The World Health Organisation has been regularly urging the developing world to look for new initiatives and programmes targeting mental health care in their public health services. But many nations in the African continent are hard pressed for funds to rise to the challenge before them.
Like elsewhere in the third world, visitors to Zambia could observe in the capital city of Lusaka hundreds of persons walking aimlessly along the roads, talking to themselves or shouting at others, carrying huge waste-collecting baskets and at times intimidating other pedestrians.
It could be schizophrenia, psychotic episodes, alcohol-related wildness or organic brain syndromes, any kind of mental disorder plaguing the country. Divorce, substance addiction, unemployment, even extreme religious beliefs in some cases result in mental disorder, experts say.
Head injuries from traffic accidents and neurological complications arising brain infection are the other factors cited. On top of it, those suffering from mental illnesses are stigmatised, scorned, condemned and ostracised. Only the aged, who have memory lapses, are exempted from this social stigma. The presence of an extended family takes care of the older citizens suffering from dementia and depression for which treatment is given at home itself. Of course, the more serious cases are recommended to mental health centres.
Zambia has only one mental hospital in Chainama Hills. And there is only one practising psychiatrist for the whole country. The 560 bedded hospital, armed with a small force of trained personnel, do what they can to treat psychiatric patients from across the country.
The situation is not different in the case of psychologists, occupational therapists and counselors and the like. here has been a steady decline in the number of frontline mental health workers over the years.
Two reasons are cited - retirement of skilled professionals, and more importantly, the brain drain, whereby the skilled leave the country for better paying jobs abroad. The dearth of training institutions is another contributory factor. Realizing the gravity of the situation, the Zambian Government has committed itself to tackling the problem throwing in whatever resources it could muster.
It is in the process of revising the 1951 Mental Disorders Act, which refers to mentally ill persons as idiots, imbeciles and invalids. The revised Act will define both the legal rights and treatment procedures of mental patients. At present, any patient seeking admission to Chainama, the only mental hospital in the country, has to get a detention order from the magistrate.
Detention orders pertain to the withdrawal of human rights of someone for 14 days. The Government is doing away with this procedure. If there has to be any detention order, it has to come from the medical practitioner who knows the patients well.
Working in association with the WHO Health Promotions Office, the Zambian Government is trying to update mental health care policy in line with the health and human rights related United Nations Millennium Development Goals.