We can function optimally in a society when there is peace, dignity and justice. That is the difference between thriving and surviving! However, when the society has conflict and chaos, so many people just survive, trying to cope as best as possible with the prevailing circumstances. However, the difficult and complex nature of such situations drives most people to the edge. Mental and behavioural mood disorders, including major depression and bipolar disorder, anxiety and schizophrenia, although they occur for other reasons as well beyond conflict, are among the top 20 conditions that result in the greatest burden of disability worldwide. In Africa, this is accelerated by drug and alcohol abuse among the youth.

When travelling to one of the countries in West Africa that was recovering from civil war, most people I interviewed seemed to be suffering from acute depression or post traumatic stress disorder (PTSD) – from the obvious observations I made. What was even more appauling was the fact that there was only one psychiatrist in the country. While staying next to a mental asylum in a different country, I also noted that most of the patients were unwell from the civil conflict they had experienced. The medical treatment they received was insufficient due to lack of essential drugs. The hospital did not treat them with the dignity they deserved either. The medical staff hurled insults at them, calling them ‘crazies’. Sometimes they chained them to trees, locked them up in rooms or publicly subjected them to beatings, sometimes when naked – to contain them and suppress ‘violent’ behaviour.

Unfortunately, mental illness in Africa is viewed with such shame and most times labeled as witchcraft. Instead of therefore getting the right diagnosis and treatment, some are taken to witch doctors. The combination of shame, lack of or low diagnosis, the mistreatment and lack of proper medical care  all cause more confusion and worsens the problem. In addition, governments’ attitudes in Africa are not helpful. They see this issue of mental illness as a first-world problem or a private matter that families should deal with and not a public policy matter that should have a budget allocation.

According to the African Youth Fact Book produced by the Africa Alliance of YMCAs, mental and substance abuse disorders were the leading cause of disability-associated burden in Sub-Saharan Africa, accounting for 19%  in 2010. As much as people do not like to give in to the mental illness labels,  major depressive disorder is the largest contributor at 40% of mental disorders. Significant population growth and aging will result in an estimated 130% increase in the burden of mental and substance abuse disorders by 2050, which will hugely affect well being and productivity. This means that if nothing is done, the burden of mental and behavioural mood disorders is likely to triple in 40 years.

The 25-34 year olds in Africa will be particularly affected because with modernisation, these young people will be living in contexts of intensified mental and emotional stressors including social isolation from peers and friends, in extreme economic, political marginalisation and in contexts of conflict and armed insecurity. The accelerated use of drugs and substance abuse to cope with these circumstances will not help the situation.

It is very clear that we need to take mental and behavioural mood disorders seriously and put in place treatment plans and facilities, or else we will not be able to cope with the burden when it hits us. We really need a reality pill so that we are proactive in keeping our citizens mentally and emotionally healthy.

Gil Harper

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This blog is a response to facts and trends in the African Youth Fact Book, spearheaded by the Africa Alliance of YMCAs. It is part of a series of projects geared towards discussing Africa’s probable future given its looming youth bulge and is spearheaded by Africa’s renowned futurist, Ms. Katindi Sivi-Njonjo. Ultimately, this project seeks policy change at governmental level, opportunities as well as behavioural change among youth to get in the driver’s seat for the Africa we want: a peaceful, prosperous, united and global player.