Tackling Mental Health

The Med Lexicon’s medical dictionary describes mental health as “emotional, behavioural and social maturity or normality; the absence of a mental or behavioural disorder; a state of psychological well-being in which one has achieved a satisfactory integration of one’s instinctual drives acceptable to both oneself and one’s social milieu; an appropriate balance of love, work and leisure pursuits.”

The World Health Organisation (WHO), also describes mental health as “a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.”

Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD) and borderline personality disorder.

Mental illnesses can affect persons of any age, race, religion or income. They are not the result of personal weakness, lack of character or poor upbringing and

cannot be overcome through “will power” or related to a person’s “character” or intelligence.

This illness falls along a continuum of severity. Even though mental illness is widespread in the population, the main burden of illness is concentrated in a much smaller proportion-about six per cent or one in 17 Americans, who live with serious mental illness. The World Health Organisation has reported that four of the 10 leading causes of disability in the US and other developed countries are mental disorders and that by 2020, major depressive illness will be the leading cause of disability in the world for women and children.

Mental illness usually strikes individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable. Without treatment, the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives, while the economic cost of untreated mental illness is more than $100 billion each year in the United States.

Approximately 25 per cent of people in the UK have a mental health problem during their lives. Equally, in the UK, Canada, the USA and much of the developed world, mental disorders are the leading cause of disability among people aged 15 to 44.

The best treatments for serious mental illnesses today are highly effective; between 70 and 90 per cent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports. The good news about mental illness is that recovery is possible.

The recent death of Welsh football manager and former soccer icon, Garry Speed, through suicide, has once again brought to the front burner the issue of mental health. A recent study has revealed that mental neurological substance abuse account for 14 per cent of diseases. In Lagos, an average of 14.1 per cent of the total population suffers from one mental case or the other. This illness may not necessarily be psychosis but untreated minor mental illnesses which affect the quality of life.

World Health Organisation estimates that about 150 million people are affected by alcohol use disorders, 40 million from depression and another 40 million from Alzheimer’s disease, while 1 million people commit suicide annually.

The causes of mental illness are complex and vary, according to the particular disorder and individuals. Genetics, early development, drugs, loss of family member, disease or injury, neurocognitive and psychological mechanisms and life experiences, society and culture, can all contribute to the development or progression of different mental disorders in people. The most common, view, however, is that mental disorder tends to result from genetic vulnerabilities and environmental stressor combining to cause patterns of dysfunction or trigger disorder. Signs of mental health condition include erratic or changed behaviour, depression, loneliness and desperation, among others.

No matter how seemingly the effects of mental health issues are, whether it is depression, epilepsy, dementia alcohol dependence or death, they can be managed effectively with the affected individual living a reasonably normal life.

Not managing mental health in the workplace has a huge impact on individuals and is equally bad for business too, with an estimated annual cost to employers of over 25 billion pounds. Recent survey indicates 40 per cent of employers view workers with mental health conditions as a significant risk while 42 per cent of employers are still underestimating the relevance of mental health in their workplace.

Given the negative perception from employers, many applicants may feel that it is in their best interest not to disclose their mental conditions. Today, 73 per cent of work places across the globe still have no formal mental health policy.

It is in recognition of the threat posed by mental illness that the Lagos State government recently adopted a policy that aims to respect the rights of residents with mental disorder. The objective is to guarantee social justice and equity for victims of mental illness as well as ensuring that the rights of people suffering from mental disorders are respected.

This new approach by the state government includes sufficient and detailed strategies aimed at reducing the impact of mental health in the state. The basic components of the state’s mental health policy include promotion aimed at conducting awareness programmes and educating the people on the effects of substance and alcohol abuse, primary care and access to services, treatment guidelines at health care level, services for people with severe mental illness, reduction of work place stress and the risk of suicides and human resources for mental health. Presently, the first step in this new policy is investment in mental health across the state.

The deduction from the Lagos intervention is that with appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can now significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. We have for long allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery of victims of mental health. It is time to take these barriers down. This is where the initiative of the Lagos State government is highly commendable.

However, it is important to state that for the Lagos State policy on mental health to be quite successful and achieve optimal result, it must be embraced by all stakeholders in the society. No matter how good the new policy is, it may not achieve the intended objectives without the active participation of private sector stakeholders, NGOs, religious groups, user groups, individuals and philanthropic organisations.

The effective collaboration of all these major stakeholders is needed in the creation of a strong network of aftercare operations and facilities such as halfway houses and assisted employment programmes.

•Tayo Ogunbiyi is of the Features Unit, Ministry of Information and Strategy, Alausa, Ikeja, Lagos