• Only six (6) psychiatrists in the country
• Minister of Health Speaks
• Politicians among the most mentally unstable
  

By Ndaba Nhuku|Five(5) million Zimbabweans have been hit by mental illness to date, an investigation reveals.
This follows a report by Dr Dickson Chibanda, a psychiatrist, who as early as 2007 highlighted that 40 percent of the country’s 12 million population, that is 4 800 000 people or more than a third of the population, have been hit by poor mental health. Another study, by ActionAid International, says economic challenges have led to widespread trauma among those affected.

The harrowing three cases below illustrate why Zimbabwe needs to take issues of mental illness in the community seriously.
 
‘‘A SUSPECTED mentally retarded man killed his mother, wife and two children with an axe in Masvingo on Monday. The man, Stephen Mabika (29), chopped off the heads of the four after killing them…..’’
 ‘‘A MAN suffering from a mental illness stormed his aunt’s home and raped her before grabbing an axe and hacking the woman’s three children to death, the Bulawayo High Court heard yesterday. After Ndodana Ncube, 42, killed the children aged between five and eight, he force-marched their mother to a neighbour’s homestead where he raped another woman and returned to his father’s home to torch six huts where five family members were sleeping. Bulawayo High Court judge Justice Martin Makonese heard this when Ncube… appeared before him facing 17 counts of murder, rape, kidnapping, attempted murder, malicious damage to property assault and robbery. Ncube was, however, freed after the High Court ruled that he was mentally unstable when he committed the horrific crimes in terms of the Mental Health Act….. the medical report showed that he was suffering from an organic psychotic, a mental disorder related to head trauma, substance use disorder…….” 
‘‘A 27-year-old mentally challenged Gutu woman yesterday morning left villagers in Gadzingo communal lands shell-shocked after she allegedly killed a local herdboy with an axe before feeding on parts of his brain and flesh from the severed head…..’’
Certainly with a caring society one or two of these cases may have been prevented, and society spared the pain.
Because of the huge challenges present in our society, it is time the health sector took mental illness seriously. For how long shall we continue reading gory reports in the media about murders and rape cases committed by individuals suffering from mental illnesses? The contemporary society should be concerned with the prevention and treatment of mental illness than reacting to it with the judicial dagger. We are all to blame because most of these men and women live amongst us, are our family members, society knows them, the health sector knows them; but we collectively neglect them till something has happened and the judiciary system is compelled to act.  People suffering from mental health need care, support and treatment before they are driven into these murderous acts.
 
Reading in detail most of these cases we find that the individuals concerned were discharged because medical reports compiled by psychiatrists showed that they were suffering from dual diagnosis, mental health problems and substance and alcohol abuse. Substance misuse could be as a result of trying to cope with their mental illness. Alternatively, mental health could also have been triggered by substance misuse. But the most essential thing is that Zimbabwe must raise the awareness of mental illness and the health sector put up more facilities that can treat those in need of the services. Mental health specialists are needed in the health sector and criminal justice system.
 
On the hand, we need to be bear in mind that most of us will suffer from one form of mental health illness or another. We may only not be aware that we are ill. There are many contributory issues as to why our society is saddled and overwhelmed with mental illnesses; high unemployment, use of illicit drugs and alcohol, poverty, political violence, break up of families, cultural beliefs not relevant to contemporary society, HIV, violence. They all need a combined effort by the state, employers, families and the health sector to deal with. Communities and individuals also need to save meager resources at our disposal by not chasing after fake witch doctors and false prophets in the belief that mental health illness is a result of witchcraft and jealousy. The government and health sector, under the Mental Health Act have an overall duty to ensure that mental health needs of the society are met by training more front-line specialist mental health workers.
 
The statistics of mental health among Zimbabweans is staggering. This should not surprise us considering the depressive atmosphere in the country; everyone is stressed out and stretched to a point of madness due to our economic quagmire and at times, political violence. Thus, most of our mental health problems are a direct result of bad national governance and ruthlessness.
 
For example, in Sept 2007  Dr Dickson Chibanda, a psychiatrist, highlighted to participants at a workshop that 40 percent of the country’s roughly 12 million population, that is 4 800 000 people or more than a third of the population, were then suffering from poor mental health.  The good doctor rightfully attributed the high level of mental illnesses where it belongs; the country’s  economic crisis and the then government’s cruel Operation Murambatsvina, which left more than 700,000 people homeless or without a livelihood after destroying their homes and the informal sector. A November 2005 study, The Traumatic Consequences of Operation Murambatsvina, conducted by ActionAid International, an international anti-poverty agency, in conjunction with the Counselling Services Unit (CSU) of the Zimbabwe Peace Project (ZPP) and the Combined Harare Residents Association, also concluded that Operation Murambatsvina had resulted in widespread trauma among those affected. We have again recently seen the same cruel government destroying houses it had legalized for construction near Harare Airport road.
Only six (6) psychiatrists 
Even the Minister of Health acknowledged how his government has become the cause of our mental illnesses. Speaking during the launch of the Zimbabwe mental health strategic plan for 2014-2018 in January 2015,Dr Parirenyatwaindicated his displeasure that mental illness is still not given the attention it deserves despite its increase as a result of pervasive economic hardships. As expected of him, the minister conservatively estimated that a mere 1, 3 million Zimbabweans have some form of mental illness, with his ministry stating that there are only 91 390 diagnosed mentally-ill patients in Zimbabwe, yet7 763 new mentally ill patients were attended to in only ten months in our hospitals from January to October 2014!
Even though, all these figures have to be taken with some doubts because our depressed economic situation and lack of trained personnel, the figures cannot be dismissed. For example, we had less than six (6) psychiatrists in the whole country in 2014 yet these are the only specialists trained to diagnose mental illnesses. So who is diagnosing the gigantic figures of mental disorders in Zimbabwe considering that all hospitals are in shambles?
 
Leaders are the worst mental health patients
And where are those suffering from acute mental health issues being treated when there are only two specialist mental health institutions in the country? Obviously we can only have a true reflection of what is happening and the national needs for mental health services if we have adequate funding, because without it, no strategy will ever succeed. We need a national conscience to care for more than half of our population that is suffering from one form of mental illness or another. There are too many people out there crying and yearning for these services. Some may not be aware they are ill, others may have relatives hiding them,  chained, wandering in the streets, or they are refusing treatment out of ignorance, fear or lack of resources. It is not their fault. As individuals and as a society we have a role to play by supporting agencies, the ministry and charities raising mental health awareness, offering care and treatment to the afflicted. We need to strengthen our cultural values that promote family and communal cohesion so that we are able to support each other.
 
Let us not forget that our leaders need the treatment too! The cruelty of some of them and all the political violence and murders we are always witnessing are just a manifestation of their mental illness!
‘Mental illness is one thing that was grossly ignored after the liberation war. Any war ends with lots of trauma patients and there is need to address that. At the moment, our economic situation in the country causes so much stress we need much use of that profession called psychology and psychiatry. And some of our leaders from the liberation war need a lot of that treatment. ‘ Chenjerai Hove – 28 January 2015