Ignorance, shame, stigma around mental health challenges

Aliu is a 28-year-old chemical engineer with an oil and gas company and is a high-flying star, having bagged a first-class from Ahmadu Bello University, Zaria. He is well respected and is a rising star. But he battles with low self-esteem, bouts of anxiety and panic attacks and is often plagued with worries that he may be found out as not good enough. He recently fell into a bout of depression and has been feeling very miserable, sleeping poorly and is generally unmotivated.

These days, he struggles to get out of bed and show up at work. He is not sure if he can talk to anyone at work or if his family will understand how he is feeling. In any case, he fears that they will look at him as a weakling and it may hinder his chances of career progression if they think he is not strong enough for responsibilities. He does not really understand what is happening to him and he is not sure of how or who can help him. “I will just keep managing,” he resolved to himself, as he stared blankly at the screen of his laptop.

Tinu is a 31-year-old mother of a six-year-old boy, Dele, who is always restless and cannot simply sit in one place for 10 seconds. She is always worn out from chasing after him. He is very impulsive and highly distractible and cannot simply settle down to do assignments or complete any task. She initially thought he was just hyperactive as a boy, but her second son who is now four years old is calmer and more organised. Dele’s teachers also complained about his restlessness in school and tendency to disrupt class and disturb other students. His mother is at her wits’ end and she fears something is not right with him.

However, her husband is adamant that his son is okay and that he was also very restless as a child. He refused to contemplate taking Dele to see a child mental health professional. When the schoolteacher first suggested it to them, he became really angry and stormed out of the meeting. How can they dare suggest that his son had a mental health challenge? Does his son look ‘mad’ to them? “They were the ones that were mad and nothing was wrong with his son,” he thought to himself. The following day he withdrew Dele from the school and enrolled him elsewhere. His wife sat alone in her office that day and cried silently. She knew her son was not really okay and wanted him to have an assessment, but his father will not hear of it. What can she do?

Akpan is an 18-year-old law student who started hearing voices commenting on everything he was doing and sometimes commanding him to do certain things. The voices often told him that everyone in the world hated him and were always gossiping about how to kill him. He became really scared and stopped going to class as it would appear like everyone was looking at him strangely and the voices will provide scary commentary of what was going on. He could not believe that his roommates and friends could not hear the voices too. He stopped eating and could barely sleep at night. How he wished he could get rid of the voices in his head so he could know peace.

His family said he was possessed and took him out of school for deliverance from the demons plaguing their son and preventing him from fulfilling his destiny. They went from one prayer house to another, but the voices persisted; he actually appeared to be getting worse. They didn’t know what else to do. However, they believed it was spiritual warfare and not a medical issue, so they didn’t bother going to the hospital. By this time, Akpan had been out of school for two years, and may never return to complete his law education.

Commentary

The biggest barriers to accessing mental healthcare services remain ignorance– about what is happening and where and how to get help. This is closely followed by shame, stigma and supernatural beliefs that the challenges are spiritual and not medical. In the case of Aliu above, it was the shame and fear of stigma and future discrimination at work that held him back from seeking help and sharing his challenges. Dele’s father, on the other hand, assumed that mental health challenges meant someone was ‘mad’ and took umbrage at that insinuation about his son. Akpan’s parents took him out of school for two years, but refused to take him to a hospital because they were convinced it was spiritual. The resultant huge suffering and misery in these scenarios represent the costly price that our society continues to pay for our ignorance.