Community mental health matters

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“I have been living with a mentally ill husband for over 16 years. It’s not easy. He used to be violent. I almost left him but he had no one to look after him. We used to live happily with all the resources we needed available. We lived a normal life as a family until he fell ill.

“He would wander away if left alone whilst I was doing other tasks. Because he was violent, I would tie him up. I would untie him when it was time for him to have a meal. Life was not easy for me.” Mary (not her real name)

Health and Child Care (MoHCC) ministry has estimated that over 1,3 million Zimbabweans suffer from mental illness and, therefore, millions of families and loved ones, like Mary, are daily having to deal with the impact of mental illness on their lives.

Many feel that this figure is a huge underestimation, that many more people in Zimbabwe suffer from some form of mental illness during their lifetime, and that the numbers are growing as people try to cope with increasing stress and trauma in daily life.

Poverty, unemployment, drought and food and water shortages have meant that people in urban and rural settings are struggling to survive and support their families.

The Covid-19 situation has exacerbated what was already an arduous daily struggle for millions of people.

Zimbabweans are known for their resilience and their ability to cope with stressful and distressing circumstances. This is due mostly because of their togetherness, our sense of community and the way that we support each other in difficult times.

There is a very high degree of stigma and fear of mental illness and neighbours and family members often shun households in which there is a mentally ill person.

This causes sufferers and their families to hide the problem and prevents them from seeking help and support, denying them the opportunity to cope with a mentally ill family member and denying the ill person help.

This stigma is a result of fear created by the myths surrounding mental illness, which have been passed down from generation to generation, which erodes the support which could prevent stress and anxiety from developing into more serious mental health issues.

Over the past three years, Tree of Life and Island Hospice and Healthcare have worked with the MoHCC in Goromonzi and Mutoko to strengthen community support for mental well-being. A two-pronged approach was used to increase awareness, amongst community members, of mental health issues and to show how to support sufferers and their families. This was combined with the support of the MoHCC in offering mental health services for more serious mental health conditions.

Mary benefited from one of the community meetings. She said “ With the coming of Tree of Life and Island Hospice in our community, I felt supported. I got friends who would come to check on me. I realised I was worsening my husband’s situation by tying him up because he became more violent.

‘‘My attitude to the situation has changed. I no longer tie him up and he has also changed. He is now calm and we can sit and have a meal together. I feel a load was removed from my shoulders.”

This community-based approach has demonstrated that by helping communities understand mental illness better, levels of stigma were reduced considerably. This reduction in prejudice and fear has meant that neighbours and friends offered more help and support to the sufferers and their carers. Simply having this support made the load bearable for the carer and often meant that the ill person also improved.

In Mutoko, one woman who was severely depressed and had tried to take her own life reported that visits by community members to her home made a massive difference “I have improved so much and am now able to share my challenges with my family members and community people. I used to keep my problems to myself and they became painful for me.

I can now share my feelings with someone who understands and it helped me very much.”

The growing levels of support from community members for carers and people with manageable symptoms have meant that the MoHCC staff have time and resources to help those with deeper needs. Mary found great support from her Village Health Workers, she replied “The fact that I’m also getting lots of support from the Village Health Workers is making me feel better. I am feeling that I’m not alone as the hospital is also helping me. I need to continue taking care of my husband.”

With the constrained MoHCC mental health services becoming increasingly overburdened, the project has shown that a community- based approach can make a big difference. The project has demonstrated that we cannot underestimate the impact ordinary people in the community can have, simply by supporting each other in times of stress and mental illness. With knowledge and understanding, fear and stigma can be reduced. A community’s resilience, based on community togetherness, mutual support—Ubuntu — can be the biggest weapon against the mental impact of stress and trauma in tough times.

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