Case A: Halima was a second-year university student when she was diagnosed as having bipolar disorder. She suffered a manic episode, characterized by disinhibited behaviour, hearing voices, and grandiose delusions. She went around the campus hugging everyone and telling them how rich and brilliant she was. She had previously been depressed 2 years earlier. Her parents were embarrassed when they came to campus to see her in the clinic. She was referred to the Psychiatric Department of the Teaching Hospital where she was admitted and subsequently recovered after a few weeks.
However, when she returned back to campus, she noticed that her friends and classmates were avoiding her. Some students were actually rude and intrusive, including unsolicited suggestions that she goes for deliverance (Christians) or Ruqiya (Muslims) as it may be a spiritual problem. Her roommate became obnoxiously loud in her prayers against demonic spirits of mental illness whenever she was in the room. She increasingly became so uncomfortable in the school that she begged her parents to allow her to withdraw and write university entrance exams again to start afresh in a different university.
Her parents were initially worried that she would have lost 3 years but when she broke down and started weeping, as she narrated in graphic detail, the shame and stigma she was going through in the University, they reluctantly had to agree with her that a fresh start elsewhere may be best. Her father sighed, as he hugged her close, and whispered a silent prayer that she does not suffer another episode in the new University; or that the students and staff there will be better behaved and more understanding. Thank God they could afford to forfeit the financial expenses already incurred. Otherwise, she would have had no choice but to try and face up to the challenges….or quit school altogether, he concluded to himself.
Halima’s mother, on the other hand, was more worried about her chances at marriage in the future if people knew that she had suffered a mental health challenge. In fact, this was going to be a problem not only for Halima but also for her other siblings too, if they become tagged as a family with mental illness. Maybe, the entire family should seriously consider relocating somewhere new, she thought to herself.
Mental health challenges may present with some psychosocial disabilities. According to a report of the United Nations High Commissioner for Human Rights, an individual with a psychosocial disability is described as “a person…who, regardless of self-identification of diagnosis of a mental health condition, face[s] restrictions in the exercise of their rights and barriers to participation on the basis of an actual or perceived impairment.”
Psychosocial disability refers to disabilities that may arise from mental health challenges. It should be clarified that not everyone who has a mental health issue will experience psychosocial disability, but those that do, can experience severe effects and social disadvantage from obstacles to their living a productive and fulfilling life. A psychosocial disability may result in their being treated unfairly, excluded from normal societal engagements, and deprived of their basic human dignity and fundamental human rights.
Nearly everyone with a mental health challenge will be subjected to varying degrees of shame, stigma, and discrimination and thus societal exclusion. Common mental disorders that frequently result in psychosocial disabilities include depression, bipolar disorder, psychotic disorders, intellectual disability, autism, and anxiety-related disorders.
Even more galling is the secrecy and hushed tones which surround these occurrences as families are often too eager to sweep them under the carpets and are too ashamed to be open about the challenges; or even seek help – where it is available. Thus, the majority of affected persons end up in trado-spiritual treatment centers, where their human rights are more likely to be trampled upon; and abusive practices are rife.
Access to quality mental health care services is also very poor, with the World Health Organization’s World Mental Health Surveys revealing a treatment gap of 80% for Nigeria, which means that 8 out of every 10 Nigerians with a mental health disorder in the preceding year, did not receive any care for their mental disorders. This is not surprising, considering the grossly insufficient numbers of mental health professionals available in the country; as well as the low government priority and funding for mental health services.
Thus, persons with mental health problems who experience psychosocial disabilities continue to face many forms of stigma and discrimination, as well as exclusion from participating in economic, educational, civil, and social rights such as marriages. Halima for instance was going to quit her university and restart elsewhere, simply on account of the harassment, she was experiencing.
Tribune Article for the column “Your Mental Health & You”
Thursday, 10th November 2022