By Arret Jatta
In The Gambia, mental health remains largely stigmatized and neglected leaving many individuals to navigate their struggles in silence.
The World Health Organization (WHO) defines mental health as a state of well-being that includes the ability to realize one’s abilities, cope with normal life stresses, work productively and contribute to one’s community. Mental health affects how we think, feel and act, and also influences how we handle stress, relate to others, and make choices.
A situational analysis of mental health conducted by the Mental Health Leadership and Advocacy Program (MHLAP) in the Gambia in 2012 revealed that, of an estimated population of 1.478 million people, approximately 120,000 had a mental disorder. Global Burden of Disease (GBD) statistics from 2017 indicated that more than 34 percent of Gambians have a depressive disorder and 35.9 percent have an anxiety disorder.
Mental disorder is believed to be highly prevalent in the Gambia with the country’s mental health care infrastructure largely inadequate. Moreover, there is a very low level of social networking and lack of community support systems. These conditions leave many people battling with depression, anxiety, and other conditions of mental disorder with little room to access efficient and effective therapeutic support and rehabilitation.
Fatou Njie (not her name) 27 is one of the many Gambians who had a mental health challenge. But she described her experience as a “nightmare.”
Unlike many Gambians silently battling with their mental challenges, Fatou is seeking therapeutic support.
She explained how social and cultural stigma and inadequate support for mental health in the Gambia frustrated her quest for rehabilitation.
“In our society, people with mental disorders and mental illness are largely discriminated against. Society would call you all sorts of names. My experience was a horrible one. But I was a strong woman who fought so hard to stay strong and associate with people around me.”
Fatou adds; “I always prefer to isolate. And it got to a point that my social life was negatively affected. I didn’t want to associate with anybody. At first my parents didn’t understand my situation. It was difficult because living with people, they may not understand at times and some would probably think you are just being rude or trying to associate you with other things. That really makes it hard for victims to open up about what they are going through.
She attributed her mental health struggles to the passing of her father whose death traumatized her life.
“I was so close to my dad. He passed unexpectedly and his death left me emptied. my mother was alive but I was really close to daddy and so after he left this world, I lost a big part of me. After his death his relatives came and took away all his belongings leaving my mother and I in a dire situation. No one supported us, no one was there for us” Fatou recalled with tears flowing from her eyes. “I struggled to complete my high school. There was nobody from my father’s relatives to pay for my school dues. I waited and they never came through. I grew up with that trauma, in that distressful state of life. It affected me a lot and at some point I hated most of them.”
Fatou is now undergoing psychosocial support. She said it is helping her overcome her mental problems and to live happily.
“I am trying to contend with those difficult circumstances and understanding that they are destined to happen. I have come to understand so many things and how to control them,” she stated.
Fatou also recounted how she attended a discussion about mental health and came to notice the presence of all the signs and symptoms mentioned there in her behaviour.
“The resource person of the programme realized my tribulations and he approached me to advise that I should seek therapeutic support and that was how I started the process” she said. “I learned a lot about a lot of coping mechanisms; to stop self isolation, and socialize with people more often. It is helpful, and I was also advised to sleep instead of overthinking. After sleeping I wake up feeling better and also writing about my daily life, I do that a lot and it helps.”
“We have a lot of mentally challenged people, when they were helped at an early stage, they would probably not end up like that. Also I think we should be talking to people and stop judging them based on their appearance. Let us accept each other the way we see each other and be kind to one another because your kindness can go a long way,” she urged.
Mental health can have a variety of symptoms and signs and some of them are not recognized.
According to Silvia Lorenzo Jawneh, a practicing psychologist, the common signs and symptoms of mental health noticed in many Gambians are; low mood, feeling of withdrawal and isolation, anxiety, overthinking, depression, lack of confidence and self esteem, lack of settling boundaries in relationships (family, social and romantic) fear of judgment and difficulty in sleeping. “Most of my patients are experiencing mental health issues but without having a mental health condition. So when one has a mental health condition, it means they are sick and it can lead to one not functioning properly.”
Silva pointed out that individuals’ living habits and lifestyles can also influence their mental health and well-being. “In the Gambia, I see a lot of individuals trying to please people and it reaches a point that they are not living for themselves. And it is important to get in touch with ourselves and how we can satisfy our needs. Our sleeping and eating routine also influences our mental health and lack of movement and exercise, the lack of healthy boundaries.”
She lamented how mental health is neglected in the Gambia and blames the government for paying less attention to it.
“People don’t know much about mental health, they only understand mental illnesses which are incorrect.”
Emphasizing the importance of seeking and accessing therapy in mental health, Silvia added that; “going to therapy is to have a safe space where you can open up about what you are going through without being judged, threatened or feel uncomfortable. The therapist is supposed to make you feel okay and accompanied. These journeys also help a patient to see the light in the darkness. But people need to change their mindset and approach to mental health. We need to normalize it and understand it is part of us and it is everyone’s business.”
Health Minister Dr Ahmed Lamin Samateh in response to a question by Banjul North Modou Lamin Bah in the National Assembly earlier this month disclosed that the government is working to introduce a mental health bill.
Minister Samateh, however, stated that upon submission to the cabinet for subsequent discussions, it was realized that there were gaps in consultations during the development process of the bill.
He explained that this warrants a final stakeholder consultation to incorporate the views and ideas before it is presented to the National Assembly.
Fatou’s experience serves as a powerful reminder of the importance of addressing mental health. Giving support and recognition to the victims and the struggles that they face, we can dismantle the social and cultural stigma that often prevents people from seeking the help they require. Together, we can foster a culture of understanding and support, paving the way for a healthier future for all and ensure everyone feels valued and their voices are heard.
