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Youths’ mental health in focus

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KAWIYA—People need to be transparent

By Yamikani Yapuwa:

Every day has been a struggle for 25-year-old Jane since the relationship with her boyfriend hit the rocks six months ago.

She constantly feels a sense of worthlessness and this often sends her into emotional tantrums.

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“My expectations were very high and when we fell out, I became hopeless. I have been pre-occupied with self-harming and suicidal thoughts,” Jane states.

Elsewhere, Cynthia developed a mental health disorder after being emotionally abused by her partner. She also lost her child while going through the ordeal.

“I was abused by the person I trusted and believed would take care of me. I had always expected that he would stand with me for better and for worse. Losing my child was the worst thing that happened in my life,” Cynthia explains.

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She reveals she used to spend most of her time alone and almost gave up on life.

Similarly, Blantyre-based Daniel, 31, went into mental breakdown after divorcing his wife.

“I broke up with my wife two months after our holy matrimony. I dated the lady for almost eight years and we had a child between us before the wedding. At the time of breaking up, she was three weeks pregnant,” Daniel says.

The separation led him into states of solitude, resentment and mood swings.

The unfortunate thing is that the three youths have not had access to mental healthcare services because they did not know where to seek such support.

“I was just battling the effects because I didn’t know where to seek redress. I have never heard of any clinic which provides services related to mental health,” Jane confesses.

“I didn’t get any support because I have never heard about any mental health services since the condition is not considered a major problem,” Daniel concurs.

Similarly, Cynthia did not imagine she needed any medical help and the fact that people do not look at mental health seriously contributed to her reluctance to seek support.

Zomba Mental Hospital Psychiatric Officer, Henry Kawiya, singles out common mental issues among the youth in Malawi as depression, anxiety and substance abuse.

“Although we have not done a national representative study on the extent of depression, a survey that was done in Lilongwe found that 18.9 percent of youths that were HIV-positive had depression,” Kawiya says.

St John of God Hospitaller Services Clinical Psychologist, Ndumanene Silungwe, says most mental health problems emerge during puberty either due to genetics or dysfunctional lifestyle.

“Across the globe, post-adolescence makes up the main population for mental health problems. Anxiety and depression often begin during adolescence, from 15 years and above, and so is the onset of substance and drug abuse,” Silungwe observes.

He says most youths do not seek help for mental health problems because they do not have information on how the condition presents itself.

Dr Michael Udedi agrees with Silungwe in a 2016 study authored with four others and titled ‘An Integrated Approach to Addressing the Issue of Youth Depression in Malawi and Tanzania’ which shows that lack of awareness and little knowledge about common mental disorders contribute to stigma that prevent young people from seeking support.

“This situation combined with the shortage of trained health personnel to effectively treat young people with mental disorders, has created an environment where many young people suffer in silence,” reads part of the study which was presented at the 6th annual Malawi Mental Health conference in Blantyre.

The World Health Organisation (WHO)’s Mental Health Action Plan 2013-2020 also notes that most health systems have not yet adequately responded to the burden of mental disorders and, consequently, the gap between the need for treatment and its provision is huge all over the world.

“Between 76 and 85 percent of people with mental illnesses don’t receive treatment for their condition in low and middle-income countries,” reads WHO’s action plan.

Moreover, WHO Mental Health Atlas 2014 says more than 45 percent of the world’s population lives in a country where there is less than one psychiatrist for every 100,000 people and there are even fewer neurologists.

In Malawi, there are only three designated mental health facilities, namely Zomba Mental Hospital, St John of God in Mzuzu and St John of God in Lilongwe against a population of close to 18 million people.

Malawi Health Equity Network Executive Director, George Jobe, feels that Malawi is “greatly” missing out on offering services to prevent mental health breakdowns and that the system is more curative than preventive.

“We believe that most of the people who commit suicide and those experiencing mental impairments, including the youth, would have been saved had it been that we have robust systems,” Jobe says.

He suggests that Zomba Mental Hospital should expand and establish clinics in all district hospitals with well-trained staff and proper medication where youth-friendly counselling services should be provided.

“We also need to place emphasis on prevention instead of cure. Additionally, Malawi needs to introduce psycho-social support services at mental care facilities and encourage private hospitals to provide such services,” Jobe says.

Silungwe cites strengthened families, positive parenting as well as education about mental and soul health as crucial in promoting mental health among the youth.

On the other hand, Kawiya says people need to be transparent about mental health because it affects everyone in society, noting that certain patterns in young people should also be observed.

Minister of Health, Khumbize Kandodo Chiponda, says the government is going to review the service-level agreement with St John of God to include out-patient services to allow people to have access to counselling and medication services for free at the facility.

“We have since discovered that we have a lot people who are not hospitalised but they still need to be counselled or get medicine,” Chiponda says.

Speaking on the sidelines of 2021 World Mental Health Day commemorations, the minister urged partners to join her ministry in efforts of promoting mental health and psychosocial support.

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