A few days ago, the Al-Jazeera programme The Stream asked, “why is there a mental health emergency in Africa?” We decided to approach a few of our psychology scholars and alumni for their insights. Fundiswa brings fresh perspective on the double-edged sword of resilience and community oriented societies, as well as the missed opportunity of intersectoral collaboration.
A multifaceted understanding of the mental health crisis allows for a move away from the blame game towards being proactive about addressing the crisis. Avoidance and suppression of emotions, due to perpetuated stigma in society, are considered as major influencers in this crisis. This may be due to a fear of vulnerability that comes from a culture of silence in the African diaspora, which sees people being fearful of speaking out about their problems. There is an emphasised pride in being resilient, which results in people internalising a belief that one is weak if they need help from others. Repeated silent culture narratives perpetuate shame and judgment towards emotional struggles and as the stigma grows, in youth and adults alike, there is a minimisation of mental health difficulties and an overwhelmingly painful suppression of their struggles. There is a subsequent reliance on religion and culture as a way to cope, and a stigmatisation towards accessing mental health services. This results in a disappointing separation of what can be an excellent integration of mental health, religious and cultural resources which individuals can access without feeling ashamed. In addition, mental health stigmatisation has also influenced a fear of the unknown, as there is not much knowledge into what it actually means to seek these services.
There is a great emphasis on the individual seeking mental health services and for people raised in the African context, they may not be accustomed to the idea of solely focusing on themselves in a community that emphasises togetherness. This results in feelings of guilt when seeking mental health services as there is the knowledge that people close to them cannot seek or access these services. There is also fear that one can change through these services but may not receive support from their “unchanged” community. Dr Noluthando Moyo-Mubayiwa once said “there is no advantage in offering Rolls-Royce treatment to individual people while ignoring the communities they come from”. Therefore, this westernised individualistic approach needs to be transformed to cater to the collectivistic African culture, in both language and modalities practiced by mental health professionals.
Limited resources and lack of access to services are other influencers in the growing mental health crisis. Individuals become further discouraged from seeking help when faced with limited mental health services. There are only 2.5 psychologists for every 100 000 people in South Africa, which means the demand for services is much greater than the number of professionals who can provide it. Most of these psychologists will opt for private practice which most South Africans cannot afford to pay for. Due to this shortage of professionals, vulnerable South Africans who do seek help rely on NGOs and NPO’s for access to free mental health services, and they are often faced with untrained counsellors or counsellors who do not speak their language. The inability to access mental health resources then reinforces an idea that mental health is solely for the privileged.
Addressing the mental health crisis does not just fall on the professionals in the field who are tasked to provide services and create awareness. It requires a restructured perception of mental health from society and an integration of mental health services with other social resources. It requires a focus on both the individual and community, and mental health policy changes. It requires African governments and their societies to be more proactive in addressing the crisis. It also requires individuals to regain their power in this crisis by reaching out to friends, family, support groups, anonymous help lines and mental health professionals and speaking up. This is not about the blame game, it is about moving beyond the closed-door discussions and actively doing something about normalising mental health services, speaking out, and seeking these services without any judgement.
Fundiswa Mdunge is a Canon Collins Scholar, Masters of Arts student in Community-Based Psychology at the University of Witwatersrand, Intern Psychologist at the Centre for Psychological Services and Career Development at the University of Johannesburg.