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The sad state of mental health across Africa : It's time to tackle mental health

Over the past few years, the Life Esidimeni tragedy has been making headlines in South African news publications. The tragedy involves the deaths of over 140 psychiatric patients who were transferred to ill-equipped non-governmental organisations (NGOs) when the provincial Department of Health terminated its contract with the Life Esidimeni group. Mmusi Maimane, leader of South African political party the Democratic Alliance, has labelled this tragedy as nothing short of murder by the provincial government. The NGOs were simply incapable of providing specialised care to the psychiatric patients and death certificates and reports indicate that many patients died due to hypothermia and dehydration. Furthermore, family members have revealed that the patients were given standard, non-tailored medication and that their bodies were badly decomposed.


Sadly, the Life Esidimeni tragedy has simply confirmed what many healthcare professionals and mental health care organisations have known all along: mental health continues to be neglected not only in South Africa, but across the African continent too. Perhaps it comes as no surprise considering that Africa faces numerous other socio-economic challenges and infectious and non-communicable diseases like HIV and AIDS, malaria, tuberculosis, hypertension, and diabetes. Yet research indicates that these diseases often have high levels of co-morbidity with mental illness. For example, research has indicated that people living with HIV are twice as likely than the general population to become depressed. Perhaps it’s high-time to shine the spotlight on tackling mental health issues?

Some sobering statistics indicate that the proportion of people with mental disorders who don’t receive treatment ranges from 75% in South Africa to over 90% in Nigeria and Ethiopia. Naturally, this is incredibly problematic as mental disorders can only be managed and treated with either medication and/or therapy. Aside from poor healthcare infrastructures and inadequate access to affordable psychiatric treatment, people living with mental disorders do not seek treatment because they are misunderstood, stigmatised, alienated, and ostracised from society. What it essentially comes down to is ignorance: people don’t understand mental illnesses and therefore do nothing to help. 


However, there is a beacon of hope. Although there is still a long way to go, there are some effective interventions happening across the continent. For example, group interpersonal therapy exists in northern Uganda to help people with mental illnesses cope and manage their conditions. In Zimbabwe, the ‘Friendship Bench’ is a counselling service offered by lay healthcare workers. In South Africa, LifeLine, a non-profit organisation, offers 24-hour over-the-phone counselling. Furthermore, mobile-phone technology also offers hope, support, and encouragement in the form of smartphone health apps. 


Affordable smartphones and increased access to internet services offer people across Africa the chance to seek help online. For example, health tracker apps, motivational apps for depression and anxiety, apps offering advice, and medication reminder apps can provide added support and encouragement. When it comes to mental illnesses, medication – like antidepressants, mood-stabilisers, and anti-psychotic drugs – is usually an essential part of the treatment plan. However, these types of medications are ineffective if they are not taken correctly and it is therefore important for patients to get into a routine so that they can adhere to their medication and treatment plans.


While simple alarm clock reminders may work, medication reminder apps, such as MyTherapy, offer extra features that can provide valuable support. Apart from reminding patients when their next doctors’ appointments are and when to take their medication, MyTherapy, which is available for free download, also allows patients to track their moods, symptoms, side-effects, and overall health. Furthermore (and because taking medication mostly relies on self-efficacy), MyTherapy lets patients invite family and friends on the app, thereby ensuring that taking medication becomes a group-effort.


Africa needs to start giving more priority to mental health because by addressing such an issue, countries will see an improvement socially and economically. Human rights offences will be reduced. The economy will improve because people will be able to work. The overall health of society will improve. The benefits are huge. It shouldn’t have to take another tragedy like the Life Esidimeni one to give prominence and attention to mental illness. 


About the Author: "Tracey is an English Literature graduate currently completing her MA degree at University of Pretoria in South Africa, who also spends much of her time living in Bavaria, Germany. Tracey considers herself as an advocate for mental health and strives to be a social justice warrior of sorts. South Africa will always be her home, but Munich has definitely won her heart."


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