Facing a neglected crisis

In Malawi, people with mental disorders are not uncommon.

They come in different conditions, but the sad reality is that many were not born with the conditions.

Some cases could be averted if diagnosed early.

But  mental disorders remain largely neglected, often treated with stigma and rarely receive the same urgency as physical illnesses.

Typically, most Malawians look away as their relatives suffer mental breakdowns.

Many causes

According to St John of God Hospitaller Services clinical director Michael Chisimba Nyirenda, causes of mental illnesses include family history, failure to cope with tragedies, trauma, loss of a loved one, drug and substance abuse as well as infections such as HIV and Aids.

But some of the cases you see started with depression, a treatable condition which sometimes leads to suicide.

Depression is more widespread in girls and women while men and boys are particularly more prone to mental disorders resulting from drug and substance abuse, he says.

Zomba Mental Hospital psychiatric clinician Harry Kawiya says some people suffer depression because of stress relating to financial problems, job losses and academic failure and self-blame.

The mental hospital in the old capital treats more women with depression than men.

This is also true for Likoma where women constitute 10 out of 15 depression cases treated every month.

Health workers on the island district refer critical mental patients to St John of God, Bwaila Hospital and Zomba.

Treatable, but…

Mental disorders, including depression, are treatable, but this varies according to severity of the condition.

“Some may need medication while others may need counselling and psychosocial services apart from medication,” says Nyirenda.

Both St John of God and Zomba Mental Hospital have special departments that offer psychosocial services, including counselling.

People grappling with depression, drug dependence, alcohol addiction, stress, trauma and other psychological issues drop in to receive expert psychotherapy.

However, severely depressed clients seldom receive counselling as most of them refuse to talk about their situations.

They mostly get counselling when their mood has improved, says Kawiya.

Up to 40 in 100 patients admitted to the country’s hospitals suffer from depression, according to Minister of Health Peter Kumpalume.

The common mental disorder remains a neglected silent killer-ranked the second-leading cause of death in 15 to 29-year-olds.

Clinical psychologist Chiwoza Bandawe of the College of Medicine, a constituent college of the University of Malawi, says it is worrisome that there is not much counselling happening in the country’s health facilities.

“There is a need for cases of depression to be recognised early,” he says.  “We need to train religious leaders, teachers and guardians on how they can detect depression or mental disorders in their early stages.”

The tragedy is that depression remains a  major cause of suicide, warns Bandawe.

“The early warnings include remarks about being tired of life and being ready to die. They need to be noted and probed with seriousness before they turn into something tragic,” he says. n