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If you love booze, you could be mentally ill- Dr Chitayi

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Everyone is going cuckoo and there is hardly any help in sight Do we blame juju or seek spiritual help? Dr Boniface Chitayi, a psychiatrist, speaks

Is it true that the full moon raises the degree of illness in mental patients?

This is a myth! More than 300 years before the birth of Christ, Hippocrates, a Greek physician said that mental disorders arise from the brain. This assertion has stood the test of scientific study over time.

Why does mental health attract such stigma?

It is because mental disorders are poorly understood. People wrongly believe that mental disorders are caused by spiritual forces such as witchcraft, demons or curses. There is also the wrong notion that mental disorders are due to drug abuse often viewed as a personal failure.

Again people hold the view that mental illness once diagnosed cannot be cured, which is not true. As a result people fear any process that could lead to association with mental illness.

Is mental illness hereditary?

Mental illnesses are known to arise from a combination of biological, psychological and social causes. Heredity is biological.  In most cases the three areas interact to produce a mental disorder.

Is it true that certain professions predispose workers to mental illness?

Professions accompanied by high levels of stress will result in higher incidences of mental illness. Sales persons, hoteliers, brewers, bar personnel, entertainment industry, journalists, police, the armed forces and medical practitioners are for instance more likely to suffer alcohol use disorder.

Why is it that few doctors specialise in mental health?

During medical training, the emphasis on Psychiatry is inadequate. Some medical students will miss their Psychiatry rotations therefore denying themselves a chance to develop interest in the discipline.

The stigma against mental disorders often spreads to mental health professions therefore creating reluctance among doctors to choose Psychiatry.

What are the signs that your child, spouse or colleague at work could be suffering mental illness?

Sustained change in ones behaviour is the most important clue of a changing brain chemistry hence possible mental illness.

A sudden excitement that seems not to have any explanation coupled with an increased sense of confidence and self-esteem may be showing early signs of bipolar mood disorder. But different mental illnesses have different symptoms.

Are functional alcoholics mentally ill?

Yes, high functioning alcoholics are mentally ill though strictly speaking functional alcoholics do not exist medically. This is a term likely to be used to refer to someone who continues holding a job (and performing as expected) despite meeting the criteria for alcohol use disorder.

Occupation is often the last area that suffers in alcohol use disorders. The two main reasons is that the person using alcohol does everything to hang onto their job. However in due course, the job suffers too.

Therefore people who seem to be functional despite problematic usage of alcohol should embrace mental health care.

Can ‘mad people’ be treated and their health restored?

‘Mad people’ is a stigmatising term that does not convey much meaning. Let us discard equivalent terms in all local languages including the Kiswahili term ‘wazimu’ as a way of reducing stigma. We must accept the inconvenience of looking at different mental disorders as different entities.

The causes of mental disorders, their symptoms and patterns of recovery will vary from one person to the next. This is due to genetic factors, co-morbidities present, access to appropriate treatment and support to adhere to treatment.

When the right circumstances are met, nearly all mental disorders can be treated successfully.

 As a country, what do we need to fix mental health?

The government should increase budgetary allocation to mental health, support mental health research as well as mental health advocacy initiatives.

The government also has a role in the development of human resource for mental health. Mental health professionals and mental health facilities should respect patients’ rights and promote awareness in the community. The media should take a lead in promoting mental health education.

Any best practices from around the world?

The future of mental health does not lie in the construction of huge mental hospitals such as Mathari national teaching and referral hospital in the counties, but in building the capacity of health workers at the health centre and the county hospitals to handle minor mental disorders.

In fact all hospitals in Kenya were gazetted as mental health facilities nearly 30 years ago.

There seems to be a rise in suicides and mental illnesses...

When mental disorders increase and remain untreated, the suicide cases will increase as well. It is known that mental illness underlies over 95 per cent of all cases of completed suicides.

According to the ministry of health, about 7,000 Kenyans die every year from suicide. The solution to this devastating state of affairs is the provision of the highest attainable standard of mental health services.

Does it make sense to arrest and charge those who attempt suicide?

Arresting, charging and imprisoning people who attempt suicide is atrocious. When the law is used against survivors of suicide, they suffer a double tragedy. Kenyan legislators must enact a law that protects people who survive suicide who need mental health care.

Would you attribute increasing reports of domestic violence to mental health?

It is possible that some cases of domestic violence are a result of mental illness. The mental disorders can range from alcohol use disorders to mood disorders such as depressive illness to Othello syndrome where one spouse suspects that the partner is having an extra-marital affair despite all evidence to the contrary.

How can schools be strengthened to better detect or deal with cases of mental illness?

Students who show extreme and recurrent defiance of school rules and violence against fellow students should be evaluated by a mental health professional. Consistently poor academic performance can also be a sign of a disorder. School nurses should receive mental health training.

What happens when it is the doctor who is mentally ill?

Our health system does not provide optimal conditions for the recovery of the doctor or nurse who suffers a mental or even physical illness. The stigma suffered by health professionals at the hands of fellow health professionals is often higher.

Is there anything we can do as individuals to prevent mental illness?

Prompt treatment of infections that affect the brain such as malaria and meningitis, seeking counselling if exposed to psychological trauma and adequate sleep.

What does it mean to raise a child or live with a spouse who is mentally ill?

Mental disorders often exert a huge financial burden and emotional distress on the affected family. The government can ease the financial burden on the families of persons living with mental disorders by fully subsidizing psychotropic medication in public hospitals.

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