Assignment #16 - Irene Kim - Speech (Final)

Irene Kim

Matthew Logsdon

AP Language & Composition

15 December 2019

Witchcraft or Mental Illness?

Challenging the Stigma of Mental Health in Developing Countries

At age 17, Sitawa Wafula discovered she had bipolar disorder, epilepsy, and severe depression. When she came to her parents seeking sympathy and support, she was met instead with disappointment and disgust. Her community isolated her, attributing her manic episodes and unusual behavior to witchcraft. Instead of the treatment and reassurance that mental illness sufferers so desperately need, she was “shunned and ridiculed” (Wafula). Wafula comes from a small town in Kenya called Nairobi, where mental health awareness is lacking and the resources are virtually nonexistent. According to a national audit, in the entire population of Kenya, which accommodates nearly four million people, only 79 psychiatrists are at work, 50 of whom are open to the public. That’s one psychiatrist for every 80,000 people. 

As you can imagine, when Wafula’s parents sought medical help, her psychiatrist could not give her any information. Nothing about her illnesses, what side effects she could expect from her medication, how to handle her “manic and depressive bouts” (Wafula). This is because the psychiatrist, along with many others in Nairobi, was untrained and unaware of the significance of mental illness. 

And Kenya isn’t the only nation struggling with a lack of awareness. Developing countries all around the world, spanning east and west across the African continent to Asia, where India, the Middle East region, and several countries in the Southeast struggle to match the bare minimum of Western mental health standards.

Now obviously, the main goal is to elevate mental health resources, facilities, and trained professionals in developing countries. However, to do this, individuals must first be aware of what mental illnesses are and the gravity of them. That way, they become a priority for communities, governments, and the nation as a whole. So essentially, my speech will be in three parts. First, I will address the current stigma of mental health in developing countries, then provide solutions for gradually erasing this stigma, and then for allocating more resources towards mental health.

Now, believe it or not, there are a lot of counterarguments to the importance of mental health. Thomas Szasz, in his first publishing called The Myth of Mental Illness, argues that there is technically no such thing as mental illness. In his book, he defines ‘illness’ as a deviation from the norm. With mental illness, Szasz argues, there is no ‘norm.’ And therefore, we cannot diagnose a mental condition as a disease with complete accuracy. Szasz has a point. Most mental illnesses occur on a scale; it’s incredibly subjective. Where Szasz went wrong is that these conditions, no matter how variable or arbitrary, are still considered diseases. By dismissing a potential illness as invalid or unreal, we make it infinitely harder to find real treatments for them. 

My point is that in order to better treat mental disorders, we must first learn to erase our stigmas of those who have them. Lisa Pryor, a medical doctor and author for The New York Times, suggests a “nuanced discussion of mental health” to help educate the general public about mental disorders and foster a greater community acceptance towards them. She has a point--we won’t get anywhere by not talking about these things. During community gatherings or even one-on-one conversations, opening up the subject of mental health will help familiarize the issue to developing countries.

Sangu Delle knows this communication challenge very well. Currently a TED Speaker and health activist for the African community, he was once living in reclusive shame due to major stress and anxiety. Even more, when his friend was diagnosed with schizophrenia, people called him “mad” and said he had “gone mental” (Delle). These beliefs are deeply rooted within his community’s culture. Individuals in his Ghanian community, particularly males, are expected to suppress their emotions and deal with their problems. Delle felt ashamed, growing up with mental concerns in a community that dismissed them. He felt “suffocated by the rigid architecture of [his] African masculinity” (Delle). He quotes a study conducted by Arboleda-Florez, in which individuals in Nigeria were asked the question, “What is the cause of mental illness?” 34% responded drugs, 19% responded it was the will of God, and 12% attributed it to witchcraft and spiritual possession. Less than half understood the most likely and proven causes, including “genetics, socioeconomic status,” and traumas such as “war, conflict, or the loss of a loved one.” (Delle)

So now we’ve covered awareness, but what can we do to actually solve this problem? What can we do to increase the amount of resources, facilities, and trained mental professionals in the areas that need them? In the past decade, several people have spoken up. Christopher Szabo, a professor of psychiatry at the University of Witwatersrand, South Africa, conducted a two-year study on the effect of improved mental care facilities throughout South Africa. The project trained just six groups of mental care providers, each with 15 health professionals mentored in areas of psychiatry, psychology, occupational therapy, and nursing. The program also improved communication between each facility and created sustainable care to make it more accessible to the whole population. Even though the professionals were only briefly trained with basic skills of mental health care, it proved to be a far improvement from previous shortages.

Sitawa Wafula, the bipolar-afflicted teen that I mentioned earlier, has now become a passionate speaker against the stigma of mental illness in her home country of Kenya. She has taken action in her own way by creating a text and call hotline for those struggling with any mental issue, from medical disorders to couples therapy. Trained volunteer counselors respond immediately to concerns at no cost, via text. The process is quick and simple, but it’s helping millions.

So, here’s my final pitch. Developing countries struggle with a severe undersupply of mental health resources and awareness. But this isn’t just their problem. Help spread awareness by participating in global discussions and supporting new causes. Work towards a healthier global mental state by showing interest in worldwide mental care and voicing your concerns wherever possible. But most importantly, don’t be afraid to prioritize your mental health. As Sangu Delle says, “Speak up if you're struggling. Being honest about how we feel does not make us weak; it makes us human.” (Delle)

Annotated Bibliography

Benning, Tony B. “No Such Thing as Mental Illness? Critical Reflections on the Major Ideas and Legacy of Thomas Szasz.” BJPsych Bulletin vol. 40,6 (2016): 292-295. doi:10.1192/pb.bp.115.053249.

Delle, Sangu. “There’s No Shame in Taking Care of Your Mental Health.” TEDxLagos Conference, TED. Feb. 2017. Lecture.

Pryor, Lisa. “How to Have a Better Conversation About Mental Illness.” The New York Times, 11 July 2018, https://www.nytimes.com/2018/07/11/opinion/talking-about-mental-illness.html?searchResultPosition=1. Accessed 26 July 2019. 

Szabo, Christopher, et al. “Mental Health Leadership and Patient Access to Care: A Public-Private Initiative in South Africa.” International Journal of Mental Health Systems, vol. 11, no. 1, Sept. 2017, pp. 1–8.

Wafula, Sitawa. “When I was Diagnosed with Bipolar Disorder, People Thought I was Cursed.” National Public Radio, 5 July 2016. Accessed 25 July 2019. https://www.npr.org/sections/goatsandsoda/2016/07/05/477928132/when-i-was-diagnosed-with-bipolar-disorder-people-thought-i-was-cursed

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