State of Mind a documentary film on mental health in Zimbabwe by Hopewell Chin’ono is powerful! It explores the issues and challenges faced by mental health patients, their families as well as professionals in the field. It looks at how one creative and passionate Dr Dixon Chibanda has disrupted the field challenging status quo through The Friendship Bench initiative.  In this documentary Hopewell  follows the stories of a few families as they tackle mental health related illnesses over a nearly two year period. 

What is Mental Health?

WHO defines mental health as a state of well-being in which every person realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to contribute to his or her community. 

Most people at some point during the course of their life will suffer from mental illness(es), the most common being depression and or anxiety. Some people will recover and ‘bounce back’ with little to no intervention whilst other people may require intervention to recover, cope or integrate their illness into their everyday existence.  It is NOT weakness to need help.

They’re various psychological disorders according to the American Diagnostic and Statistical Manual on Mental Disorders that though not an exhaustive list fall within some of the below categories;

  • Neurodevelopmental 
  • Bipolar and related disorders
  • Anxiety
  • Trauma and Stressor- related disorders
  • Dissociative disorders
  • Depressive
  • Substance abuse and  addictive disorders
  • Schizophrenia
  • Personality disorders
  • Disruptive, Impulse-Control, and Conduct Disorders
  • Sleep – Wake Disorders
  • Feeding and Eating Disorders
  • Somatic Symptom and Related Disorders

Currently they’re debates and challenges around the DSM and the field of Psychiatry and Psychology. One of the major concerns is that  it is heavily Western.

Africa and other cultures across the world present unique complexities that do not always ‘fit’ into presenting models of prognosis and treatement options.

They’re emerging schools of thoughts around African psychologies , re-looking and possibly dismantling the current structures taught at tertiary level in African Universities.

Zimbabwe a country of hopelessness…

Zimbabwe is a country fraught with harsh socio-economic challenges. Years of poor governance, corruption,greed, social injustices, economic decline  and political unrest has brought the country to its knees.

Everyone is born with an  innate desire to be free and to  live a life of purpose and meaning however each one of us defines it for ourselves.

The youth of Zimbabwe find themselves between a rock and hard place. Since gaining independence from colonial rule in 1980 ,Zimbabwe a country once known as the bread basket of SADC is in crisis.

High rates of unemployement and the volatile unsustainable business environments make it extremely difficult for the average citizen to survive day to day.  Dreams have been crushed, creative expressions stunted and hope is fading particularly among youth.

As the saying goes ‘Idleness is the devil’s playground’ Idleness usually creates a chain of unhealthy behaviors especially in restless young people. Some youth will start to use recreational drugs, addictive substances and or alcoholism.

These are temporary forms of escapism from their everyday hopeless realities. However this only makes a bad situation worse.

People who already suffer from mental illness or are more vulnerable to mental illnesses when under the influence of addictive substances can get out of control and be a danger to themselves and to others.

Alcoholism and addictive substances abuse is classified as a mental illness on its own. It can however also exist as a comorbidity with other mental disorders in the same person.

This exacerbates a whole myriad of problems for the individual, immediate family members and the professionals involved in the healing process. This is highlighted in the cases of Claudius Mukoki and Evans Maredza in the documentary. 

Evans Maredza’s word for word ‘singing of Bob Marley’s song War inspired by the speech given by Haile Selassie is of particular interest to me. Evans seems to capture and understand to a depth felt by him the meaning, energy and power in the words.

Most of us in order to survive and thrive learn to cope and adjust to the injustices of this world but perhaps people like Evans see a truth they simply can not ignore or pretend to ‘adjust’ to in order to ‘function’

Perhaps they wonder why the rest of the world carries on with the lies and charade that all is ok yet they’re the ones being medicated? Makes one wonder who needs the healing…

Mental illness, the elephant in the room

Sadly it is the poorest and most marginalised communities who rely heavily on a relatively functional government system that suffer the most. Think of the female patients at Ngoma-Huru Psychiatric hospital  neglected and  without sanitary pads for use during their menstrual cycles, an insult to their dignity. 

Poor public health service delivery, shortage of skilled labour and limited resources are a few of the daily problems faced by State hospitals. These challenges perpetuates the pain and suffering and at times leads to tragic and premature deaths of patients.

Rumbidzai Ndoro a loved and supported daughter and mother who is featured in the  documentary State of Mind brings this home for us.

Rumbidzai Ndoro was a mentally ill patient who  died in August 2018 due to Lithium toxicity. At the time of her death she was being treated at Parirenyatwa psychiatric Hospital, a  junior doctor made an error on her dosages.   

Rumbi’s mental illness was severe , in the documentary we’re given  a small glimpse into her medical history from her family and from Dr Chibanda. It appeared  Rumbi only responded ‘better’  to Lithium treatments . She however suffered from severe side-effects including a near death experience post the delivery of her baby, Tapiwa.

One wonders why this Lithium treatement option continued in-spite of its clear dangers to Rumbi?  Perhaps alternative medications were simply too expensive or difficult to source?

Perhaps Rumbi’s family could not afford these medications and the State hospitals nolonger provides the medications free of charge or at a subsidized cost?

A lot of ‘Perhaps’ and a country failing its people. I was deeply moved by the unexpected tragic ending to Rumbidzai Ndoro’s life. 

 

 

What is the Friendship bench project?

The Friendship bench Zimbabwe initiative was founded by Dr Dixon Chibanda in 2005.  In an effort to bridge the gap and try to  meet the ever increasing demand for mental-health- related services, the friendship bench came into existance.

This organisation trains lay grandmothers in offering counselling to  anyone who may be going through difficult challenges. Dr Chibanda in the documentary informs us that they’re about 14 psychiatrists in Zimbabwe in a population of about 15 million people and not enough psychologists and or  other trained mental health proffesionals.

This means most people will not see a doctor or get the help they need. Dr Chibanda then implemented an unusual solution to this problem. Through The Friendship Bench, He has taken mental wellbeing to the communities. 

In Africa across many indigenious native languages there is no word for depression. In Zimbabwe, depression or if someone is trying to express themselves using language on how they’re feeling inside , they will usually say ‘ndiri kufungisisa’  meaning ‘I’m thinking too much’.

The grandmothers involved in the Friendship bench project highlighted  some of the causes of Kufungisisa/Thinking too much include but are not limited to issues around financial harships, death and loss of loved ones, men abondondening their marital homes,  HIV/AIDS infections due to infidelity, suicidal ideations, unemployment, low self-esteem, hopelessness etcetera.

The Friendship bench counselling sessions are structured  to achieve the below four goals;

  • Kuvhura pfungwa (Opening the Mind)
  •  Kusimudzira (Uplifting)
  • Kusimbisa (Strengthening)
  • Kusimbisisa (More Strengthening) 

From the Frendship bench individuals are then moved to the 5th stage of the healing process which is Circle Kubatana were hand-projects skills such as weaving Bags are taught as income-generating and self-empowerment.

The frienship bench Zimbabwe project has been a great success story. To date it is operating in over 70 different communities in Zimbabwe and over 300 grandmothers have been trained with a plan to continue spreading and reaching to as many people as possible. Some other African countries are looking at adopting this healing method.

Ending the stigma and shame attached to mental illnesses

Whilst there’s been milestones achieved in the field of mental illnesses we still have a long way to go.  One of the enemies we need to face is the stigma  and shame that’s often attached to mental illnesses, mainly due to ignorance and or fear. We fear what we do not understand.

In the documentary , the film maker Hopewell Chin’ono whether deliberately or not , l like that he did not edit out a scene where one of the mental health workers labels  patients as  ‘Benzi’ in the Shona language meaning a ‘Mad/Crazy person’ . 

This shows that even with people who’re trained and suppossed to be helping in the healing process, the language used is still very problematic as it perpetuates the stigma and shame associated with mental illnesses. We need to change our narrative on how we talk about mental health.

Our health is important in body, mind and spirit. A healthy country equals a thriving and flourishing economy.

Stress though useful to a point, in excess can be crippling. High stress levels are one of the biggest triggers to mental and physical illnesses. It is therefore important to look after one’s mental wellbeing in as much as one looks after their phsycial wellbeing through exercise, sleeping well, eating healthier foods etcetera.

Mental illness is not a respecter of persons, it does not discriminate based of educational background, social status, gender, age et cetera. It can happen to anymore. This is  well documented in the film through the case of the Dr Dentist.

Healing is not always linear

Mental health is complex and sometimes abstract , healing therefore cannot always be linear.  Treatment options are  varied and diverse though mostly Western based.

In the documentary whilst the primary focus is advocating for community based therapy as well as prescribed medications depending on illnesses, severity, medical history etc. Dr Chibanda tried to not discredit or judge alternative methods towards healing for example consulting with traditional healers, church leaders etc . In South Africa ancestral calling and mental illnesses are sometimes closely linked.

Dr Chibanda and team have been genius in successfully implementing and practising a form of healing therapy that fits within the context and complexities of people living in Zimbabwe. I believe this approach can be translated into similar contexts across Africa and the world. An Ubuntu community based apporoach to healing in combination with modern medicine.

A must watch documentary for every Zimbabwean, African and  the world at large!