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As discussed in previous articles, mental health is defined as a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a meaningful contribution to their community.

We all desire to be treated with dignity and respect by others in life. Unfortunately, those with mental health challenges often find themselves stripped of dignity and devalued in their families, communities, schools and workplaces. 

As we commemorate World Mental Health Day tomorrow (Tuesday October 10,) reflecting on this year’s theme, ‘Mental health is a universal human right’, may we consider how we can ensure dignity and respect for people living with mental health conditions.

What causes us to devalue and discriminate against those living with mental health challenges?

1. Fear and lack of understanding about mental health conditions

We often fear what we do not understand and increased knowledge and understanding about mental health problems is an effective tool to fight stigma at individual, family and community level. Greater awareness about mental health challenges will lead to earlier identification of problems and normalise seeking of prompt care.

2. Stigma

Stigma has been described as a state of being discredited and seen as of lesser value than others due to who you are or due to a condition you may have.

· Public stigma

This occurs when the family and community holds a generally negative view of mental health illness. Those affected by mental illness are seen as less valuable or defective. This can lead to discrimination and ill treatment of those who disclose their mental health challenges. 

· Structural stigma

The negative views and attitudes about mental health can influence the policies around mental health, the funding or investment towards mental health care, the structure of mental health services and quality of mental health care. Even at an international level, mental health is often side lined in terms of funding and support. 

Health workers can sadly  perpetuate mental health stigma through poor knowledge and understanding about mental health problems, limited skills in identifying mental health problems correctly, use of discriminating language and negative attitudes towards those with mental health challenges. 

· Internal or self-stigma

Public and structural stigma can result in an individual who is struggling with their mental health viewing themselves as ‘less than’ or less valuable than others because of their mental health challenges. This is known as self-stigma and can make it difficult for someone with a mental health problem to open up and seek for help.

· Stigma by association

The negative attitudes that an individual with mental health challenges experiences from others can be extended to family members, friends and other people close to them. Caregivers of those with mental health problems are often affected by this stigma and are often overlooked in terms of psychological support. Mental health workers who work with those with mental health challenges can also experience this kind of stigma.

3. Erroneous beliefs and stereotypes

There are many beliefs in our communities about causes of mental illness; beliefs that all people with mental illness are violent, beliefs that people with mental health conditions are weak or ill-disciplined and beliefs that mental illnesses are not genuine health problems deserving of psychosocial and medical care.

4. The influence of media

Negative portrayals of mental illness in news articles, television shows and entertainment programmes can influence how people with mental illness are perceived and treated in the community.

5. Language used about mental ill health in the community

Terms such as ‘crazy’, ‘going mad’, ‘going nuts’ that are used to describe mental illness in communities can result in stigma, discrimination and undignified treatment of people living with mental health conditions.

6. Poor social support, leading to poor quality of life 

Discrimination in families and communities can result in deterioration of quality of life of those living with mental illness. This can result in further undignified treatment of those with mental health conditions in communities as they are shunned and shamed in society.

What is the impact of undignified treatment of people living with mental health conditions?

· Low self-confidence and feelings of worthlessness.

· Fear and anxiety about people finding out about our mental health challenges.

· Fear of discrimination and change of status in our families, communities and workplaces.

· Loss of livelihood due to discrimination.

·  Family strain due to some members misunderstanding one’s mental health condition.

· Poor health seeking behaviour as we hide our symptoms and avoid mental health services for fear of stigma and discrimination.

· Underinvestment in mental health services if the conditions are not seen as important as other health problems leading to limited access to quality care for those in need.

How can we ensure that people living with mental health conditions are treated with dignity?

· Increased community awareness about mental health problems to improve understanding, decrease stigma and discrimination against those with mental health conditions.

· Creating psychologically safe families, communities and health care systems that are responsive to the needs of those living with mental health conditions.

· Increased investment in the mental health care services to improve access to quality and dignified mental health care

· Telling our own stories about mental health challenges.

Many of us have had mental health challenges and telling our story can help to change attitudes and beliefs about mental health problems. 

Sharing our story can help others struggling with mental health problems not to feel so isolated and alone. Telling our story can also help give others courage to reach out and get help.

If you or someone that you know may be struggling with a mental health condition, please contact your nearest healthcare provider and get help.

Association of Healthcare Funders of Zimbabwe (AHFoZ) article written by Dr Chido Rwafa Madzvamutse, Consultant Psychiatrist.

Feedback: (Dr. Chido Rwafa Madzvamutse Whatsapp+263714987729) (www.ahfoz.org <http://www.ahfoz.org>; [email protected]