In Africa, the concept of the cause of mental illness is still dominated by supernatural factors where spiritual healers and traditional healers are still quite prominent in the pathway of care for the mentally ill.
When folks suspect that their relatives have certain disturbances in their behaviour owing to the impact of stigma, the majority of our patients get taken to the alternative caregivers.
The methods they apply are often barbaric and injurious to the patient in the process of conducting exorcism, which is the driving out of strange spirits from the victims, some are beaten, leaving wounds on the body which could get infected and invariably cause physical illness.
A good number are starved through prescribed prayers and fasting that leave them malnourished with depressed immunity, making them prone to physical illnesses that may invariably kill them.
They also take them through sleepless nights, leading to profound sleep deprivation which can worsen the problem of the mind.
I have seen some tied down with ropes while some actually do menial jobs on the farm and even go around begging.
From the research findings done in Africa, especially Nigeria, it has been discovered that a good number of our patients are still being treated under these circumstances despite the availability of orthodox mental health care.
It has also been discovered that these barbaric methods have been responsible for deaths among this group of patients.
The methods used are essentially risk factors for these patients to develop physical illness that invariably kill them. Some die from overdose of various orthodox drugs mixed with concoctions while a good number have died cheaply from the side effects of these drugs when administered illegally by alternative practitioners who do not know the antidote.
When complications arise, they do not know what drug to use to manage such side effects like extreme protrusion of the tongue that can make breathing difficult, upward rolling of the eyes where some may apply direct lotions that could make patients lose their sights or extreme tremulousness and rigidity with stiffness that will not allow them return to their normal lifestyle.
These treatment modalities are not complete until certain sacrifices, usually expensive, are made to the gods while some are compelled to give money gifts to gods as an atonement for the sins they have committed that has brought mental illness. When we consider the cost of traditional treatment both in terms of financial and human resources, it is very grave. So much money is spent almost at enormous cost to the dignity and esteem of the patients. Usually as a consequence of their methods, patients hardly ever come back to how they used to function before they took ill.
Some lose their jobs, lose their marriages, and may even be told to move away from their families.
This is often at a grave cost to growing children, wives, husbands and even communities.
The fact is that orthodox mental health care is empirical and dignifying as medications developed over time for different kinds of mental illness have proved to be efficacious leading to remission of symptoms and restoration to premorbid level of functioning.
The environment is usually decent with recreational facilities and ample opportunities for social interaction with other patients, health workers and family members. They are properly dressed and no form of inhuman treatment is allowed. Beyond the medications, there are experts trained in the use of psychological principles to modify behaviour because some illnesses require counselling and psychotherapeutic intervention with the sole aim of restoring behaviour to what it was before the individual took ill.
Certain factors in the background of the patient’s life are seriously evaluated and taken into consideration which could be in the growing up years, schooling, work environment, marriage and even religion which are factors crucial in the management and complete recovery of patients.
These are issues that require interventional strategies and could continue long after such patients are discharged from the hospital. Social workers also investigate the social circumstances and dynamics of the patient and draw up programmes of intervention.
In developed countries social workers follow patients into the community to assess the social circumstances and support available in the life of a patient. All these services are not as expensive as the cost incurred in our alternative care facilities.
The holistic approach and the ultimate plan of rehabilitation and reintegration of the mentally ill back to the society is unequalled in orthodox care.
Findings have established that the orthodox methods hardly ever contribute to the death of our patients while the ultimate goal of intervention is to restore the patient to the premorbid level of functioning as much as possible compared to the alternative traditional healers.
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