By Problem Masau
Zimbabwe’s economic malaise has spurred mental illness with 1,3 million people now suffering from related ailments, officials say.
This raises concern over the well-being and ability of Zimbabweans to withstand further challenges in the economy.
It also comes as inflation has started to rise amid foreign currency shortages with companies sinking into losses and viability challenges.
Further worsening the situation is an acute shortage of qualified experts to deal with the growing mental illness cases in the country.
Curative services principal director in the Ministry of Health and Child Care Sidney Makarawo said that harsh economic climate was among the drivers in the rise of mental illnesses in Zimbabwe.
“About 450 million people in the world are suffering with mental illness related cases in the world while over 1,3 million Zimbabweans are living with the condition. This is because of harsh economic climate, depression and anxiety,” he said.
Zimbabwe’s economy has been on a free fall and many people have found themselves unemployed in the shrinking economy causing mental distress.
Several other workers have also been going without pay over the past few years as companies battle reclining economic fundamentals.
A report by Research and Advocacy Unit titled Trauma and Mental Health in Zimbabwe shows that there has been a rise in mental illnesses since 2000 mainly due to economic hardships.
Data from World Health Organisation shows that there were just above 600 000 mentally ill people in 1999, and the figures have doubled to 1,3m in less than 20 years while population growth has relatively remain stagnant.
“It is a vicious cycle. When the economy is not performing well, it leads to unemployment forcing people into substance abuse, anxiety and depression. The ultimate destination is mental illness,” sociologist Pardon Taodzera said.
A patient who requested anonymity because of the stigma said he lapsed into mental illness after being retrenched from work.
“I used to work as a distributor but I was retrenched and because of the depression, I was diagnosed with mental illness related condition.
“However, I soon realise there was no enough psychotic drugs from the public health facilities and they cannot buy on their own.
“I used to hear strange voices but I can no longer hear them because I am on medication and I am stable,” he said.
Zimbabwe has only 14 psychiatrists for 1,3m mental patients translating to a rate of 0.08 percent per 100 000 people, according to the WHO.
Currently, mental health services, including staff and drugs, remain in dire shortage across the country with just 20 registered clinical psychologists working in Zimbabwe and nine public Mental Health Institutions, for a country with a population of about 13 million people.
During a meeting in Harare this year, mental health stakeholders appealed to government and the donor community to increase funding for mental health in Zimbabwe and help ease the challenges patients are facing in accessing mental health care.
The stakeholders highlighted the critical barriers that people continue to face to obtain essential mental health treatment and care in the country. Stakeholders also called on policy makers, healthcare providers, the donor community and United Nations (UN) agencies to place mental health issues at the top of their agenda when discussing priority issues.
Zimbabwe Prison and Correctional Services psychiatrist Patrick Mhaka said the main challenges that the mental patients were facing include, shortage of psychotic drugs, lack of human and financial resources and lack of appropriate mental healthcare facilities.
Curtailed access to decentralised treatment, care and support, stigma and discrimination and lack of mental health education are also among the major challenges worsening the situation.
“There are few mental health trained personnel such as psychiatrists, mental health nurses, clinical psychologists, occupational therapists and speech therapists, compared to the needs of the population,” he said.
Similarly, there are very few donor organisations that support mental health activities despite the magnitude of challenges.
This is in contrast to other areas such as Malaria, maternal health and HIV and AIDS which are receiving attention from funders.
Another psychiatrist Nemache Mawere raised concern that the challenges mental health patients face can cause serious risks to their health, dignity and lives.
“Due to shortage of psychotic drugs, patients suffer from severe mental distress, causing multiple relapses of the disorder after they are discharged from central health facilities or tertiary care,” he said.
MSF appealed to the donor community to support community psychiatry or the availability of care at the community level to ease the problems that mentally challenged people are facing.
“MSF has started to pilot the community psychiatry model in 13 Polyclinics in Harare city to allow mental patients to get access to treatment, care and support closer to their homes,” said MSF Head of Mission for Zimbabwe, Abi Kebra Belaye.
Belaye said solutions to improve mental healthcare provision in Zimbabwe include recruiting and employing increased numbers of mental health personnel and investing in staff training of existing ones so that they are able to treat mental health disorders and assist patients and their families at all levels.
“There is also need for national authorities and donors to avail funds to purchase psychotropic drugs to ensure that there is a constant supply and also ensure that patients in the rural areas also have access to medicine like any other disorders,” said Belaye.
WHO country representative David Okello said more needs to be done because the high numbers of mental illnesses in Zimbabwe is a crisis and stressed the need to reduce the number of mental health patients who are sent to prisons like Chikurubi and Mlondolozi.
“We have a crisis in Zimbabwe, but perhaps not only in Zimbabwe. We need to appeal to decision makers, prisons are not meant for mental patients. Let us spread the word that mental health is as good as physical health,” he said.
Okello bemoaned the culture of neglecting mental illness patients in psychiatric hospitals.
“The truth is no one is invincible, no one can say is immune to mental illnesses. You should not throw away your relatives, mental health is not a contagious diseases,” he said.