Perception and history of mental health services in Malawi

So, what is Mental Health exactly? Put it simply, Mental health is a good state of the mind. A healthy mind and mental well-being. When the mind is not healthy then it becomes an illness.

Mental illness, also called mental health disorders, generally refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior.

Examples of mental illness can be varied but generally they include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviours.

Many Malawians just like everyone else, have mental health concerns from time to time. However, a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.

A mental illness can make you miserable and can cause problems in your daily life, such as at school or work or in relationships. In most cases, symptoms can be managed with a combination of medications and talk therapy (psychotherapy)

Signs and symptoms

Signs and symptoms of mental illness can vary, depending on the disorder, circumstances and other factors. Mental illness symptoms can affect emotions, thoughts and behaviors.

Examples of signs and symptoms include, but not conclusive;

• Feeling sad or down
• Confused thinking or reduced ability to concentrate
• Excessive fears or worries, or extreme feelings of guilt
• Extreme mood changes of highs and lows
• Withdrawal from friends and activities
• Significant tiredness, low energy or problems sleeping
• Detachment from reality (delusions), paranoia or hallucinations
• Inability to cope with daily problems or stress
• Trouble understanding and relating to situations and to people
• Problems with alcohol or drug use
• Major changes in eating habits
• Sex drive changes
• Excessive anger, hostility or violence
• Suicidal thinking

Sometimes symptoms of a mental health disorder appear as physical problems, such as stomach pain, back pain, headaches, or other unexplained aches and pains.

If you have any signs or symptoms of a mental illness, discuss it, don’t try to bury your face in the sand and pretend all is well.

Most mental illnesses don’t improve on their own, and if untreated, a mental illness may get worse over time and cause serious problems.

Suicidal thoughts and behavior are common with some mental illnesses. If you think you may hurt yourself or attempt suicide, get help right away from mental health specialists such as MentalCare Malawi and others.

For the next few weeks, we will be discussing the general perception of Malawians about mental health.

In this first article, on behalf of MentalCare UK Malawi, we shall look at the perception in relation to the history of mental health services in Malawi. In the next article, we shall shift the gears higher and delve into looking at the perception in relation to the aetiology of mental health disorders.

Thereafter, we shall look at the perception in relation to presentation of mental disorders.

Perception

Firstly, perception could be seen as how human beings form impressions, opinions or inferences about something.

Unfortunately, often times, such impressions are found on limited information, which could be biased and wrong. In this discussion we will look at perception as how Malawians form impressions, opinions or inferences about mental health or mental wellbeing.

The perception that Malawians have about mental health is influenced by a lot of factors; these factors range from the history of the practice of mental health in Malawi to the aetiology of mental health disorders.

History

Mental health services in Malawi were born at Zomba Maximum Prison and the first mental institution the country ever had was the Zomba Lunatic Asylum (ZLA).

ZLA was a wing of the prison services whereby prisoners with mental illness were isolated to and cared for by prison warders. In 1953, the ZLA gave birth to what we now call the Zomba Mental Hospital (ZMH).

Against the background as alluded above, mental health services were being provided separately from physical health services and mental disorders were seen as an illness of prisoners or outcasts of the society.

The Zomba Mental Hospital, situated in the colonial capital city and perched the magnificent Zomba Platue and Chawe Hills, was strategically placed adjacent to the Zomba Maximum Prison and about a Kilometers from the Zomba General Hospital (ZGH). Zomba General Hospital was providing all health services except mental health services. Even the other central hospital had (almost) nothing to do with mental health services.

Because of this setup, over the years, mental health has not been seen as a part of human health yet according to the World Health organization “there is no health without mental health” because health encompasses both physical, mental and social wellbeing of humans.

In my opinion, this setup has contributed to the stigma and discrimination against mental health.

Fortunately, over the years, this setup has been changing till now we have mental health units in all the central and district hospitals.

Integration of mental health into the primary, secondary and tertiary health care is more likely to improve public negative attitude towards mental health because more people are now seeing mental health as part of health.

Conclusion

In conclusion, the general perception of Malawians about mental health has been improving over time. With the coming in of social media, more people are now talking about mental health. Malawians are now appreciating that mental health is a cross-cutting issue requiring everybody to take part in mental health awareness.

In conclusion, the general perception of Malawians about mental health has been improving over time. The ushering in of more sophisticated social media platforms and outlets, many a people are now talking about mental health.

Malawians are now appreciating that mental health is a cross-cutting issue requiring everybody to take part in mental health awareness. It is now pleasing to note that mental health advocacy is no longer for mental health workers only.

With an improved perception, demand for mental health service is increasing rapidly.

• Precious Makiyi is one of Malawi’s leading Mental Health experts. He is a passionate and dedicated Child and Adolescent Mental Health Practitioner. Dr. Makiyi runs an initiative on mental health and well-being in Malawi.

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