Permission to Panic – the Ongoing Battle of the Mentally Ill [opinion]

EARLIER this year, Windhoek-based clinical psychologist Shaun Whittaker disclosed that Namibia has one of the highest suicide rates in the world.

Announcing the sobering statistics, Whittaker said during 2013, a total of 473 people committed suicide in the country.

Across the globe, the average suicide rate is 16 per 100 000 people, while Namibia has 22,5 per 100 000 individuals who take their own lives (‘Nam suicide rate one of world’s highest’, The Namibian 18 March 2014).

If we lived in a reasonable society, these statistics would have probably made us sit up and contemplate how the status quo could be altered. However, it appears our attitude towards the frequent deaths of predominantly young people, who feel unable to create meaningful and painless lives for themselves, has added insult to injury.

When University of Namibia student Lucia Kaunamwene Mwaalwa (22) committed suicide on 15 May 2014 – merely hours before she was due to graduate – the news of her death spread across social networks immediately. It soon became evident that the overall response to her passing was ignorant, disheartening and a societal demoralisation of the highest order.

The people – most of whom appeared better capable of using social networks than attending to burning issues in the real world – quickly condemned Mwaalwa, saying she “should not be able to rest in peace”, considering she “had eternally sinned by ending her own life”.

The same people later said “there are no problems which cannot be solved” and that “the girl was fine because she still prepared dinner on the eve of her death”.

Few of the commentators mentioned possible issues in Mwaalwa’s environment and even fewer thought her suicide was connected to mental illness – one of the major hushed up topics of our time.

The Statistics

The WHO says there are an estimated 450 million people worldwide with mental disorders. Three quarters of them apparently live in developing countries and 85% of those are not receiving treatment. But even those who receive help often face stigmatisation from a society which does not recognise and comprehend mental illness in its entirety.

For Namibians suffering from schizophrenia, depression, anxiety, dementia, alcohol dependence and other mental, neurological and substance-use disorders (which, according to the National Institutes of Health, make up 13% of the global disease burden, surpassing both cardiovascular disease and cancer) help is so limited that more often than not, it remains a privilege of those who can afford help at private institutions – a miserable state of affairs, involving an institution like the Ministry of Health and Social Services (MoHSS), which unashamedly returned an unused N$53 million to Treasury last year.

In spite of various health reforms which have been implemented since independence, mental health has not been prioritised in the last 24 years.

And although MoHSS promised much-needed integration of mental health and more choice of treatment in March 2005 through the introduction of a National Policy on Mental Health, this policy – as urgently required as it is – has not been implemented until today. The absence of such a policy has led to many problems, among them the upsurge in domestic violence.

A Connection between mental illness and domestic violence

Since 1990, the number of cases involving indecent assault, attempted rape, rape and murder has been skyrocketing and this year alone, The Namibian reported that 22 “love partners” were killed by their significant others. These figures have now made Namibia the country with the highest rate of GBV in the region (‘Nam tops region in gender-based killings’, The Namibian, 3 June 2014).

Politicians, the police, various researchers and ordinary citizens have come up with numerous explanations for this scourge in recent months. The evidence for many of today’s issues, however, can be found in anecdotes, which are far older than Namibian independence.

In 2000-2001, Dr Anthony Feinstein, a professor of psychiatry at the University of Toronto, was awarded a Guggenheim Fellowship to study mental health issues in post-apartheid Namibia.

He established that during the liberation struggle, Namibians felt united in the common purpose of ending apartheid. There was no doubt in the people’s minds that, with independence would come a better life, social and financial improvements and the long-anticipated feeling of victory.

Feinstein claimed that when the apartheid era finally did come to an end, the change was primarily visible through the acknowledgement of newly-won political freedoms. Ordinary people, however, continued to feel the repercussions of centuries of systematic oppression nonetheless. They were unemployed, struggled for land and housing and were dealing with family units traumatised by the war and still looking for missing members.

Over the years, as Namibians tried to reconcile with their past and their perpetrators, many felt that social deprivation was ever-present and awfully difficult to overcome. Their frustrations led to the much-discussed increase in violence of all sorts. The century-long state of war and dehumanisation brought about a culture of violence that, in the presence of a N$6,6 billion defence budget and the absence of an external threat, has turned Namibians against one another.

Many mentally ill citizens nowadays end up in jail for minor as well as major crimes. Generally, the State does not respond sympathetically to the mentally ill, but with handcuffs and imprisonment instead. As humane and affordable ways to deal with this national crisis are unavailable in the “Land of the Brave and the Neglected”, law enforcement agencies increasingly resort to sending those, whose mental health has been compromised, to jail instead of specialised mental health care facilities (which are non-existent to start with). Needless to say, this adds to the destruction of once intact family units.

By denying Namibians the chance to adequately reconcile with their past, it can be expected that the learning process in the field of mental health over the next few years will include more humiliation and pain than revelation.

Thus, we have to ask ourselves: How many senseless deaths will it take for us to review our mental health system and finally assist those who need help the most? And when will our attitude towards the sufferers of mental illness change?

They say “if it ain’t broke, don’t fix it”. Considering the many damaged and traumatised souls of our family members, friends and colleagues, the de-sensitised minds of those who are in denial about mental health, and the under-resourced, understaffed and overstretched mental health facilities offered by the State, we sure have a lot of fixing to do.

Anne Marcus is a sub-editor at The Namibian. She has previously worked as a researcher in media law and aocacy.

Source : The Namibian