It is important to emphasise that seeing a psychiatrist does not necessarily mean that one is “mad”. At times people need help to cope with the challenges they face, whether at work, in their academic pursuits or otherwise, which may threaten their mental health.
The question, “Who needs a psychiatrist?”, is becoming more pertinent than ever before in the history of man. Not only because the different turmoil across diverse parts of the world have led to an increasing number of individuals with one form of mental illness or the other. But, also, because of the misconception by a considerable number of people that “psychiatrists” attend to only “mad” people. The erroneous impression most people have of mental illness is that of a disheveled, matted-haired, tattered-clothed individual who goes around hoarding rubbish and talking to invisible beings.
This is as far from the truth as it can be. Truth is, mental illness bears the face of your neighbour, a colleague at work or a member of your church or mosque. However, a lot of people find this simple fact hard to process. While I cannot fault them for this, considering the longstanding stigma and its attendant psychosocial consequences that have been associated with mental illness, I am also mindful that people give their own explanations to what confounds them.
Unfortunately, in Nigeria, dare I say worldwide, mental illness has continued to be shrouded in a great deal of mystery, leading to different reactions in which general perception has oscillated between the extremes of fear, ridicule, revulsion and ignorance, on one hand, and fascination, voyeuristic curiosity and normalisation on the other hand. It is therefore not surprising that several misconceptions surround mental illness and the role of the “psychiatrist.” The mere mention of a “psychiatrist” sends cold shivers down the spine of most people. “Why a psychiatrist?” “Isn’t that a doctor who treats ‘mad’ or ‘insane’ people?” “Is my case that bad?” “After all, I am educated. I have a good job. I don’t need to hear about a psychiatrist”. And the list of excuses goes on and on.
…there exists a huge burden of mental illness, and a dire need for psychiatrists around the world. Yet, Nigeria has about 250 qualified psychiatrists to a population of 40-60 million people with mental illness. Even more bothersome, of late, has been the massive exodus from the country of doctors in different areas of specialisation.
Health, if the World Health Organisation (WHO) is to be believed, is a “state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity”. Is there “health” without “mental health”? Not if “mental health” is understood as a “state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make contribution to her or his community”. WHO, the author of that last quote, also estimates that more than 450 million people worldwide suffer a form of mental illness. In the U.S., the National Alliance on Mental Illness reports that one in five people will experience a form of mental illness every year and for one in 25 persons, it will be severe and persistent. Our Federal Ministry of Health recently put the number of Nigerians suffering from one form of mental illness or the other at about 20 per cent to 30 per cent of the population.
What this therefore means is that there exists a huge burden of mental illness, and a dire need for psychiatrists around the world. Yet, Nigeria has about 250 qualified psychiatrists to a population of 40-60 million people with mental illness. Even more bothersome, of late, has been the massive exodus from the country of doctors in different areas of specialisation. Needless to say that a number of these psychiatrists are leaving the country for perceived greener pastures. Can we blame them for not being patriotic or for wanting to “check out”? No! In a country with little or no job prospects for newly qualified specialists in various medical fields, little wonder this exodus continues. Evidently, not every doctor desires farming nor tailoring, as suggested by the Minister of Health in one of his interviews.
Beyond her other hobbies, though, a psychiatrist is a qualified medical doctor specialising in the study, prevention, diagnosis and treatment of mental disorders. The psychiatrist is trained to evaluate patients, determine whether a person’s symptoms are the result of an underlying medical condition, which may result in the manifestation of a psychiatric disorder from a solely psychiatric condition, as seen in some cases of schizophrenia or the combination of a medical and a mental disorder.
The sense, therefore, that psychiatrists treat only ‘mad’ or ‘insane’ people is a distortion of the fact that the public perception of mental illness revolves around psychotic behaviours. Yet, a significant number of people worldwide (Nigerians inclusive) experience less profound forms of psychiatric illnesses such as anger problems, sleep disorders…
Psychiatrists are licensed to prescribe appropriate medications, as well as to engage in psychotherapy to alleviate these mental disorders. They usually work with other mental health workers, including psychologists, nurses, social workers, vocational therapists, speech therapists etc., and in liaison with other non-psychiatric physicians. Psychiatrist also engage in intersectoral collaboration with the public, private sectors and civil societies to ensure the best care possible for people with mental illness.
The sense, therefore, that psychiatrists treat only ‘mad’ or ‘insane’ people is a distortion of the fact that the public perception of mental illness revolves around psychotic behaviours. Yet, a significant number of people worldwide (Nigerians inclusive) experience less profound forms of psychiatric illnesses such as anger problems, sleep disorders, anxiety and trauma-related disorders. The reality, then, is that not all people seen by a psychiatrist have obvious forms of mental illness.
Part of our uniqueness as human beings are our idiosyncrasies and foibles. Most people will have a mental health challenge from time to time, usually following significant life events. However, these feeling are usually time- and event-specific; getting better after a while. Peradventure, these feelings become pervasive and affects one’s ability to carry out day-to-day activities, one’s ability to cope with life’s stresses and relationships with people, then it is advisable to schedule a visit to a psychiatrist. It is important to emphasise that seeing a psychiatrist does not necessarily mean that one is “mad”. At times people need help to cope with the challenges they face, whether at work, in their academic pursuits or otherwise, which may threaten their mental health. Conversely, treatment, usually involves the use of medications, psychotherapy, otherwise called talk therapy to address the possible problems that may have predisposed, precipitated or perpetuated the illness in an individual.
Margaret Uddin-Ojeahere, a Fellow of the West African College of Physicians, is a psychiatrist with the Jos University Teaching Hospital and a mental health advocate.
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