To have mental illness or HIV?
Some Batswana would rather be infected with HIV/AIDS than have a mental illness, a study undertaken by Psychology Department at the University of Botswana (UB) has revealed. Presenting the results of the qualitative study concerning the stigma to HIV and mental illness in Botswana at a seminar held at UB recently, Neuropsychologist and Lecturer in the Psychology Department UB, Shathani Rampa said majority of people interviewed said being diagnosed with HIV was better because treatment was readily available and easily accessible compared to treatment for mental illness. And unless you tell people, no one can know you have the virus unlike with mental illness.Moreover, people with mental illness were commonly characterised as being dangerous, cognitively impaired, unpredictable, untrustworthy, sickly and unkempt, naked or improperly dressed.“Many felt being a mental health patient was as good as being an ex-convict from prison, you are never trusted or depended on by society ever again,” she shared. According to Rampa, the study which was conducted in June 2017 in Gaborone showed that there was still a lot of misunderstanding on mental health, what it looks like and that the stigma was driven by this lack of understanding. She said this highlighted the need to increase public awareness on mental health issues.Furthermore Rampa said: “Treatment for mental, neurological disorders is an uphill task in our country where resource allocation for mental health is low, pushing the number of mental health cases up. “There should be at least one psychiatric nurse in every clinic nationwide, but that is not the case. A patient in Gantsi for example has to travel all the way to Maun to get help.” The country’s entire population is served by one psychiatric hospital, Sbrana Psychiatric Hospital located in Lobatse, with only 7.1 acute psychiatric hospital beds, and 0.29 psychiatrists per 100,000 people according to the World Health Organisation [WHO], 2015. This and the difficulty in re-integrating mentally ill patients back into society is what is at the heart of lack of adherence to medications and the high rates of relapses experienced, according to Rampa.Recovery from mental illness, Rampa said, is possible, what is needed is for government and society to create an enabling environment.Mental disorders are common and include depression, anxiety, bipolar, attention deficit hyperactivity, among others. Lecturer in the Department of Psychiatric Mental Health Nursing Institute of Health Sciences in Lobatse and Co-Founder of Embrace Emotions Support Network (EESN), David Mangwegape explained that although the exact cause of most mental illnesses is not known, research indicates that mental disorders are brain disorders caused by a combination of biological, psychological and environmental factors. “To put it simply, mental disorders are a product of disruption in the communication of the nerves of the brains called neurotransmitters. If they do not function well, then the disorder occurs,” said Mangwegape. Whereas biology plays a role in determining who gets a mental disorder and who does not, Mangwegape adds that socialisation and the environment will affect the manifestation and severity of the illness. And according to him, Depression is the common most diagnosed mental health illness in Botswana with women being the most affected largely because of their low socio-economic status and issues of violence against them. “We also have an emerging number of substance use disorders, many male youth are affected and this could be attributed to high unemployment rate and failure to resolve relationship issues amicably,” he said. Some people who develop a mental illness may recover completely; others may have repeated episodes of illness with relatively stable periods in between. Still others live with symptoms of mental illness every day. They can be moderate or serious and can cause severe disability.According to WHO, half of all mental health illnesses begin around the age of 14, with most cases going undetected and untreated. Among adolescents, depression is the third leading mental health illness. In addition, suicide is the second leading cause of death among 15-29-year-olds. Focusing on the African continent, the global needs for mental health care are gradually becoming more visible, but such needs remain inadequately addressed, according to a report by Doctors without Borders. “A lack of services, data and awareness around mental health issues will inevitably further exacerbate the situation among African youth,” it said. The “Its when the Trees Blossom” Explanatory beliefs, Stigma and Mental health in the context of Botswana research study, was done through the support of Penn Mental Health AIDS Research Centre (PMHARC) and Botswana-UPenn Partnership (BUP). In-depth semi-structured interviews were done with 42 respondents from a public HIV clinic, a public mall, and a community centre.