Bola was a brilliant 19-year-old Engineering student at the university when his room-mates observed that he was talking to himself and behaving in an odd manner. They tried to engage him but when he was not responding, they reported to the University Health Services who came for him with an ambulance.
He was later referred to the Teaching Hospital where he was diagnosed with schizophrenia. His parents were invited and counselled by the doctors but they were adamant that their son was not having a medical problem. A spiritual leader had warned them a few weeks back to be prayerful, lest the enemies succeed with their plans against their family.
Now it was very clear to them now, that his illness was spiritual warfare and the work of the devil. The parents insisted that he should be discharged, and took him back to the village. That was the last that his classmates heard of him, as he never returned to school.
Fast-forward 20 years later, and we discover that Bola is now a tired and poor farmer in his village, who looks much older than his actual age of 39 years. He had spent a couple of years at a traditional healer’s home and never fully recovered his functioning.
His family recruited him to join the family on the farm and then arranged a wedding for him with a young girl from another family who was also being stigmatized on account of epilepsy.
Both families thought both of them would be a good match as they both had disabilities. They now have three children who are not in school.
Tunde was a successful and charismatic medical doctor who ran a highly reputable private hospital in town. He worked long hours and comfortably provided oversight and supervision for the clinical, logistic, administrative and financial aspects of his establishment.
However, his wife and two children were involved in a tragic accident while returning home from school, and they died. Dr Tunde became a shadow of himself and became very irritable and miserable. Everyone understood and were sympathetic.
He became very short-tempered and would frequently snap at everyone – including patients who have come to his hospital. He stopped paying attention to details and often appeared distracted and lost in thoughts.
His friends attempted to step in, by asking him to take a break and go on a vacation but he dismissed such suggestions. When they become more worried, they suggested a psychiatric evaluation which only infuriated him more. ‘What do they mean’? ‘Does he look like he was out of his senses’? He retorted. So, they left him alone.
Gradually, his best hands resigned and left, and the hospital deteriorated and became dilapidated. His income drastically fell and he decided to close the place down. He turned to alcohol and would lock himself in the house and drink all day long.
Eventually, his friends and family decided that they could not just stand idly and watch him destroy himself. They broke into the house, with the help of policemen and brought him to the hospital for involuntary hospitalisation.
He was diagnosed as suffering from severe depression with suicidal tendencies; further complicated by alcohol abuse.
The onset of mental health problems is often in adolescence and young adulthood. Indeed, a large scale global epidemiological study revealed that about 50 per cent of adult mental health problems would have started by the age of 14 years.
Unfortunately, this is the most crucial period for young people to acquire skills and an education that will empower them for productive adulthood and the ability to earn an income.
Thus, the majority of these young persons would either be in school or in the phase where they are learning a trade; when these mental health challenges knock them offtrack, as we see with Bola in Case 1. With adequate treatment and psychosocial support, Bola should have returned to the university to complete his education.
Chances are high that if he had graduated with a first-class in Engineering, he would have secured a good job and his economic status would have improved.
Same also applies to the young girl he married in the village, who also stopped schooling and was married off because she had epilepsy. These events have led to a vicious and a generational cycle of poverty – as their three children in the village are not enrolled in school.
It is therefore clear that ‘mental’ health is wealth, as demonstrated by Cases 1 and 2. But we need to dispel the shame, stigma and ignorance surrounding mental health problems.
If they receive prompt attention and treatment, the negative and downward spiral can be avoided. They can, and should be leading productive and healthy lives. Support is crucial to a positive outcome.