This week was 'Mental Health Awareness Week' at Coe. I don't know if I have ever been so Coe-m sick.
I have had plenty of experience with the stigma that surrounds mental health issues. Therefore, in coming to Rwanda, I was very interested to see how a post-conflict nation addressed such problems. My hypothesis was that Rwanda would be far more accepting of mental health issues compared to the U.S. or even most of the world because practically every Rwandan has experienced a close death, or witnessed traumatizing events. I knew depression, PTSD, and anxiety had to be rampant in this society. My experience thus far has shown me that a high prevalence of problems does not indicate low stigma.
One of our speakers, Dr. Munyandamutsa Nasson, summarized the mental health scenario in Rwanda well when he said that people here are much more willing to accept that someone is struggling from trauma than an actual mental health diagnosis. I spent a significant amount of time thinking about that, as it frustrated me greatly. The doctor spoke of the genocide leaving people hopeless and mistrusting. These are two of the main characteristics of major depressive disorder. Yet, Rwandans as a whole refuse to acknowledge that one can experience those extreme feelings without having experienced something traumatic. What I learned from Rwanda is that ‘tangible pain’ is more than just physical. When you try to explain depression to someone, they often want to know what has happened in one’s life to make them depressed. In Rwanda, there is always a simple explanation for pain- the genocide. One need not say more.
This differs significantly from what I saw in Northern Uganda, partly because not everyone was affected directly by the conflict, the way people in Rwanda were. However, I was particularly interested in how mental health problems are dealt with in Uganda because so many victims of the conflicts are/were children. I was disappointed but not entirely surprised to hear that there was a severe lack of psychiatrists and therapists- only two in Northern Uganda. However, for me, that still does not justify the stigma that is clearly rampant.
When we visited the health center in a Patiko village, one of us students asked if former child soldiers were helped with mental issues there at the center. Quickly this became a conversation about those young people who attempt or commit suicide. Right before my eyes, professionals- doctors, nurses, politicians- were all laughing as they described the frequent suicide attempts. Never have I felt the stigma surrounding mental health as much as I did in that moment. The doctor said that when the person does not succeed in ending his or her life, they are sent to prison. One man said it was the same as manslaughter, so they obviously deserved to be punished.
I had to walk away from this conversation. However, on the bus ride home, I was sitting next to one of the politicians and thought about what I could possibly say to him regarding my thoughts on mental health. Finally, I was able to articulate a polite way of expressing my opinion. I told him that in my experience, someone who tries to take their life feels completely hopeless; therefore, I do not believe putting that person in prison will restore their hope. He responded, “maybe, but they will be alive”.
Clearly, he didn't get it. So many people don't, and it's not their fault. It is time to address the GLOBAL issue that is mental health stigma.
I have had plenty of experience with the stigma that surrounds mental health issues. Therefore, in coming to Rwanda, I was very interested to see how a post-conflict nation addressed such problems. My hypothesis was that Rwanda would be far more accepting of mental health issues compared to the U.S. or even most of the world because practically every Rwandan has experienced a close death, or witnessed traumatizing events. I knew depression, PTSD, and anxiety had to be rampant in this society. My experience thus far has shown me that a high prevalence of problems does not indicate low stigma.
One of our speakers, Dr. Munyandamutsa Nasson, summarized the mental health scenario in Rwanda well when he said that people here are much more willing to accept that someone is struggling from trauma than an actual mental health diagnosis. I spent a significant amount of time thinking about that, as it frustrated me greatly. The doctor spoke of the genocide leaving people hopeless and mistrusting. These are two of the main characteristics of major depressive disorder. Yet, Rwandans as a whole refuse to acknowledge that one can experience those extreme feelings without having experienced something traumatic. What I learned from Rwanda is that ‘tangible pain’ is more than just physical. When you try to explain depression to someone, they often want to know what has happened in one’s life to make them depressed. In Rwanda, there is always a simple explanation for pain- the genocide. One need not say more.
This differs significantly from what I saw in Northern Uganda, partly because not everyone was affected directly by the conflict, the way people in Rwanda were. However, I was particularly interested in how mental health problems are dealt with in Uganda because so many victims of the conflicts are/were children. I was disappointed but not entirely surprised to hear that there was a severe lack of psychiatrists and therapists- only two in Northern Uganda. However, for me, that still does not justify the stigma that is clearly rampant.
When we visited the health center in a Patiko village, one of us students asked if former child soldiers were helped with mental issues there at the center. Quickly this became a conversation about those young people who attempt or commit suicide. Right before my eyes, professionals- doctors, nurses, politicians- were all laughing as they described the frequent suicide attempts. Never have I felt the stigma surrounding mental health as much as I did in that moment. The doctor said that when the person does not succeed in ending his or her life, they are sent to prison. One man said it was the same as manslaughter, so they obviously deserved to be punished.
I had to walk away from this conversation. However, on the bus ride home, I was sitting next to one of the politicians and thought about what I could possibly say to him regarding my thoughts on mental health. Finally, I was able to articulate a polite way of expressing my opinion. I told him that in my experience, someone who tries to take their life feels completely hopeless; therefore, I do not believe putting that person in prison will restore their hope. He responded, “maybe, but they will be alive”.
Clearly, he didn't get it. So many people don't, and it's not their fault. It is time to address the GLOBAL issue that is mental health stigma.