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Opinions of Sunday, 19 October 2008

Columnist: GNA

Borderline Madness - Who Is Free?

A GNA Feature by Patricia Akpene Tegbe-Agbo

Accra, Oct. 18, GNA - Dzifa got down from her sleek VW Golf 5 car and took some calculated steps towards the doorsteps of Elikem her fianc=E9. She stopped midway her walk, clanged her arms as if holding on firmly to someone, and changed her steps. She beamed with contentment as she imagined walking down the aisle with her own Elikem to tie the nuptial knot in a matter of some hours.

She reminiscences how her mother among the lot would tease her and call her all sorts of names. She beams with smiles and bloats with this air of achievement all around her. After all, graduating with an MBA was no mean feat.

Above all, she is going to be a married woman, not to any man, but to her dream man- Elikem, a practising Chartered Marketer. At his sitting room, there is no sign of Elikem. She briskly walks upstairs towards his bedroom. The bedroom door is left ajar. She dips her hand into her bag and brings out a cute mirror. She pauses to take another look at herself in the mirror. To be double sure, Dzifa uses her immaculately manicured nails to straighten up her neatly ironed dress. She steals another quick glance at her face and adds a touch up to her lip-gloss, which appears to be fading. "I am now ok", she tells herself and confidently paces into the bedroom.

"Jesus"! She exclaims as she holds her head with both arms and closes her eyes tightly. There, on the bed, which she is yet to lie on was Elikem and a lady in action. "Eyram! You of all people? My best friend and my maid of honour? Having an affair with my boyfriend on the eve of our wedding?" Tears dripped down Dzifa's eyes as she starred at the two love-makers with utter dismay. She dashed out from the room and reached for her car and went home.

Dzifa meandered her way through the family members, who were busy with the final arrangements for the wedding. Even though she tried to put up an appearance, sadness was well written all over her. She sat at the extreme corner of her bed and wept hysterically. Her mother tried as hard as she could to console her to no avail prompting other family members to come in.

It was crystal clear that the wedding was no longer going to be. Her father, Mr. Agbezuge, an accomplished business tycoon whose name opened every door, would not take it likely with her daughter after the wedding was cancelled at the very last minute. His beef was that her daughter had ridiculed him. How were they going to inform all the very important personalities who were billed to attend the programme? In fact some of them have started arriving. Dzifa's mother had her own share of the 'disgrace'. Most of the women groups that she belonged to needed to be informed. Who would bell the cat?

To Dzifa, her heart was shredded, her dream shattered and her world torn apart. As if that was not enough her parents, who were concerned with the shame the cancellation of the wedding had smeared on their status, heaped insults on her at the least opportunity. The once cheerful Dzifa has become poignant. She stayed indoors most of the time and would not like to associate with anyone. She would be seen muttering some words to herself and would intermittently scream: "Ei Eyram" or "Ei Elikem".

The last time Dzifa was seen, she loitered around the Kwame Nkrumah Circle in tattered clothes. The onetime brilliant and well-behaved and adored lady was left to her fate. The parents have abandoned her and would not like to be associated with her. What a thin line between sanity and madness. Could her situation be salvaged if she had received the necessary support and counselling at the right time? This is not one of those fictions meant for your pleasurable reading only but also a story that would expose those 'little things' that we as Ghanaians take for granted when dealing with people with mental health issues and challenges.

Let us do this self-assessment before we proceed. Do you know anyone who has a mental health issue? How was your relationship with the person before the challenge? What about after that? Being frank with yourself, has your attitude changed toward the person? Was the change for the better or for the worse?

Many a mental health patient has a similar story just like Dzifa. Very stressful situations that they encountered and needed sympathy and support, but were rather met with very harsh responses not from any monsters but from us their compatriots.

This Writer has tried time and again to fathom why people who were once loved ones all of a sudden could become archenemies.

A Psychiatrist's View

A psychiatrist told this Writer recently that all were at risk of becoming mental health patients, as there was only a thin line between sanity and insanity. "Imagine someone who was involved in any form of accident that resulted in very severe head injuries. Or take for instance, someone, who had a serious disappointment resulting in very stressful condition.

Think of someone who has lost a dear one, property, money or something most valuable. Unfortunately, instead of such people receiving our encouragement, we rather condemn them as if what they were going through was under their control. This was why it has become crucial that we changed our attitude towards those who have become victims of circumstances. It could be any of us at anytime and at any place depending on which side of the coin is facing us.

One would not doubt the fact that some of the people with mental health problems caused it through their own acts of commissions or omissions. Take for instance people who indulge in drug and substance abuse. According to Dr Akwasi Osei, Medical Director and Chief Psychiatrist of the Accra Psychiatry Hospital, for last year alone, 594 (27 per cent) out of the 1,318 admissions were drug related, while at the Ankaful Hospital, 410 (26 per cent) out of the 1,569 admissions were drug related. These are huge percentages yet this represents only a tip of the iceberg as not all cases were reported to the medical institutions.

The plea is, it does not matter how one gets the mental health problem, we should show love and acceptance to them, as that could go a long way to mitigate the effects on the person, the society and the nation at large.

Mental Health Association

One might dare say that our hostility towards mental health patients was due to lack of knowledge. But thank God, a saviour has been born for us- the Ghana Mental Health Association (GMHA). After being in hibernation for a very long time after its formation some 46 years ago, the GMHA was re-launched in June this year. The Ghana Mental Health Association just like any voluntary organization according to Professor T, Asuni, and onetime Vice President of (Africa Region) World Federation for Mental Health, has several functions to fulfil in the society. These functions could be categorized into two.

The first parameter includes its roles in the community, hospital and other treatment facilities and its role with the Ministry of Health. The second function has to deal with prevention of mental illness. The GMHA has three levels in this area- primary prevention, secondary prevention and tertiary prevention. At the community level, the professionals, who are working in the Service within the hospitals are too pre-occupied with the service they are rendering, therefore, they may not have the time to devote to the education of the public as much as they would wish to do. Furthermore, even if they have the chance to do it, they are likely to present the situation in more technical terms that might be above the head of the public.

The intervention of an association of lay people between the professionals on one hand and the lay public on the other hand is most necessary so that the technical professional language could be interpreted in a way that would be understandable to the community. Another role of the GMHA is to educate the public where there is a general belief that mental health is due to superstitions and traditions, which are no more useful in present day life. The GMHA has the duty to disabuse the minds of the ordinary Ghanaian that psychiatry is only psychotic (madness).

It is an undisputable fact that the government and Ministry of Health much as they are willing to support, they cannot provide everything. The GMHA is, therefore, to supplement the efforts of the Government. They could also form pressure groups not only in the interest of the patients but also in the interest of the staff, who are at the service of these patients.

Another support, which the Association can provide for the hospital and its services, is the carrying out of research, not only in terms of monetary support but also in terms of participation. In the area of prevention at the primary level, the GMHA has the duty to prevent the occurrence of the illness. In the secondary prevention, early identification of mental health issues so that early treatment could be given. Tertiary prevention in simple terms is preventing the residual defects and disability that could be left behind by a disease process.

From Dzifa's story and the explanations given by the psychiatrists, it must be abundantly clear that mental health problems are not the preserve of any persons. It does not respect age, sex, academic or economic status, social class, looks or what have you. What makes it even horrifying is the fact that it is not predictable. It can thus happen to anyone and at any time. What we need to do is to show love to those who are victims by supporting the activities of the GMHA. Remember it could be you or someone close to you! 18 Oct. 08