Mutonga Musunga
The year 2023 has in its own way brought me thinking that the community of Zambezi region in particular has not considered the seriousness of mental health. The issue of mental instability among individuals has become a norm that is acceptable without any stress even among family members. During the past years, situations involving serious mental incapacitation were not common. The people learned to live by it and mostly divorced the family members who became victims of such consequences.
This situation has so much evolved that many regard it as normal. My main worry is that unlike in the past, now it is almost every corner of the Katima Mulilo town where you meet someone with a compromised mental state. One wonders whether the issue regarding mental instability only ends with those who roam the streets. I tend to disagree because the escalating issues of crime and abuse of narcotic substances have taken centre stage. Though not a specialist in psychology, I still believe that some mental-related circumstances can be reversible. Many of the illnesses have just developed into chronic stages because no one was available to assist. Moreover, there was no facility nearby where such a patient could be admitted for treatment and rehabilitation.
In Namibia, the prevalence of mental illnesses is estimated at 25.6% and is expected to double by 2025. The main drivers of mental illnesses in Namibia have been attributed to abuse of illicit drugs and alcohol, chronic infections as well as socio-economic factors among others. The duty vested in our social welfare practitioners is patriotic, however, the curve of mental instability keeps rising. Not only visible mental incapacity should be considerable here. Some questionable decisions taken by staff members at workplaces, impatience, anger, and aggravated temper suggest symptoms of mental instability among community members.
The main intervention to reduce the burden of mental illnesses globally and in Namibia is the integration of mental health care in primary healthcare. Unfortunately for the Zambezi region, it still remains a dream because patients who fall prey to this kind of illness do not receive the required treatment and care because there is no facility specially made to take care of these patients. It has become a norm that if a family member has such an illness, the best place to be is the street without treatment; loitering in the streets of Katima Mulilo. Seeing the situation even in villages, leaves one wondering how we can sleep with a clear conscious.
Mental health is a state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community.
It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships, and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community, and socio-economic development.
Mental health is more than the absence of mental disorders. It exists on a complex continuum, which is experienced differently from one person to the next, with varying degrees of difficulty and distress and potentially very different social and clinical outcomes.
Exposure to unfavourable social, economic, geopolitical and environmental circumstances – including poverty, violence, inequality, and environmental deprivation – also increases people’s risk of experiencing mental health conditions.
A hospital-based retrospective medicine utilisation analysis of Facility Electronic Stock Card (FESC) psychotropic medication was conducted at Intermediate Hospital Katutura over a seven-year period, 2011–2017. The main outcomes were consumption rates, Daily Defined Dose, (DDD) and/or expenditure.
Of the 580 351,4 DDD of psychotropic medicines consumed, 84% were anti-psychotics, 9.2% anti-depressants and 6.8% anxiolytics. Anti-psychotics (48.8%) and anxiolytics (47.9%) had the highest consumption by cost relative to anti-depressants (3.3%). The most consumed antidepressants were imipramine (62%) by DDD and fluoxetine (55.8%) by cost. The most consumed anti-psychotics were chlorpromazine (74.6%) by DDD and haloperidol (68.4%) by cost respectively. Diazepam (79.4%) and hydroxyzine (94.2%) were the most consumed sedative-hypnotics by DDD and cost respectively.
One can easily see that most people are affected mentally. This is becoming a challenge that calls for vigilance and cute alert. People are sick in the mind. Something needs to be done soon. Medication is expensive and may not be affordable by many if the situation becomes worse. One may never know in which state of mind the person serving you is. Some situations are discovered too late. Therefore, education in mental health should be totally encouraged in all settings. In schools, it should not only be left to life skill teachers but all teachers should pay attention to questionable behaviours.
Finally, the challenge herein does not only focus on the Zambezi region alone but a situation that calls for integrated effort towards the well-being of our society. Stress has no boundaries nowadays. We have seen children with very young age committing unbelievable crimes or even committing suicide. Zambezi as one region that is extensive in distance from the national capital really needs a facility with specialised skills to take care of the developing societal problem in mental health.
* Mutonga Musunga is a PhD candidate in Education.