Is Africa's Mental Health Challenge A Case Of Underdiagnosis or Non-Existence?

AFRICA's MENTAL HEALTH CRISIS; A NON-EXISTENT ISSUE OR A CASE Of UNDERDIAGNOSIS?

I have something in my head and I have been meditating on this for a while. Basically just trying to establish a balance where necessary.

I am an African from Nigeria but something bothers me about our general perception of mental health and I think this is a valid source of concern. 

I've had this trouble for a while now and it's safe to say that I have been pondering on this for a number of years. But this entire piece was triggered by a statement I read on Twitter.

Someone had made a submission that Africans are not known to hugely patronise antidepressants and other forms of psychotropic drugs because it is "a community- oriented" continent. 

As brilliant as this perspective is, I genuinely struggled with the absolute nature of the statement which strongly insinuates that the African continent isn't in dire need of psychotropic and therapeutic interventions because community is a perfect substitute for the use of anti-depressants. 

I must admit that this is a very intelligent perspective to the whole issue of mental health in Africa, it really is. But I can't seem to shake off the feeling that it subtly poses more dangers to the already weakening threads of our fabric as a people. 

I engaged this thought for a while trying to see where it was compromised and I think that the statement would be better of as a angle instead of an absolute statement of fact. 

It needs to be contextualized. 

Exploring the context within which the statement was made, I interpreted the intent and meaning of the statement to be that, 'perhaps, Africa is keeping her head up and making an attempt to cope through their mental struggles by leveraging the community outlook of their culture.'

I think that the statement above is better suited for the state that Nigeria and Africa by extension currently is. 

Why?

1. It does not invalidate the real struggles and consequences of untreated mental and emotional disturbances in the land. It also doesn't minimise the struggles of a real people trying to keep it all together.

2. It perfectly portrays the African population as a people with strong mental capacity who are making an attempt to show up everyday even though they are broken. I think that it does a bit of justice to the identity of Africans being a hopeful people.

With the points listed above, I do think that substituting mental health intervention like therapy and psychotropic drugs for community support might be taking it a tad too far. 

A valid point of view? Yes, but very damaging if taken out of context. 

I would like to show a not-so recent map that shows the mental health struggles of people living in Nigeria.

Premium times, October 10,2021.

Some of the concerns in this article:

• Mental health expenditure in Africa is generally lower than in other parts of the world. 

• Mental health in most African countries, does not receive the same priority as physical health.

• Depression is a significant public health problem in Africa.

According to a 2019 study published in the journal BMC Psychiatry, the prevalence of antidepressant uses in Africa ranges from less than 1% to 2.7%, which is much lower than the global average of 6.8%.

'So, is mental health challenge in Nigeria and Africa by extension, a case of Underdiagnosis or unimportance?'

How to know if Mental Health challenge is really a thing in Nigeria would be to look at the burden on the economy. There is a way to gauge if the concept of mental health is actually a thing to be concerned about. 

I addressed this in my previous article, where I examined the burden of mental health on a nation. The article addressed the ancestral question of "Is mental health really a big deal in Nigeria?" I'd suggest you read that first before continuing this piece. 

Do find the link here. 

https://fifiscornerr.blogspot.com/2024/01/mental-health-impact-on-economy.html?m=1

Now that we have dealt with the vagueness and skeptimism surrounding the concreteness of mental health matters, we should deal with the first concern I highlighted earlier. 

• Mental health expenditure being low in Nigeria compared to other nations of the world:

I do not think that expenditure being low in Nigeria or Africa is generally because we are a people who aren't capable of being broken and so are never challenged in our mental health. We also aren't a different specie of humans who possess super-abilities that goes against the normal human wiring. 

Rather, here's what I think. I think it's a case of lack of awareness. 

We do not spend because we do not know. 

We do not spend on these things because we do not see it as consequential, neither do we we understand the consequences. If we could measure the implications of these silent struggles, then we are likely to spend more to address it. 

See picture attached for reference. 

2020 Mental Health Atlas for Nigeria 

If there was enough structure to sufficiently create awareness, people would give priority to any break in their mental health instead of simply coping with it. 

Another angle to look at it from would also be the plague of self medication which is mostly driven by financial incapability. Usually, some of these drugs are subsidised but in countries like Nigeria where very little is done on the side of the government, individuals are left to adequately cater for their own mental health matters. 

Treatments for drugs and psychotherapies can run into months; for a nation where half the population are grappling with internal poverty, this might be too much to handle.

See picture below for reference. 

Concerns one and two have the same root and the same answer can be applied to both. 

Let's take a look at concern 3. 

Why is depression a public health concern in Africa? 

I do not think it is possible to treat this away from the state of the African economy. 

'If an economy is depressing, her people would most likely be depressed.'

This isn't to place the ultimate blame on the government but to establish between an environment and the state of mind of the people who live there. 

Let's examine some of the causes of depression. 

1. Unsatisfactory social environment

2. Relationship problems

3. Oppression

4. Lack of basic needs

5. Lack of contact with nature.

 Human beings are designed to operate as humans and we are emotional creatures. The management of our emotions ultimately affects how well we function. 

If one stays depressed for too long, it affects the immune system and this seems to be one of the problems with Africa. 

Generational poverty has been passed down for many generations, and the consequence of this is that generational depression and pain has also been passed down for generations.

 

If this isn't a problem, I do not see what else would be. Depression, sleep disorder, and anxiety is a menace in the Nigerian population. Our addictive lifestyle should say more about this. 

Social media addiction, parenting style and exploitative work culture reveals all of the issues we try to pretend do not exist. 

Except in rare cases where depression and some mental health conditions are caused by genetic makeup and biological reasons, environment, conditioning and upbringing play a major role in the development of these disorders. 

Anti-depressants are not popular in this part of the world because of some of the reasons I highlighted above. 

While I wouldn't necessarily advocate for the constant use of psychotropic drugs (Antidepressants) because they are inducing and do not help to address the root cause of the problems; I think it is important that we do not turn a blind eye to the devastation that mental Ill-health is causing on our economy. 

Other forms of interventions are needed to get people out of emotional distress if we must snap the cycle of generational trauma that is prevalent in Nigeria and Africa at large. 

Coping with community support is absolutely fine but why not cut the lifespan instead? 

This is a pandemic that requires intervention at all levels.