Perception of Mental Illness In Ghana
by Ernest Armah
On January 17, 2011, the Accra Psychiatric hospital decided to discharge six hundred inmates who have been ‘cured’ of their mental illness. What necessitated this action was the fact that some families have refused to come for their relatives at the hospital due to stigmatization. This was illustrated in the words of Dr. Akwasi Agyemang, the Chief Psychiatrist at the Ghana Health Service, “the first thing is for us all to understand that mental illness is like any other illness”.
Mental illness (abnormality) refers to the psychological dysfunction in an individual associated with distress or impairment in functioning and a response which is atypical and culturally unexpected. (Durand et al, 2003). Public perception of mental illness is very crucial to the treatment of it because the management of abnormality requires a concerted effort of both community health centres and individual members of society. This collaboration goes a long way in facilitating recovery and integration of the mentally ill back into society.
In 2004, Kabir and others set out to assess the knowledge, attitude, and beliefs about the causes, manifestations and treatment of mental illness among adults in a rural community in Nigeria. The data they obtained from the 250 adults they administered questionnaires to was that mental illness manifests itself in aggression/destructiveness (22 percent), loquaciousness (21.2 percent), magic/spirit possession (18 percent), etc. Almost 50 percent of the respondents harboured negative feelings toward the mentally ill. However, literate respondents were seven times more likely to display positive feelings towards the mentally ill.
The above study influenced the manner in which the questionnaire to extract information from the five respondents was constructed. The six-item improvised questionnaire combines both open-ended and close-ended questions which sought to obtain from respondents their knowledge, understanding, causes, and treatment of mental illness. The questionnaire also explores the spiritual dimension attached to the occurrence of mental illness.
The respondents collectively have not had tertiary education. Out of the five respondents, two people (a middle aged man who is an Electrician and a female who is a seamstress) said they have not heard of the term mental illness before. However, when they were asked the name they would give to people walking naked on the street and speaking gibberish, they almost unanimously tagged them ‘mad people’. This is consistent with the idea postulated by Kabir et al (2004) that cultural environment plays a pivotal role in the perception of mental illness. To quote them, “The recognition of mental disorder also depends on a careful evaluation of the norms, beliefs and customs within the individual’s cultural environment”. The implication here is that to tackle mental illness, there is a need to start from reshaping and reorienting existing cultural beliefs about the mentally ill.
On the contrary, the remaining respondents possessed appreciable knowledge of mental illness. It should be noted that these respondents were literate. This falls in line with the earlier research which was cited in the third paragraph of this paper.
Upon asking his understanding of the subject, Joseph (name changed for the sake of confidentiality) who was a high school graduate and a chorister said that mental illness is as a result of “so much burden and thinking that one’s mental capacity becomes overwhelmed”. He moved on to say that the symptoms for mental illness include excessive self-talk, absent-mindedness, and frequent visits to the hospital in the absence of any apparent ailment. According to Joseph, the causes for mental illness are broken-heart and job loss. He refuted the spiritual explanation of mental illness. He said the people who can treat mental illness are psychologists and psychiatrists.
Mary, (name changed for the sake of confidentiality) also a high school graduate demonstrated her understanding of mental illness by saying that “mental illness are mental disorders that impairs functioning”. According to her, the mentally ill are not normal. Mary said that the causes of mental illness are broken-heart, taking in hard drugs, etc. Abuse of drugs is one of the causes often suggested. This is parallel to one of the results obtained by Kabir et al that drug misuse (alcohol, cannabis, and other street drugs) had a percentage of 34.3% of the responses as a major cause of mental illness. To Mary, mental illness can be cured by a psychologist and a counsellor. She also debunked the spiritual connection to the subject.
Martha, (name changed for the sake of confidentiality) a confectionary store owner said that mental illness is largely attributable to enormous consumption of alcohol and hard drugs. When the questioner asked her about the symptoms of mental illness, she said she cannot answer that but can identify a “mad” person if she sees one. She subscribed to the spiritual element of mental illness, saying that “some abnormality runs in some families because some men and women cannot keep their libidos in check but go about chasing other people’s spouses and thus, they are cursed and this curse runs through the entire family”. In the survey that was conducted in the Karfi village in Nigeria, divine wrath/ God’s will and magic/spirit possession accounted for 19 percent and 18 percent respectively. Though the statistic in this regard is very minimal, it explains why some people send their family members or friends who are mental ill to witch-camps. It can be hypothesised that illiteracy plays a crucial part in this regard.
I did not proceed to ask the respondents of how they would react to the mentally ill. This was partly because the possible treatment of the mentally ill was implicit in their statement of the causes of mental illness.
There is a need for intensive education on mental illness. From the responses that were obtained, it was realized that there is a scanty knowledge of mental illness in the public domain (though the sample was not representative, other studies have reiterated the abhorrent treatment and stigmatization of the mentally ill). As the saying goes, a journey of a million miles begins with a step. Therefore, the campaign for education of mental illness should start with a strong encouragement to Abnormal Psychology students to sensitize their families, friends, church members, etc on the issue of mental illness. This is one of the things that the questioner did.
Somewhat related to the above, the various media platforms should be used to educate the general public about the intricacies of mental illness. This would help in demystifying mental illness and eventually curb stigmatization. In the conclusion of their study, Kabir et al noted that “A better understanding of mental disorders among the public would allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization towards such persons”.
It is also imperative that government starts a programme to clear the mentally ill off the streets and prosecute their irresponsible family members. This is because often, their weird appearance and mannerisms irrigates public stigmatization of the mentally ill.