The stigma of mental disabilities

Strange misconceptions crop up when the subject of persons living with disabilities comes up. People imagine all sorts of terrible things, usually very debilitating conditions.

That’s both true and false at the same time. Some disabilities are truly horrific. But most disabilities aren’t severe, and go unnoticed by the larger society.

What’s not obvious is that most people live with one kind of a disability, or another. I would go so far as to say the vast majority of people have at least one disability.

The most maligned – and misunderstood – disability is mental. This is especially so in countries like Kenya where taboo, mysticism, ignorance, and false spiritualities collide to create a stew of hate, fear, and ridicule.

Mental disorders are generally misunderstood in most societies. Even though one in every eight people on the planet has a mental disorder.

I would suggest that mental disorders are perhaps the most acute of all disabilities because they fundamentally affect one’s behaviour.

They manifest in significant disturbances in thought processes, distort one’s ability to regulate or totally cancel, incapacitate, or vacate one’s agency to control their behavior.

Mental infirmities can range from anxiety disorders to depression, bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia, eating disorders, disruptive behaviors or asocial disorders, and neurodevelopmental disorders, to mention a few.

Most of these conditions aren’t well understood, or diagnosed in most of those affected by them. Most people die without finding out.

The causes of mental disorders vary from one society to another. But most are a result of social dysfunction and inequities in a given society.

They may range from childhood abuse, trauma, or neglect to social isolation, discrimination and stigma from racism, misogyny, or ethnic exclusion to impoverishment, bereavement, stress, unemployment, homelessness, drug and alcohol abuse, bullying or domestic violence, gender-based violence, trauma from combat in wars, physical injuries, and birth defects or anatomical deficits.

This list is isn’t exhaustive. It’s a fact that there are many triggers for mental disorders depending upon the person’s fortitude, environment, inflexible or unhealthy traditions, aging, and cultural rigidities. In short, what will push one person over the edge may be ignored by another.

In the days of old – before colonialism – Africans had social structures and norms to address many avoidable causes of mental disorders. For example, post-partum depression which afflicts new mothers mostly because of social isolation in modern societies, wasn’t common.

That’s because new mothers were rarely alone. The task of raising a child wasn’t some lonesome effort in an isolated dankly apartment in a shady part of Nairobi. There was mirth and social celebration everywhere. In a manner of speaking, it took a village to raise a child.

Today, a new mother is left to her own devices without the cultural wisdom and knowledge of handling a new-born. No wonder some mothers, overwhelmed by it all commit suicide, or kill the baby.

Apart from the lack of diagnostic tools and the medical infrastructure to address mental disorders, there’s a terrible stigma associated with mental illness or disorders. There are virtually no stable medical facilities to deal with mental disorders in Kenya.

People who suffer the problem and their relatives are afraid to own, or acknowledge, it for fear of social condemnation, discrimination, and isolation.

Our schools are ill-equipped to address the mental challenges of the youth. Yet this is where we need the most intervention because the lives of youth are the most turbulent.

Many struggle with bullying, tress of school and poverty, sexual identity challenges, and our violent society. Instead, our youth are told these conditions are their moral fault and failing, weakness, and lack of discipline!

I’ve one enduring image seared in my mind from my youth growing up in Kitui. In Kitui Town, like every marketplace in post-colonial Africa, there were usually several people “idling” about because of mental infirmities. Usually unkempt, homeless, hungry, and filthy – these individuals were unwelcome fixtures in the town.

No one wanted to claim them. Even their families had disowned them. Normally, they would go about muttering to themselves.

Often, the town’s boys would throw debris at them. No adult would chastise the boys for such criminal conduct. That’s because the men – and the occasional woman – were regarded as “mad” or “bewitched.” They were seen as refuse or unwanted human garbage because they were “mad.”

Mental illness then, as now, was regarded as “madness” in most of Kenya. Hence the stigma that attaches to one for admitting to mental illness or seeking therapy for it.

In the meantime, suicide levels among the youth, the police, many high pressure jobs, and among the poor have skyrocketed in recent years.

School children are killing themselves at levels never seen before. Police officers are turning their guns on their spouses and on themselves at alarming rates. But our people aren’t “mad.” It’s our society that’s “mad” because it’s failed to destigmatize mental disorders and provide treatment and counseling devoid of judgement.

- Makau Mutua is SUNY Distinguished Professor and Margaret W. Wong Professor at Buffalo Law School, The State University of New York. @makaumutua.