Today, Wednesday 10 October 2018, the world would gather to focus on mental health. It is a day reserved globally for mental health education, awareness and advocacy against the scourge of social stigma and discrimination.
It is a day of particular importance that draws thousands of supporters from their homes to gather to draw attention to mental illness and its major effects on people’s life. The day is important not only because it is a day for reflection but also because it focuses on global awareness on the devastating illness and serves as good reminder of the impact and the suffering that they cause for patients as well as for their families. Significantly, the day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and on what more needs to be done to make mental health care a reality for people. It is an avenue to urge people, especially young people to show their support on this day through raising awareness on social media.
In doing all this, it is hoped that people affected by stress, depression and mood disorders are understood, supported, free from stigma and are encouraged to access appropriate therapies.
Theme for the Celebration:
This year, the celebration of the annual event is on the theme: “Young People and Mental Health in a Changing World”
The chosen theme for the celebrations this year is critically relevant to the situation in Ghana where the youthful population has benefitted from developments such as online technologies. Paradoxically, the expanded use of online technologies has also brought additional pressures as connectivity to virtual networks at any time of the day and night has grown tremendously. This predisposes the youth to mental distress and illness.
As we celebrate the day our collective challenge as stakeholders must remain even clearer. We must intensify efforts to push back against the shame that so unfairly surrounds a diagnosis of mental illness by showing our support. We should show support by talking about mental illness openly and by encouraging others to do the same. Through this way we will, working together, help to weaken the chains of stigma associated with mental illness-one link at a time.
In Ghana, as in many other parts of the world, adolescence and early years of adulthood are a critical period in life where many changes occur. Changes occur, for instance in changing schools, from Junior High School to Senior High School, leaving home from the direct supervision of parents and starting university or entering a new job. For many, these are undoubtedly exciting times of stress and apprehension, however.
In yet some cases, if these feelings are not recognized and managed, can lead to mental illness.
Mental Health and Young People
Although mental illness is fast becoming the world’s most expensive disease-particularly because it afflicts so many young people at the beginning of their working lives- the illness remain both tragic and hidden. It is tragic because the rising rate of suicide in countries around the world including Ghana underscore the pervasiveness of mental illnesses. Unfortunately, it is hidden because stigma keep people from seeking help or getting adequate treatment, closing doors that might otherwise be opened to people who are suffering so desperately.
It is noteworthy that half of all mental illnesses begin by the age of fourteen (14), except that most cases go undetected and untreated. Indeed, risk of drug use increases greatly during times of transition. Whilst for an Adult, a divorce or loss of job may increase the risk of drug use, a teenager’s risk times include moving, family divorce or changing schools. When Children advance from basic schools they face new and challenging social, family and academic situations. The young people who have the most severe unmet needs in their lives are particularly in jeopardy of participating in risk behaviors such as dropping out of school, participating in violent behavior or using drugs and alcohol.
Burden of mental illness
In terms of the burden of the disease among adolescents, depression is the third leading cause. Suicide is the second leading cause of death among 15-29 olds. In Ghana, harmful use of alcohol and illicit drugs such as marijuana/weed and of late, tramadol is a major issue because of the tendency to lead to mental disorders that have implications for workforce of the individuals involved, their families and communities and society as a whole.
The Ghanaian young adults are at the age when serious mental illnesses can occur. Yet they are taught little to nothing about mental illness and wellbeing. It is in the light of this that the Ghana Mental Health Coalition (GHAMEC) together with Mental Health Society of Ghana (MEHSOG) tacitly associates itself with the world mental health day theme.
It is important; within the context of the both the theme and the celebrations to forcefully bring attention to the issues that confront our youth and growing adults. Also it is critically relevant to start a conversation around what the youth need in order to grow up healthy, happy and resilient.
Our call and the basis for it
The Ghana Mental Health Coalition (GHAMEC) together with Mental Health Society of Ghana (MEHSOG) calls on stakeholders in mental health including government to intensify efforts to continuously highlight the needs of our young vulnerable people take a stand and demand more for this group of vulnerable persons-our very future and survival as a country depend on it.
According to the United States Government Agency that conducts data collection and research on ‘behavioral health statistics- the Center for Behavioral Health Statistics and Quality (CBHSQ) relating to mental health addiction, substance use and related epidemiology.
The Narcotics Control Board statistics also show that the youth from Junior and Senior High Schools and Tertiary institutions make up the majority. It is estimated that about 50,000 people in Ghana abuse substances. Seventy percent of these result in mental illness. The use of drugs among young people in Ghana between the ages of 12 and 17 is on the rise. Currently, about seventy percent of the inmates at the psychiatric hospitals in Ghana fall within this age bracket.
Studies conducted by Mission of Hope Society, a health Non-government organization in the Brong-Ahafo region shows that there is an alarming rate at which teenagers are involved in the use of narcotics and excessive alcohol intake. In most cases their reason for attempting to involve in drugs are associated with stress and pressure they experienced in some stages of life.
A recent study by the Ministry of Health shows that 41% of young people report their incapacity to manage their stress as the major reason for abusing drugs. Also, some teenagers who have issues with low self-esteem are vulnerable to this menace than those with self-confidence.
There is no gainsaying; drug abuse has become a serious problem in Ghana. The prevalence of substance abuse among the youth in our communities and in educational institutions is alarming. The basis of the alarming rate of the abuse (especially among the youth) includes high unemployment among the youth and the general economic situation. Marijuana has been identified as the major drug of abuse among the youth in Ghana. The age of incidence of abuse is marijuana is disturbingly low, 10-12 years.
Substance abuse problem not only affects individuals but also negatively affect families and society. Peer pressure and exposure to drug-related marketing activities are pre-disposing factors to adolescents to initiate drug abuse. Drug abuse has implications for morbidity, mortality and crime rates.
In order to ensure prevention, there should be awareness of and understanding of the early warning signs and symptoms of mental illness. It is also important that Parents and Teachers lead in providing life skills to the youth. This will help them cope with everyday challenges at home and at school.
Government should integrate and provide psychosocial support to Schools. There should also be training for health workers to enable them to detect and manage mental health disorders.
In addition, investments by the government and the involvement of the social, health and education sectors in comprehensive, integrated, evidence-based programmes for the mental health of young people is essential to risky behaviors such as unsafe sex and involvement in robberies. The government is further advised to link the investments to programmes to raise awareness among adolescents and young adults of ways to look after their mental health and to help peers, parents and leaders know how to support their friends, children and students.
Again, government should be advised to be part of the global growing recognition of the importance of helping young people build mental resilience from the earliest ages. Besides, strict enforcement of laws on narcotics use is essential in promoting and protecting adolescent health. This is because this brings about benefit not only to the adolescents but also to communities and society with healthy young adults able to make greater contributions.
The media can play an influential role in changing society. In a coordinated effort to reduce substance abuse in adolescent youth, the media needs to get involved from beginning to the end of the campaign. There is the need for local media to be involved as partners in the campaign.
Stakeholders, including government, should think about how to use the available resources efficiently and effectively to reach out to the vast majority of people with mental illnesses than providing services in a more conventional way which is expensive and unsustainable.
The fight against substance abuse cannot be effective without the involvement of a range of community stakeholders and the proper allocation of required resources.
Ghana’s response to the drugs menace has been varied including legislation, for instance, the setting up of the Narcotics Control Board, which provided for severe penalties for drug-related infractions. Thus, legislation, drug-law enforcement, prevention, treatment and rehabilitation and community measuring are important and interrelated strategies in combating drug abuse among young people. Preventive school programmes such as lectures and discussions; exhibitions; essay writing and other forms of competition for students; in-service training for teachers, healthy alternatives to drug use; a scheme for talented students; and participation in a national mass movement for literacy are some innovative ways of finding solution to the issue.
The Ghana Mental Health Coalition (GHAMEC) and Mental Health Society of Ghana (MEHSOG) take this opportunity to encourage young people to take active part in various community programmes such as the “Red Cross” and the other voluntary activities as well as in specially designed programmes carried out at the local/community level to prevent and reduce drug abuse. Discussions must also continue concerning how to strengthen the extended family system where parents and elders are respected and to utilize this important resource in coping with drug use among young people. Strengthening family can take the form of a behavioral parent training programme, children’s skills training programmes and family skills training programme to help reduce family conflicts, youth conduct disorders and substance abuse as well as improved youth social skills, parenting skills and family communication and organization.
Prevention of drug use is the best option and it is recommended that this should be done with seriousness and ideally during adolescence. Studies have shown that early use of drugs increase a person’s chances of being addicted. Therefore preventing early use of drugs or alcohol could go a long way in reducing risks associated with addiction.
Educational Authorities also have an important role to play. They are advised to use methods to help prevent substance abuse among their students. Allowing students to sign pledges that they will not use drugs or alcohol, teaming up with law enforcement to get the message across could make huge impact in turning them away from drugs. School authorities are also advised to establish mentoring programs and resort to other measures such as unannounced drug testing and zero tolerance policies to let students appreciate the seriousness of drug abuse. It is imperative that schools enlist the support of parents and encourage prevention at home. When Children hear the message of prevention both at school and at home they are much less likely to try drugs or alcohol. Schools must also elicit support of other stakeholders like District Assemblies and Traditional Authority and Churches and Mosques. The results will be better when prevention is coming from all sides so that the student/youth can hear the information in multiple ways and process the message of prevention.
Education remains one of the simplest, yet most effective tactics for minimizing risky behavior. Of course, telling a student/youth not to drink or smoke may not be enough. Students, like all consumers of information, want to see data for themselves. They will then make their own decisions based on the interpretation of the information. At the end of the day, it is more effective to disseminate or share statistics about healthy behaviors than it is to wag fingers at bad behavior!
More often than not the youth need support; they need someone who is able and willing to counter the effects of peer pressure. Family and Teachers must demonstrate that they are proud of the decision of the Adolescent to abstain or to exercise moderation. Parents, Teachers and community leaders must not underestimate the power of role models and support networks in promoting healthy behavior.
By Reverend Agatha Fiaty
Chairperson Ghana Mental Health Coalition-GHAMEC (mhLAP Stakeholder Council)