The cost of Mental Health in Namibia
BY VITALIO ANGULA, UAUEZA OKANGUATJIVI AND MARTHA NANGOMBE
ON October 10, the globe observes World Mental Health Day, this year’s commemorations will be held under the theme: Making Mental Health and Well-Being a Global Priority.
Schizophrenia patient *Jonathan Blauuw (32) (not real name) points out the class disparity in access to mental health in Namibia.
Namibia, with a Gini –coefficient of 0.59, is ranked as one of the most unequal countries in the world.
This wealth disparity translates into unequal access to health care in general and access to mental health care as
a topical issue that has lately been mainstreamed in order to break down stigma and create awareness.
“You should be able to fork out at least N$ 4000 per day at a private health center in Namibia”, Blauuw informs Confidente.
Services at the state hospital are free of charge.
JONATHAN’S STORY
I was diagnosed with Schizophrenia five years ago and my stay at the Windhoek Central Hospital Mental Health Centre was more traumatic than healing.
The place was like a prison and health care you get from nurses is not up to standard.
I am lucky because I come from a relatively well-off family but you would notice other patients being dropped and not receiving visitation from their loved ones.
There are different categories of mental health patients, from the most severe, to the moderately mild.
But they are all lumped in together, this made my stay there unbearable!
For me, I do not really trust the specialists in mental health because they are quick to diagnose and put one on medication.
This medication can have detrimental side-effects because doctors use a method of trial and error and when not supervised appropriately the medication can actually make one worse.
I would say a strong social support system is very important in the healing process of a mental health patient.
MEDICATION FOR MENTAL HEALTH CONDITIONS
Various medications are used to treat various mental health disorders;
however, specialists say there is a risk attached in seeking these medications at public health facilities.
According to psychologist Iani De Kock, although it is cheaper or even free to get medication at a public health center such as the state hospital the medication might not always be available.
“You might have stabilized on one medication but you won’t be able to get it for the next two months,” De Kock informed Confidente.
‘A majority of Namibians do not have access to private mental health care and due to that have to settle for state care which does not provide one with all the needs they require whether it be medication, rehabilitation or therapy.
Renowned psychologist Dr. Shaun Whittaker echoes De Kock sentiments however, according to Whittaker medication should only be used in the most extreme cases.
“I believe and studies have shown that a sufficient diet, a healthy lifestyle with healthy relationships and consistent exercise can do a lot for you than medication can,” Whittaker suggests.
THE COST OF MEDICINE
A mental health patient who chose to speak on condition of anonymity said he spends no less than N$ 4000 on the various medication to treat his depression, anxiety and sleeping disorder.
The legal profession by training lost his medical aid when he lost his job at one on Namibia’s leading parastatals.
According to him he had a drug abuse problem that de-generated into a mental health disorder even though he has been sober for the past eight years he says he still experiences the after effects of his over twenty years of alcohol and drug abuse.
VACANCY
“Yes treatment is expensive but I have to be on medication to save my life, I spent a lot but it is not as much compared to what I spent on my drug of choice which used to be cocaine, weed and alcohol.
ALCOHOL IS A DRUG
Alcoholism is broadly any drinking that results in significant mental or physical health problems.
According to Dr. Shaun Whittaker, alcohol is a serious problem in Namibia and needs to be treated not only as a societal, social or behavioral problem but a mental health condition that if not treated can only worsen with time.
‘One of the consequences of long term alcohol use is the development of Korsakoff Syndrome,’ Whittaker acknowledged.
Korsakoff syndrome is a disorder
of the central nervous system characterized by amnesia, deficits in explicit memory, and confabulation. This neurologic disorder is caused by a deficiency of Thiamine (vitamin B) in the brain and it is typically associated with and exacerbated by prolonged, excessive, ingestion of alcohol.
Whittaker suspects Korsakoff Syndrome is under-diagnosed in Namibia and a lot of people with the syndrome are diagnosed as schizophrenic.
“The other issue with alcoholism is traumatic brain injuries, often when people drink they tend to fight or are involved in motor-vehicle accidents which lead to traumatic brain injuries.
A lot of people get alcohol related black –outs not realizing this has to do with brain injury,’ Whittaker explained.
MISDIAGNOSIS
According to the journal of medical science, a misdiagnosis is any time a patient is diagnosed with an illness, injury, or any other condition that the patient does not actually have.
It is a wrong diagnosis!
The patient may have another condition that is similar to the misdiagnosed condition, but he or she may also not have any condition at all or at least not anything at all related to what has been diagnosed.
When the symptoms and lab tests lead a doctor to make a diagnosis that is not correct, it is called a misdiagnosis. Even if the correct diagnosis is eventually made, a misdiagnosis still occurred.
*Jonathan Blauuw, feels like he may have been misdiagnosed and he said the side-effects of the medication he was placed on included, sleep disturbance, severe weight gain, erectile dysfunction and kidney problems.
He also blamed doctors for over medicating him.
COLLUSION OF PSYCHIATRISTS AND PHARMACISTS
According to multiple sources in
the mental health space, there is suspicion and often rumors that mental health practitioners collude with pharmacists in order to increase sales in medication.
At the current moment in Namibia medical practitioners are not allowed to dispense medication.
Dr. Bernard Haufiku, the former Minister of Health told Confidente that this is a very serious allegation that cannot be taken lightly.
He however cautioned that mental health treatment is a complex practice and mental health patients who make such allegations should be approached with caution.
“There is legal reproach for any patient who feels aggrieved by the practices of a doctor however the onus would be on them to prove these allegations in a court and when the health practitioner provides the facts it may lead to serious implications
for those making such accusations,” Haufiku explained.
“Psychiatry is complex, for instance in the treatment of depression there
are five classes of medication that deal with different parts of the brain which would require a dose adjustment. That does not mean the doctor had mal- practiced but rather the patient did not respond well to the treatment,” Haufiku suggested.
The former minister further said mental health care requires a strong community based approach and Namibia in general and Africa by extension should invest in capacity building and fund research in the science of mental health in order to be able to address and treat it collectively.
“If a hospital does not even have a Panado how do you think that hospital could have the medication to treat something as complex as a mental health disorder,” he remarked.
MAKING MENTAL HEALTH AND WELL-BEING A GLOBAL PRIORITY
People with mental health disorders are often characterized as crazy. The stigma and rejection as a result can cause unintended harm which may lead to further mental health problems and in the worst case scenario the loss of life.
As the world observes this day Namibians should endeavor to make mental health a national priority.