Code red, Code red!

. . .Mental health facilities overflow with patients

. . .Covid-19, drug abuse, schizophrenia blamed

Theseus Shambare

SHAMISO (surname withheld) survived a suicide attempt.

The 29-year-old fell into a depression after losing a child at birth.

She could not shake off her grief.

As if that was not enough, the following year, she lost her husband.

And this was just a few days after losing her younger brother to a mysterious ailment.

“You can imagine going into labour to deliver a child you never get to see or hold,” she said.

“Worse still, losing three people in a space of a year was a heartbreaking experience for me.”

But Shamiso is now recovering after receiving help at a local mental health facility in Harare.

Worrying

She represents countless other people who are grappling with mental health illnesses.

UNICEF country representative Dr Tajudeen Oyewale attributes the fallout from the Covid-19 pandemic is still affecting communities.

“School closures and the loss of learning opportunities for more than 4,5 million children in Zimbabwe have also impacted their mental health,” he said.

It is estimated that more than 2 000 patients are currently admitted to both private and public mental health institutions, with others receiving treatment at home.

Chikurubi Maximum Security Prison’s psychiatric unit is currently housing over 450 inmates, while Ngomahuru Psychiatric Hospital in Masvingo Province takes care of an average of 200 patients at any given moment.

An official from Harare Psychiatric Hospital said the institution’s carrying capacity is around 110 but the figure is often exceedingly high.

It is the same case at Ingutsheni Central Hospital in Bulawayo, which is the largest mental health institution in the country with over 700 beds.

“Our mental health unit has a capacity to accommodate 34 male patients and 16 female patients, but the number of those admitted is usually much higher than that. All age groups are affected with mental illness but the number of young adults is on the rise,” said Parirenyatwa Group of Hospitals spokesperson Mr Linos Dhire.

“The causes of mental health illnesses are multifactorial, that is, they can be biological, psychological, environmental or psycho-social. The major mental illnesses attended to are depression, bipolar disorders, schizophrenia and substance use disorders. Substance use disorders are on the top of the list.”

There was a definite spike in mental health illnesses in 2020, he said, after the outbreak of the coronavirus pandemic.

“I think this was a result of anxiety and depression due to isolation,” he added.

Mr Dhire said Government should continue to raise awareness to eliminate stigma around mental health.

He also encouraged the setting up of a separate rehabilitation facility to specifically manage substance use disorders.

In a recent interview with The Sunday Mail, Dr Nemache Mawere, the chief medical officer of Ingutsheni Hospital, raised concern over the rising number of mental health patients.

“The number of patients being admitted keeps rising. For instance, the acute admission ward for male patients, which is Khumalo Ward, has 98 beds, but usually, we have more than 220 patients admitted at any given time,” he said.

Underlying factors

There are some people who check into private mental health institutions dotted around the country for support.

The Goromonzi-based International Wellness Centre currently houses 13 patients, with all the cases related to drug abuse.

The average age of its patients is 25.

“Unlike physical illness, mental illness can be difficult to detect. Here, we mainly deal with drug-related issues, but what we need to point out is that these are just manifestations of underlying factors,” said International Wellness Centre clinical psychologist Nyasha Jonathan Ndhlovu.

“From the onset of our operations in 2018, we noticed an increase in mental illness from 2020, during the Covid-19 pandemic, and this had been caused by idleness, negative coping skills, stress and anxiety.

“Some individuals ended up taking any substance or drug they could get hold of to get a certain high because of the situation, therefore, getting hooked on the drugs.”

He said failure to secure jobs after college also had a mental toll on youths.

“Youths suffer self-condemnation after college as they remain idle at home. They see themselves as failures and in trying to face that, they end up getting lost in drugs, worsening their illness.”

Television personality and mental health advocate Vickie Mlilo-Maponga, who notably survived three suicide attempts, believes a united and happy family is the centre of a healthy society.

“Families are the cornerstone of our lives, shaping our experiences, beliefs and behaviours. It comes as no surprise, then, that family dynamics play a significant role in our mental well-being.

“When family members feel heard, understood and loved, it enhances their sense of belonging and self-worth,” she said.

Suicidal tendencies, bullying and criminal behaviour, she added, are the result of broken families.

“No one gets into a marriage with the intention of divorcing. When it happens, it affects not only the couple but the children as well. Divorce by parents brings in feelings of loss, anger, confusion, anxiety and many others in children and the couple.”

In her case, Mlilo-Maponga had lost a newly born baby and unsuccessfully spent years trying to conceive.

Unfortunately, she failed to find someone to confide in.

During one of her suicide attempts, she took over 50 pills.

She was later diagnosed with cynical depression, which she treated by taking some pills while receiving counselling from professionals.

Today, she is a mental health champion, helping others fight the scourge.

Roots

Serenity Mind Centre mental health specialist and psychiatrist Dr Anesu Chinoperekwei says child abuse, trauma and neglect contribute to mental illness.

“Children who have experienced complex trauma often have difficulty identifying, expressing and managing emotions,” observed Dr Chinoperekwei.

“They often internalise and/or externalise stress reactions and, as a result, may experience significant depression, anxiety or anger.”

Children who grow up in a family where parents fight physically or verbally, it is argued, are bound to suffer mentally.

“The result will manifest in the child. They will express their wrath to anyone they associate with.

“In a marriage, the partner will suffer at the hands of such an individual and, in the end, we may witness a nasty fight in marriage or during divorce. That is when we also hear of a partner killing another. People who have traumatic backgrounds are a danger to themselves and others.”

According to Ngomahuru Psychiatric Hospital medical superintendent Dr Parirenyatwa Maramba, schizophrenia has been overlooked as the driver of mental illness.

“This is a combination of physical, genetic, psychological and environmental factors. Some people may be prone to schizophrenia, and a stressful or emotional life event might trigger a psychotic episode,” he said.

Suicide, he added, is a result of unattended mental health issues as there is a lot of stigma around it.

“The stigma, misunderstanding and labelling are just too much and a lot of people prefer to suffer in silence. They end up using drugs or committing suicide. Mental health can be hereditary, as well as a result of stressful situations, and there are also unknown causes of mental illness.”

Of the 200 patients they have, the majority are in their late teens and early 20s.

“Early marriages have a negative impact on youth. Immature debates escalate into serious conflicts, with the worst situation ending in tragedy.

“Mental illness has always been there, but the past five years have seen a tremendous increase in substance-induced cases, probably due to Covid-19-induced conflicts when people were locked at home,” said Dr Maramba.

Alternative views

Mr Philip Sibanda, a psychology lecturer at the University of Zimbabwe, said accidents also contribute to mental illness.

“Head injuries during accidents and witchcraft are also contributory factors to mental illness. Failure to handle a poverty situation can lead to stress and eventually mental illness. However, the main effort must be towards how to maintain good mental health and how to handle each situation,” he said.

He also called for a mindset shift.

“More parenting programmes for parents and caregivers can provide the much-needed safety and security for children and adolescents to flourish and thrive,” he said.

Chief Chundu, born Abel Mbasera, told The Sunday Mail Society that “mental illness can be handled properly if traditional social structures are used”.

“When an individual bottles up issues, they are bound to suffer,” he said.

“In our traditional structures, starting from the family setup, there are elderly people (aunties, uncles and grandparents) whom our youths can confide in.

“When the situation worsens, we have our herbalists, who use different natural herbs that can cure mental illness but are combined with counselling.”

Above all, he said, the nhanga/gota platform is where the elders give advice to youths.

Government has developed the Zimbabwe National Mental Health Policy 2019 to 2023, which includes plans for improving mental health services in the country.