbeing and for the sake of others around them,” she said.

Security forces

Police forces have joined hands with the efforts initiated to promote mental health welfare in the community as well. Inspector Verediana Mlimba from Dodoma social welfare says that through the promotion of mental health awareness it will be easier for people to develop skills to identify those with mental disorders.

“It all starts with an evil thought before a person tries to commit a crime. They develop negative thought which then builds into intentions to hurt others. This will help consolidate the safety of an individual person as one will be able to note the preliminary behaviours of an individual with a mental breakdown that intends on hurting others,” said Inspector Mlimba.

She further disclosed that a person drops out of nowhere and tries to kill, beat or harass others. There are signs and actions that are shown before the crime takes place such as blackmails and threats with weapons being held. All that and more can be identified for the public interest through proper mental health awareness for all in society.

How to breakthrough mental disorders

Dr Sadiki Mandari from Mirembe National Hospital proposed multi-sectoral partnerships as a strategy towards dealing with mental health issues in Tanzania. He says the efforts undertaken by the mental hospital in charge alone are not enough to battle a mental breakdown. It is a war to be fought by everyone in the community.

“Mental health has to be tracked down from an individual level by ensuring that one is fully aware of mental health issues. Intrapersonal levels of family and friends where we have to fight against stigmatization have to be reformed so as to extend more room for people to fully receive mental health care without being judged or bullied,” he said.

Institutional levels such as workplaces and schools should call for more help because these are places that may also contribute to the development of mental issues. Teachers who are also guardians need to be educated through sessions and symposiums that will enable them to develop skills to deal with children with mental disorders.

Workplaces are often filled with questions if some employees had a credible contribution to the company or institution. These are people on the cut list at times of financial crisis in the institution as they are seen to contribute less to the company.

Some of them go through mental health issues battles silently or are not even aware of it. There is a need to develop a special therapy unit for its employees in workplaces. This is to help ensure the mental stability of employees as well as an increase in production.

“Work can be too stressful at times and pressurizing, a reality that leads to mental burnout in a person. It is important for both private and public institutions to set a space for mental facilitation for their employees. This will be an aid in the efficiency and quality of work produced by employees in a stable mental health state,” said Dr Mandari.

More to that the managing director of Mirembe National Hospital, Dr Paul Liwalo called for professional support due to insufficient numbers of mental health medical experts. It has been lagging the mental department behind in the struggle of promoting mental health in the community.

“So far we have about 45 medical experts in the mental health department which is less than one percent. Some of the doctors are still progressing with further studies to become specialists in mental health but the number is still vastly dissatisfactory. There is a need to extend the number of mental health specialists to keep up with the growing demand for medical attention in the country,” he said.