CHAPTER ONE
Introduction
Background to the Study
Mental illness remains one of the major health problems globally and in some developing countries like Nigeria, the situation is aggravated by beliefs. Mahto, Verma, Verma, Singh, Chaudharmy and Shantna (2009) observed that mental illness is common, affecting more than 25 per cent of all people at some times during their lives. World Health Organization – WHO (2001) stated that 450 million people suffer mental health disorder. Out of this number, 40 million people suffer severe forms of mental illness such as schizophrenia and dementia and 200 million are incapacitated by less severe mental and neurological disorders such as anxiety. Similarly, Kabir, Zubair, Isa, Abubakar and Aliyu (2004) reported that 20 per cent of all patients seen by primary health care providers have one or more mental health disorder. Mental illness affects people of all gender, ages, regions, socioeconomic status and societies. In America, one in four adults- approximately 57.7 million people experience a mental health disorder in a given year and one in 17 people live with serious mental illness such as schizophrenia and major depression (National Alliance on Mental Health, 2006). It further revealed that the direct cost of mental health services, which includes spending on treatment and rehabilitation, is estimated at $69 billion in the United States while the indirect cost, which refers to loss of productivity at the workplace, school, and home, are $78.6 billion. In Nigeria, there is paucity of data, however, World Health Organization – WHO (2001) reported that 20 per cent of Nigerians suffer mental illness meaning that there are millions of Nigerians suffering from this scourge.
An illness is unhealthy condition of the body and mind. Houghton (2004) defined illness as a medical condition that disrupts or impairs normal physiological function affecting part or all of an organism. Illness can be seen as how an individual respond to disease or impairment and this might enable the person to take action aimed at bringing relief and cure of the illness. Ability of an individual to recognize onset of illness often depends on the severity and widely held views about the condition. Culturally, our opinion towards illness varies and some people through childhood are trained to ignore some symptoms, while others are told to resort to faith-healing or other methods (Ewuzie, 2006). Although an ill person is expected to seek relief or cure for the ailment, sometimes the individual may be ill advice or there may be denial and failure to acknowledge the need for treatment especially when it involves mental illness.
Mental illness is a disturbance of the mind and emotion. Cohen and Kleiman (2009), referred to mental illness as a wide variety of disorders ranging from those that cause mild distress to those that severely impairs a person’s ability to function. From the view point of Ewhrudjakor (2009), mental illness is a disorder of one or more of the functions of the mind such as emotion, perception, memory or thought which causes suffering, to the person and embarrassment to the family and society. People suffering from mental illness exhibit limitations in everyday functioning which include difficulty with interpersonal situations, problem coping with stress, difficulty concentrating and lack of energy or initiative. Mental illness is conceived as a wide variety of disorders ranging from mild distress to very severe forms of illness that severely impairs with a person’s ability to function effectively in the community. The severity and the level of maladjustment determine the classification of mental illness.
Mental illness may be classified in different ways. Owuka (1994), classified mental illness as psychosis and neurosis based on severity. Psychosis according to him is a serious form of mental illness in which the individual is totally disorganized, looses touch with reality and lacks insight into his condition. Such conditions include organic psychosis and functional psychosis. Neurosis, he further stated is a mild form of mental illness in which an individual has insight to his condition, is in touch with reality and able to seek help to solve his problem and examples of neurotic conditions are anxiety neurosis, hysteria, phobias, obessional conditions and reactive depression. Makuolu (2012) noted that mental illness covers a wide range of diagnosable disorders. Such disorders include schizophrenia, affective disorders, alcohol and drug use disorder, obsessive compulsive state, dementia, behavioural and emotional disorder of childhood and adolescents. Mental illness is not caused by a single factor.
Several factors may impact on the development of mental illness. Kishore, Mukherjee, Parashre, Jiloha and Ingle (2007) observed that mental illness arises from a combination of complex interaction of genetic, biological, personality and environmental factors. American Psychiatric Association (2000) identified psychological trauma emanating from childhood, medical conditions such as brain damage, stroke, brain tumor, degenerative diseases, deficiencies in diet and effects of drugs as other causes of mental illness. Severe mental illness alters a person’s life dramatically. Persons with mental illness can experience symptoms and distress that can make it difficult for them to hold job, go to school, relate with others or cope with routine daily chores.
A number of symptoms have been associated with mental illness. Cohen and Kleiman (2009) stated that a person with mental illness may exhibit marked personality changes, inability to cope with problems and daily activities, prolonged depression and apathy. Other symptoms include marked changes in eating and sleeping patterns, thinking or talking too much, hallucinations, neglect of personal hygiene, extreme moods – high or low, excessive anger and hostility or violent behaviour. The bevaviour of a person suffering from mental illness may be bizarre and there might be expression of strange ideas which might be a departure from the standard norms of behaviour acceptable to the society (Owuka, 1994). If detected early, a person with mental illness can successfully be treated.
Mental health professionals use a number of methods to treat the condition. Cohen and Kleiman (2009) revealed that the most common method of treatment of the mentally challenged persons are drug and psychotherapy .In drug therapy according to them, a person takes regular doses of prescription medication intended to reduce the symptoms of mental illness while psycho-therapy is used in the treatment of mental illness through verbal and non verbal communication between the patient and a trained professional. Other treatment options used are electroconvulsive therapy, and surgery. When adequate information is given to adults on mental health, it will help them to minimize situations which can lead to mental illness.
The mentally ill person faces challenges in their environment because they are more likely to be exposed to misconceptions on account of their condition of health. Angermeyer and Dietrich (2006) opined that community beliefs relating to causation, treatment and prevention are the main social-cultural factors that can influence the outcome of mental illness. Studies carried out by Sharma (1998), Mohammed and Mohammed (2008) showed that African societies have a peculiar attitude towards the mentally ill persons and this is evident in rejection, scornful dispositions and negative beliefs. Quimi (2007) held that people tend to react in a very discriminating way towards the mentally ill. This is why Adewuya and Makanjola (2008) stated that wrong views about mental illness is widespread in Nigeria and has led to situations where people seek medicare in spiritual houses and asylums which further impair recovery and social integration. Persons with mental illness may be regarded as irresponsible, violent and difficult to get along with. It is often seen as result of bad parenting and the depressed are perceived as having personality weakness or character flaw. The mentally ill are addressed in derogatory languages, served food with unimaginable plates and given used clothes to wear.
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