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The Breakdown of Ghana’s Mental HealthCare - The Causes of Mental Illness

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WHAT CAUSES MENTAL ILLNESS?

The JusticeGhana Samaritan Street Project- The MenthGhanaIn Ghana, as it is true of most African cultures, the causes of mental illness could have many definitions or interpretations. Mindwsie, however, writes that most mental health professionals believe that there are a variety of contributing factors to the onset of a mental illness. Research shows that there are physical, social, environmental and psychological causes for mental illness.

On physical causes (Biological factors)- it is found that each individual’s own genetic make-up can contribute to being at risk of developing a mental illness and traumas to the brain (via a form of head-injury) can also sometimes lead to changes in our personality and in some cases ‘trigger’ symptoms of an illness. The most cited instance is Misuse of substances (such as alcohol or drugs) and deficiencies of certain vitamins and minerals in an individual’s diet can also play a part. In relation to Social and environmental causes (Factors around us), it is found that where someone lives and their living conditions along with family and community support networks can play a part along with employment status and work stresses. Living in poverty or social isolation, being unemployed or highly stressed in your work can all put pressure on an individual’s mental health.

The psychological factors (Your Psychological state) Coping with past or current traumatic experiences such as abuse, bereavement or divorce will strongly influence an individual’s mental and emotional state which can in turn have an influence on mental health. On family history, there is evidence to suggest that heredity can play some part in the development of some forms of mental illness. However like with many physical health conditions (such as Heart Disease or Diabetes) it is suggested that the fact that a family member has experienced a mental illness does not necessarily mean that all other genetic family members will experience the same condition and that as with physical health conditions, the other factors shown above will indeed play a significant part too.

At the national launching of this year’s World Mental Health Day- dubbed: “Mental health and older adults”, on 10 October 2013, at Koforidua, Dr Akwasi Osei who also formally launch the “Restoring Dignity Project” which advocates for the re-integration of cured mental patients into the society said that last year, the three mental hospitals in Ghana handled 99,994 patients, while community mental health nurses attended to 260,000 patients. According to Professor Joseph Bediako Asare- former Chief Psychiatrist, he was happy that there was a law in place and advised implementing institutions to ensure that the right structures were created to ensure effectiveness and efficiency. The Australian High Commissioner, Ms Joana Adamson, praised Francis Acquah- a Ghanaian Mental Health Nurse in Australia and President of the Mental Health Foundation Ghana, for his drive and commitment to raise awareness and improve the situation of persons living with mental health illness. She revealed that in Australia, one out of five people suffered some form of mental illness and that half of the population could also experience mental illness during their lives.

HOW IS MENTAL ILLNESS DIAGNOSED?

There are no ‘tests’ as such, for mental illnesses. Unlike diseases such cancers, heart disease or diabetes, mental health problems cannot be diagnosed by checking the blood or body fluids of the person experiencing symptoms, as would be the case with a physical health condition. However, a diagnosis, per Mindwsie, will usually be made by an experienced psychiatrist working with other health professionals after a period of observation of the individual to identify symptoms. A person’s medical history and recent life events will also be taken into consideration so as to ensure a correct and accurate diagnosis. More often than not, family and friends play an important role by discussing changes they have noticed in an individual’s behaviours. A check of the person’s physical health will also be necessary to ‘rule out’ any symptoms that could be contributed to a physical condition.

The Minister of Health- Ms Sherry Ayittey is therefore right in calling for community sensitisation campaigns to create public awareness on the fact that mental disorders were preventable and treatable, so as to encourage families to take better care of their relations with mental challenges.

It is medically established that no one could be expected to be able overcome mental health problems without support and that asking for this must not be seen as a sign of weakness as it takes great strength and courage to reach out and ask for help. The first step in this direction as Mindwsie points out is to reach out and talk to someone about what you are experiencing whether that is to be a friend, partner, family member or your doctor. Thus although for most people, going to the doctors can generate series of anxieties and frustrations, but seeking out professional help will be the first step in terms of understanding and learning to live with and recover from, mental illness.

Research shows that people with mental illnesses or disorders may experience a wide range of symptoms which can vary in their severity. For example, anxiety may be mild, or so severe that the person affected finds it impossible to concentrate on their work, watch TV, or perhaps will be unable to leave their home for months or have difficulty sleeping, feeling hopelessness or guilt, or believing that other people are plotting against you - but as with anxiety, Mindwise writes that the extent to which different individuals are affected by these symptoms can vary enormously. “for example, someone with a chest infection is likely to find that their breathing is affected causing them some discomfort, whilst someone with schizophrenia may experience hallucinations which may cause them anxiety and problems concentrating. People with different illnesses or disorders will have different illness experiences, including; the types of symptoms experienced; how daily life and ability to function ‘normally’ is affected and what types of treatment may be effective.”

While some people might have groups or ‘clusters’ of symptoms like schizophrenia or manic depression (otherwise known as bi-polar disorder), “these two conditions both involve episodes of psychosis which can result in the person affected losing touch with reality because their thinking or mood has been disturbed- they may hear voices or see, taste or smell things which are not real, or develop strange beliefs, perhaps that they are being pursued by aliens or the mafia. Or they might experience very high or low moods which have a strong effect on the way they behave. Some people will only ever experience a single ‘psychotic episode’, while others will have recurring periods of problems, perhaps at times of particular stress in their lives.” Thus, the types of symptoms we are experiencing are vital not only in helping the health professionals to diagnose the condition we have but also, can help to establish the right treatment for a particular condition in order to give us the best chance of a successful recovery. For example, within the health profession, dual diagnosis describes people who have mental health problems and drug or alcohol problems.

The mental health problems may include schizophrenia, depression, bipolar disorder or Personality Disorder. It is said that having a mental health diagnosis significantly increases our risk of misusing alcohol and drugs. Research carried out by the Royal College of Psychiatry (2002) found that people with a diagnosis of schizophrenia are more likely to misuse alcohol. They are also 6 times more likely to use street drugs (Chrome, 2003). The following psychiatric problems are common in dual diagnosis: Depressive disorder such as depression and bipolar disorder; Anxiety disorders including generalised anxiety disorder or panic disorder; Obsessive Compulsive Disorder and phobias, not forgetting other psychiatric disorders such as schizophrenia and Personality Disorders. It is said that whereas the use of legal drugs like caffeine, nicotine, or alcohol is socially acceptable in some situations, encouraged, for some, their misuse (i.e. use that is problematic or which leads to harmful behaviour), can yes, also act as a contributory factor to the development of a mental illness.


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