02 Dec 2018

Mental health disorders was once believed to be adult problem, but it has since been realised that young people should be the focus of attention where mental health problems are concerned.

Speaking at World Mental Health Day commemoration in Gaborone at Princess Marina Referral Hospital recently, Dr Butale said young people’s mental health should be taken into consideration just like their physical health as it was vital in developing well-rounded healthy balanced adults.

He cited that the World Health Organization (WHO) described health to include mental health as an important aspect of being and further asserting that there was no health without mental health. Therefore, one cannot talk about health without preference to a person’s mental being.

Dr Butale emphasised that good emotional wellbeing of young people was as important as their physical health as it allowed for a resilience in coping with whatever life threw at them. The event, which was themed; Young People and Mental Health in a Changing World, was connducted by Marina Psychiatric clinic, Psychology, the hospital Social Work department in collaboration with Botswana Network for Mental Health (BONMEH).

As Botswana is classified as a middle-income country, he said such posed challenges coming with  the socio-political status, adding that young people encountered socio-cultural problems such as the slow demise of the family system.

He cited that in the past mothers and grandparents stayed home offering support to children while fathers worked to put bread on the table.

“Nowadays almost everyone, including the old have to work and bring income home, leaving no one to support and guide the young ones at home,” he said.

MP Butale explained that young people found themselves in the middle of a changing culture, where the population has a mixture of people from older generations with their cultural expectations as well as a more westernised background with its expectations.

Dr Butale said such a changing cultural structure was a serious challenge to a growing person.

Education and learning challenges with high failure rates in schools, lack of employment with its own issues such as criminal activities, substance abuse, suicide as well as homicide, Dr Butale identified as socio-political challenges in the society.

He said some young people live with challenging chronic diseases that needed to be juggled with their natural development, citing that a young person with HIV faced a different challenge from that of her/his peers.

Dr Butale said some of the current debates pointing towards mental disorders have a strong developmental component in that such disorders came about due to some neuro-development errors in the brain, adding that some happened in-utero while others are afflicted during childhood development and late adolescence.

He said these milestones marked critical stages in the brain and self-development.

Dr Butale said it was disheartening at times as mental healthcare was often left behind and dismissed as just a rudiment of healthcare.

“There is no doubt that there is stigma surrounding mental health, be it towards mental illnesses themselves, people living with mental illness or even towards the mental health professionals and the stigma is the driving force behind the poorly fine-tuned mental health service delivery,” he said.

The MP indicated that the hospital statistics showed that about 650 attendees were registered in the past six months with highlights of high rates in schizophrenia, depression, anxiety, bipolar affective disorders and substance abuse and young people average about 60 per cent of the regular attendees.

Making recommendations, Dr Butale said specialised mental health services targeting specific issues faced by young people were vital, stating that it was high time youth friendly services that address needs of young people with little or no stigma were be developed.

Giving a commentary on the use of narcotics in Botswana, Senior Superintendent Gontlafetse Segolodi indicated that good mental health was a sign of positive way of life while ill mental health tends to be associated with the opposite.

Mr Segolodi said while mental health could be affected by internal factors, it could also be influenced by external factors and chief among these are illicit drugs.

He said research shows that there is a relationship between mental health and illicit drug use although the causality of the relationship has not been formally investigated, adding that it was known that locally a lot of people who present with psychosis at the medical facilities had a history of Marijuana use.

WHO, he said, identifies drug addiction as a brain disorder, thus the use of drugs was itself a mental illness.

“Anti-social behaviour, crime and disorder in schools are issues that can be linked to the use of illicit drugs such as dagga, crack cocaine, crystal meth, meth-cotinine as well as cough syrups containing codeine being commonly abused by the youth,” he said.

Mr Segolodi said illicit drug use, mental illness and crime were synonymous, noting that it was evidenced by the growing number of illicit drug trade and use cases, emergence of new patterns of crime and the growing number of psychotic presentations in health facilities.

Therefore, he said it was imperative to find a common ground where all stakeholders can work together in alleviating the problem from the society.

Representing Marina Psychiatric department Ms Mmakgosi Tau said her department was faced with a lot of stigma noting that it disturbs people coming for heal both the service provider and the user. Ms Tau said patients who used drugs made it had for the department to offer proper help to the patients.

She indicated that lack of sign language interpreter posed a very big challenge when attending to special needs patients as both the parents and the service provider were not familiar with sign language. ENDS