That everyone with mental health challenges on the African continent may succeed

Aminu was a brilliant third year law student when he started hearing voices and behaving irrationally. He was taken to the clinic and, subsequently, to the Teaching Hospital where he was managed for a psychotic illness. He subsequently recovered but his parents insisted that he stopped his medications after two months as they are convinced it is a spiritual warfare and they had fortified him with prayers. He did not want to stop his medications as he understood the explanations given to him while he was still in hospital. But he also did not want to disobey or have to lie to his parents. So, he stopped them and six months down the line, he suffered a relapse. This time round, his parents did not take him to the hospital at all. He was taken from one spiritual home to the other with minimal impact After two years and having spent all the family savings without progress, the parents simply let him be, and he soon started roaming the streets; sleeping wherever he could find some shelter.

Lydia was working in a bank as a young graduate and was engaged to get married to a lawyer, but she developed a psychotic illness and was talking irrationally and accusing everyone of trying to harm and kill her. She was subsequently admitted into hospital and within two to three weeks, she was fine and had been discharged home. She resumed work subsequently but everyone started avoiding her like she had a mysterious sickness. It became extremely uncomfortable for her because discussions will stop once she entered a room. And to make matters worse, her fiancé started avoiding her and then called off the engagement. Because his family did not want him to marry into a family with ‘madness’ as it may affect his own children in the future. She was heartbroken and wondered how it could possibly be her fault that she fell ill. However, her family was supportive and that was the only place where she found refuge.

Commentary:

Beyond the challenges that come with symptoms a mental disorder, there are more worrisome psychosocial difficulties that frequently hinder their progress. Thus, many affected individuals and their families are unable to fulfil their potential and return to normal and productive lives.

The situation is worsened by the pervasive shame, stigma and associated discrimination that they are frequently subjected to, across the African continent. Thus, many drop out of school, as we see with Aminu, or may lose their jobs, have difficulties getting married or participating generally in everyday activities of the community. They hardly have a voice to speak about their experiences and demand an improvement in the way they are treated.

SUCCEED Africa Launch in Nigeria:

It is in against this backdrop that we celebrate the recent launch of a six-year project that is titled Support, Comprehensive Care and Empowerment for people with psychosocial Disabilities in sub-Saharan Africa (SUCCEED Africa). This is an international study that will hold simultaneously across the African countries of Nigeria, Sierra Leone, Malawi, and Zimbabwe, with central coordination by the London School of Hygiene and Tropical Medicine (LSHTM). It is funded by the Foreign, Commonwealth and Development Office in the United Kingdom, and aims to create regional centres of excellence in research, capacity-building and outreach on psychosocial disabilities. The College of Medicine, University of Ibadan is the Nigerian Organisation on this project.

The hope is that the SUCCEED Africa project will address the psychosocial worries of persons with serious mental disorders (psychosis) while creating hubs of excellence to develop solutions that are pragmatic and locally-relevant. Even more heart-warming is the philosophy of working with service users to co-produce the research ideas, implement, and review them and generally empower them to have a strong and credible voice about service development. This fulfils the mantra of “nothing for us without us” by ensuring they are carried along and actively involved.

It is long overdue, but nonetheless a pleasant development to witness new projects that aim to address the mental health challenges of our societies on the African Continent. It is doubly more satisfying, to see a focus on the challenging psychosocial difficulties and disabilities that are often problematic for affected persons. Yet these problems are not usually addressed by the routine mental health services as currently organised.

Conclusion:

Engagement of service users, policy makers, all stakeholders, civil society organisations and the media should help to encourage active participation, thereby increasing the chances of a successful project implementation. Failure is not an option. We truly desire that everyone with a mental health challenge (and their families) on the African Continent succeed. We hope the SUCCEED Africa project will increase the odds in that direction.

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