As this year’s World Mental Health Day was commemorated on October 10, with the theme, ‘Mental Health as a Universal Human Right’, we cannot but reflect on the sad situation of human rights violations of persons with mental illness and their families. It is still very common to hear of children withdrawn from school, spouses divorced and sent packing, young adults whose education are halted and their lives derailed, adults dismissed from work, females sexually assaulted, people chained and beaten or deprived of food and water – all purportedly on account of mental illness! These are terrible circumstances that must be stopped.
Furthermore, every major city or town has several homeless, mentally ill persons roaming the streets, sometimes naked, and everyone just ignores them as we go about our daily business. Until something happens that generates attention, then the government sweeps in to clear them off the streets. What is usually missing, unfortunately, is a follow-up plan for long term treatment and rehabilitation of the affected persons.
The reality in most instances is that a combination of factors culminates in mentally ill persons ending up on the streets as homeless persons. Here in our environment, the most prominent factor is ignorance about the causes of mental illness and the fact that they are treatable in hospitals. In many of such cases, the hospital is never under consideration as a viable treatment option. Other equally critical factors include poverty and the impoverishment that accompanies mental illness in a family.
Linked to ignorance are the superstitious beliefs that we all harbour about the spiritual, rather than medical nature of mental illnesses. We think: ‘Maybe he did a money ritual which backfired, why should I get involved?’ Or, ‘Maybe he is paying for his previous bad deeds,’ or ‘Someone cast a spell/curse on him.’ So, we rationalise and simply go on our way.
Challenges across the country
Across the country, in almost every state, citizens are abandoned to roam the streets on account of mental illness. Some states periodically pick them off the streets for rehabilitation, but this is usually not a very well thought through and comprehensive in approach. They are usually adhoc and short-term with no sustained follow-up and rehabilitation programme for the long haul. Thus, such efforts are doomed to failure and are forgotten within a few years – if they last that long! This trend is worrisome, and we have to do much better.
The approach should be in three phases. Phase One should involve picking up the mentally ill and assessing them in a health facility where they can receive comprehensive medical as well as mental health assessment.
Phase Two should include a period of appropriate in-patient care to adequately tackle identified physical or mental health problems.
Finally, Phase Three should involve long term rehabilitation and ongoing support to assist them in establishing productive lives.
Project Hope by Asido Foundation
It is gratifying that the Asido Foundation is carrying out a pilot project, termed Project Hope that aims to faithfully implement the three phases as a model to show that this can be achieved. It is partnering with the Oyo State Ministry of Women Affairs and Social Inclusion, the Ministry of Health and other relevant stakeholders for this cause. We hope this will kickstart other efforts and coalesce to ensure that we restore hope to mentally ill people and their families.
The situation of homeless mentally ill persons (present to varying degrees all over the world) is often a reflection of the extent to which our society cares for its most vulnerable citizens. It is simply a lack of responsiveness from all stakeholders in society that citizens roam the streets because they suffer from mental illness, especially when effective treatment is available and affordable.
Questions for us all to ponder: If I develop a mental illness, what will become of me? Where will my family take me to? The aim of Project Hope, with the support of governments – starting with the Oyo State government, is that no citizen should be abandoned to the streets on account of mental ill-health. We can do this, and we have no option really but to take action. Every citizen deserves to have access to quality mental as well as physical health care, in line with the third sustainable development goal (health and wellbeing for all).
We need all stakeholders to support Project Hope of the Asido Foundation, and every state government across the country to rise to the occasion and do the needful. The days of simply looking away from the problem and wishing it away are long gone. Now is the time for evidence-based action. Are we ready, or are we going to demonstrate that we are the truly sick ones as a society that simply does not care? Time will tell.
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