Overcoming mental health challenges isn’t just a matter of personal wellbeing but a crucial element in creating robust, peaceful and prosperous societies worldwide, including in Africa. This was underscored earlier this month on World Mental Health Day.
For generations, Africans have faced sustained adversities due to insecurity, humanitarian crises and colonial repression. Communities have had to cope with continued trauma stemming from genocides, insurgencies, terror attacks, political turmoil, socio-economic disparities and religious and ethnic discrimination. Trauma in Africa is often transgenerational, affecting the collective mental wellbeing.
According to the World Health Organization (WHO), in 2022, over 280 million globally were living with depressive disorders, and 85% of those in developing countries had no treatment for mental health issues. Given that most Africans suffering from anxiety, depression and post-traumatic stress have limited access to mental healthcare, these statistics should be treated with caution. Stigmas also hinder the complete representation of mental health issues.
According to a recent report exploring the United Nations’ (UN) renewed approach to transitional justice, mental healthcare and psychosocial support services are pivotal across Africa. They can bridge gaps in development, humanitarian efforts, violence prevention and post-conflict transformation. By providing these services, nations and communities can foster individual wellbeing and societal resilience, and find a path towards lasting peace.
However, in the face of Africa’s many development and governance problems, mental healthcare is underprioritised and underfunded. Most African states haven’t achieved the WHO’s Mental Health Action Plan goals, and despite 25% of African countries having revised or developed mental healthcare legislation, it is still the second-lowest performing region.
A significant obstacle to providing mental health and psychosocial support services throughout Africa is the lack of financial support from governments and human resource deficiencies. On average, African Ministries of Health allocate only around 90 US cents per person for mental health – up from US 10 cents reported by the UN Children’s Fund in 2016.
According to WHO, Africa has an average of 0.1 psychiatrists per 100 000 people. In some European countries and the United States, expenditure is much higher, generally averaging several hundred to over a thousand US dollars per capita annually.
Another challenge in Africa (and elsewhere) is the abundance of gender-, religious- and culture-based stigmas that prevent individuals from seeking help or participating in psychosocial support workshops. Stigmas usually arise due to misinformation, ignorance and a lack of awareness of mental illness and trauma. Mental health is a socially constructed concept, so different cultural, religious and ethnic groups have various ways of conceptualising it and deciding which interventions are appropriate.
Due to a lack of conversation, mental illness and trauma are often disapproved topics, so they attract stigmas. This discourages open discussions and efforts to address the issues, furthering stigmatisation.
Mental health is a socially constructed concept, so cultural, religious and ethnic groups understand it differently
Worldwide, people dealing with mental health issues encounter discrimination, isolation, and sometimes violence. Traditional notions about the origins of mental illnesses can sometimes result in detrimental actions like exorcisms or isolation rather than relying on evidence-based treatments. Eliminating stigma and fostering awareness can encourage individuals to seek help without worrying about negative consequences.
Measures to tackle stigmas include integrating mental health into primary healthcare and using community education to focus on terminologies, signs and symptoms. Uganda’s Village Health Teams engage vulnerable communities and incorporate cultural strength and resilience into the assessment and training of caregivers. Other practitioners have developed handbooks for religious leaders on how to offer timely and informed psychosocial support and make faith spaces safe for those seeking help.
The role of language is crucial. The UN Development Programme report on integrating psychosocial support into peacebuilding says practitioners should reconsider the language used in Western, individualised and medical concepts of mental health. They should instead promote collective approaches that focus on communities or groups as beneficiaries. While some mental illnesses may need individualised treatment, group approaches are less affected by stigma. Practitioners can also reduce stigma by using language relevant to the local environment.
A Guest Editorial