Mental health is a crucial component of individual, community and national well-being. Unfortunately, mental health services in Zimbabwe have long been neglected, leaving many without access to the support they need. Zimbabwe is a country fraught with harsh socio-economic challenges. Years of poor governance, corruption, greed, social injustices, economic crisis, political unrest and social decay has brought the country to its knees
What is mental health?
Mental health is a state of well-being in which an individual realizes his or her own ability, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. Most people at some point during the course of their will suffer from mental illness(es), the most common being depression, anxiety, alcohol and substances disorder, schizophrenia, psychosis. Some people will recover and ‘bounce back’ from a mental health challenge with little to no intervention whilst other people may require intervention to recover, cope or integrate their illness into their everyday life.
In Zimbabwe, mental health services are currently underdeveloped. There are six public institutions with psychiatric beds: Harare Hospital Psychiatric Unit, Parirenyatwa Hospital Annexe, Ingutsheni Hospital, Mpilo Hospital Psychiatric Unit, Ngomahuru Hospital and Mutare Hospital Sakubva Unit, and they are not well-equipped to handle the needs of the population. Mental health care is also not widely available at primary care level. This means that many people with mental illness do not have access to treatment and support.
The government has acknowledged the need to improve mental health services in Zimbabwe and has made some progress in recent years. In 2016, the Ministry of Health launched a national mental health policy. The policy outlines the government’s commitment to improving mental health services and includes plans for expanding access to treatment and support.
Despite these efforts, much more needs to be done to improve mental health services in Zimbabwe. There is a need for more investment in infrastructure, training for personnel, and raising awareness about mental illness among the general population. Only by taking these steps will Zimbabwe be able to provide adequate care for those with mental illness and promote good mental health for all its citizens.
How does mental health affect the social, economic and political status of individuals?
The mental health of a nation has a direct impact on the social, economic and political status of its citizens. A well-functioning society requires mentally healthy individuals who are able to contribute to the economy and participate in political life.
Mental health problems can lead to social exclusion and isolation, as well as financial difficulties. People with mental health problems are more likely to be unemployed and living in poverty. They may also have difficulty accessing essential services, such as healthcare and education.
Political participation is also affected by mental health. People with mental health problems are less likely to vote or engage in other forms of political activity. This can lead to them being marginalised and excluded from decision-making processes that affect their lives.
The mental health of a nation therefore has a significant impact on the wellbeing of its citizens. Improving the mental health of the population should be a priority for any government concerned with improving the social, economic and political status of its people.
What are the consequences of mental health problems on a community?
Mental health problems can have a profound and negative impact on individuals, families, and whole communities. Mental health unaddressed is also economically expensive for nations. The consequences of mental illness are far-reaching and can touch every aspect of a person’s life.
Mental health problems can lead to:
• Social isolation and withdrawal
• Difficulty keeping a job or sustaining meaningful relationships
• Substance abuse
• Homelessness
• Violence
• Suicidal thoughts or attempts
The mental health sector in Zimbabwe
The mental health sector in Zimbabwe is currently underdeveloped and faces many challenges. The country has a high prevalence of mental disorders, but there is a lack of trained mental health professionals and facilities to meet the needs of those affected. This has resulted in a large number of people with mental illness going untreated.
There is also a lack of awareness about mental health issues in Zimbabwe, which often leads to stigma and discrimination against those affected. This can further worsen the situation for those struggling with mental illness as they may not seek help for fear of being ridiculed or rejected.
The government has recognised the need to improve the mental health sector and has recently allocated more resources towards this goal. However, much more needs to be done in order to address the current crisis.
Challenges to the sector
One of the most significant challenges to the mental health sector in Zimbabwe is the lack of resources. This includes a lack of trained staff, medication, and facilities. There is only one psychiatrist for every million people in Zimbabwe.
This shortage of resources leads to long waiting lists for mental health services. It also means that many people with mental illness do not receive the treatment they need. This can lead to further deterioration of their condition and even suicide.
Another challenge to the mental health sector is the stigma around mental illness. Mental illness is still seen as taboo in many parts of Zimbabwe. This means that people are often reluctant to seek help or even talk about their experiences. This can make it difficult to get an accurate picture of the true scale of the problem.
The lack of awareness about mental health issues also makes it difficult to provide effective services. Many people do not understand what mental illness is or how it can be treated. This means that they may not access services even if they are available.
The final challenge is funding. The economic crisis in Zimbabwe has led to cuts in government spending on health care, including mental health care. This has made it difficult for organisations to provide adequate services. It has also meant that many people cannot afford to pay for private treatment.
Milestones on Mental health in Zimbabwe though social change impact film and Initiatives
State of Mind a documentary film on mental health in Zimbabwe by Hopewell Chin’ono critics and explores some of the challenges faced by mental health patients including their families and the professionals who treat them. State of Mind highlights insights on health through the community-based Friendship Bench initiative by Dr Dixon Chibanda. In this documentary the journalist Hopewell follows the stories of families affected directly and indirectly by mental illnesses over a two-year period.
In the documentary film, State of Mind, Hopewell challenges the human rights violations and dehumanisation of people living with mental health illnesses. The journalist captures the problem of language in mental health which further entrenches stigma. One of the mental health workers is recorded using labels with negative connotations to patients such as ‘Benzi’ in the Shona language meaning a ‘Mad/Crazy person’. This shows that even trained professionals who are supposed to have possess critical consciousnesses as they assist in the healing process, still lack mental health literacy and self-awareness through the use of language that perpetuates the stigma and shame associated with mental illnesses
Sadly, it is the poorest and marginalised communities who rely the most on functional governments that suffer gravely. Female patients at Ngoma-Huru Psychiatric hospital have been reported to be neglected and to without sanitary pads leading to poor sanitary hygiene.
Rumbidzai Ndoro in the documentary film, State of Mind was a key highlight of cross human rights violations, medical negligence and lack of accountability. Rumbi as she was called 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, however poor medical history tracking, lack of trained and experienced professional led to the unfortunate death of the patient.
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 existence.
The organisation trains lay grandmothers in offering counselling to anyone who may be going through difficult challenges. Dr Chibanda in the documentary informs us that there are around 14 psychiatrists in Zimbabwe in a population of 15 million people and not enough psychologists and or other trained mental health professionals. This means most people will never see the door of a trained mental health professional like a psychiatrist or psychologist
To bridge this gap after one of his own patients died by suicide when he could not reach her in time, Dr Chibanda was inspired and started the imitative, The Friendship Bench, which takes mental wellbeing to communities.
In Africa across many indigenous native languages there is no word for depression. In Zimbabwe, depression or if someone is trying to express themselves using language on how they are 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 hardships, death and loss of loved ones, men abandoning their marital homes and responsibilities as fathers to their children, 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 Friendship 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 Friendship 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. Other countries have adopted the friendship bench model including Jordan, Kenya, Malawi, Tanzania and the US – where 60,000 people in the Bronx and Harlem areas have accessed the therapy.
