Actress Adah Ameh’s passing is a wakeup call for Black Africans to take mental health seriously

By Hans Ngala

The passing of Nigerian Actress Adah Ameh on July 17, 2022, after prolonged depression, two years after the death of her lone daughter – is a wake-up call for Black Africans about mental health. The tragic death of Ameh proves that Black people are not immune to mental illness as was previously believed. It is also a clear indication that mental illness is not something that affects only poor people because the list of celebrities who have taken their own lives as a result of mental conditions such as depression, is inexhaustible.

 Africans have tended to treat mental illness as something that only affects white people, but statistics from the World Health Organization (WHO) indicate that 4 in every 10 people in low and middle-income countries (including Cameroon) suffer from mental illness.

Seeing the need to address the often-neglected domain of mental conditions, the Cameroon Baptist Convention (CBC) Health Services – Cameroon’s largest private healthcare organization, introduced mental health units in its major facilities.

Mental illness has become quite an issue in Cameroon following the onset of the Anglophone Crisis six years ago and is exacerbated by factors such as loud gunshots, kidnappings, and beheadings according to INTERSOS, an international NGO operating in the embattled region.

Also, research in the British medical journal, The Lancet; has shown that too much exposure to social media increases the chances of developing mental illness as social media tends to expose users to the lifestyles of their peers and idols who only publish the glamourous aspects of their lives, leading social media users to develop a sense of inadequacy.

It also revealed that exposure to pornographic material caused some men to have a false sense of what sex ought to be and their marriages did not do as well as the marriages of men who were not exposed to porn.

These are just some of the ways mental illness manifests, but what is mental illness?

Nangue Tekem Hermine, a psychiatric and mental health nurse at Ekoumdoum Baptist Hospital in Yaounde quotes a definition from the WHO which defines it as a “state of wellbeing in which an individual is able to identify his potential, cope with daily stressors and contribute to the development of his community”.

Our reporter Hans Ngala spoke with Nangue Hermine and below is a transcript of the full interview:

Hans: What are the common symptoms of mental illness?

Nangue: Mental illness can present in different forms. Some signs may be like those of physical conditions, including:

Headache

Multiple bodily sites pain

Changes in appetite/weight

Changes in sleep patterns (poor sleep or excessive sleep)

Fatigue

Persistent sadness

Loss of interest in pleasurable activities

Changes in behavior

Excessive thinking

Intense fear/worry

Neglect of personal hygiene

Incoherent speech

Hearing or seeing things that others don’t (hallucination)

Hans:  What are some examples of common mental illnesses we have in Cameroon, or the ones you people see commonly at the CBC Health Services?

Nangue: Mental illness exists all over the world. About 4 out of 10 persons in low and middle-income countries like Cameroon who need services for mental, neurological, and substance abuse conditions, do not receive them. Even when available, intervention is neither evidence-based nor of high quality.

Also, 4 out of 10 people coming for general consultation actually need psychological intervention. These figures are just to tell you how common mental illnesses are. Our mental health services operate in the form of a liaison psychiatric unit where patients are mostly seen on an out-patient basis or in the community during outreach and home visits. We see an average of 60 patients monthly. The most common types of mental illness present in our context include depression, anxiety disorders such as generalized anxiety, post-traumatic stress disorder (PTSD), panic attacks, psychosis, schizophrenia, bipolar disorder, dementia, substance use disorder (alcohol tobacco cannabis cocaine, etc) which is a fast-growing phenomenon among the youth and young adults.

Hans: What are the common causes of mental illness in Cameroon?

Nangue: It’s rather unfortunate that in this part of the world most people still associate mental illness with witchcraft, karma, or demonic possession. However, it is not the result of weakness or deficits in personality. It is rather the result of chemical imbalances in the brain. These representations of mental illness interfere with health-seeking behaviors and design inappropriate therapeutic itineraries which generally contribute to worsening of symptoms and poor prognosis. It is important to note that many persons with mental illness live a positive and productive life when on treatment, so early diagnosis and management make the difference.

On the other hand, mental illness has no respect for age, class, status, or sex. It can affect anyone at any time in their life.  Reports from WHO are clear that 1 out of every 4 people has a mental illness. In medical jargon we say the cause of mental illnesses is idiopathic, meaning there is no exact cause. However, we acknowledge the fact that a combination of factors contributes to its onset. These include genetics/heredity; meaning mental illness runs in some families. Others are caused by head trauma resulting from road accidents, brawls (fights), falls, etc. Some other cases are caused by congenital abnormalities or birth defects. Sometimes, some people get news that they have certain infections such as meningitis, syphilis, toxoplasmosis, HIV/AIDS, or cancer that can develop into mental illness. However, they forget that there is now effective treatment for something like HIV for example and those on treatment live healthy and normal lives like anyone else. In fact, we are all at risk of dying from a car accident than because of HIV, if we are on treatment. For others, mental illness comes from stress as a result of poverty, job loss, loss of property, and socio-political instabilities like in the Northwest and Southwest Regions of Cameroon. Substance abuse is one of the leading causes of mental illness among youths in Cameroon.

Hans: Why do Cameroonians find it hard to admit that they are mentally ill?

Nangue: Mental illnesses come with lots of emotional suffering, and pain associated with stigmatization, discrimination, and rejection which further interferes with help-seeking behavior, thereby increasing the risk of deliberate self-harm and even suicide.

Mental illness is real. It is not witchcraft as some pastors like to label it. It is simply abnormal functioning of the brain. In the same way, your kidneys can fail or you can develop a cardiac problem, and your brain can also have a dysfunction. Mental illnesses are treatable in hospital settings. Drugs are available and affordable and will help you live a fulfilled life.

There is nothing mysterious about mental illness as some pastors and witch doctors tend to present it. There is a huge lack of awareness about mental illness in Cameroon.

Hans: Oftentimes, suicide comes as a result of prolonged depression or other mental conditions. How can you tell that someone is being suicidal?

Nangue: They may keep talking about dying. They may use expressions like “I’m no longer going to be a burden to anyone”; “It is soon going to be over” and similar expressions. Also note that for every suicide, there had been at least twenty attempts.

Hans: On average, how much does treatment for mental illness cost?

Nangue: Mental care is very much affordable. Consultation fees range from FCFA 3,000 to FCFA 5,000. Generally, clients only need to refill their treatment when they are on long-term treatment. So it is difficult to say exactly how much treatment can cost. I have a client who just needs FCFA 900 for their monthly treatment, while others need up to FCFA 12,000 for their monthly treatment.

Hans: Social media is another thing that comes up a lot in relation to mental health. Is there any link between social media use and mental illness?

Nangue: We live in an era where you can find the good, the bad, and the ugly on social media. People are exposed to violent images with just a click. Alarmist information and predictions and misinformation that circulate on social media can generate a lot of fear and anxiety in some people or even worsen symptoms in those already struggling with mental illness. Also, doomscrolling or doomsurfing – the act of spending excessive amounts of screen time devoted to the absorption of negative news can aggravate mental illness. Increased consumption of predominantly negative news may result in harmful psychophysiological responses in some cases. Also, many persons are victims of cyberbullying and body shaming which can all trigger or worsen symptoms.

Hans: How long can it take for someone with a mental condition to return to normal after starting treatment?

Nangue: Just like physical illness, e.g. diabetes and hypertension, you cannot tell the exact duration. It depends on the diagnosis, the severity of the condition and the duration of the illness. What I know for sure is that early diagnosis simply makes the difference. Recovery depends very much on compliance and the availability of a good support system such as family and friends as well.

Hans: Where can those with mental illness find help in Cameroon?

Nangue: Mental health services are offered by Baptist Hospital Mutengene; Nkwen Baptist Hospital, Bamenda; Etoug-Ebe Baptist Hospital, Yaounde; Ekoumdoum Baptist Hospital, Yaounde; Mboppi Baptist Hospital, Douala; Jamot Hospital in Yaounde; Laquantinie Hospital, Douala and in almost all regional hospitals and some private clinics.