On “Because WE matter” a series on Child and Youth Mental Health by Dr. Nneka Orakwue-Ononye, a Child and Youth Psychiatrist, Assistant Clinical Professor at the University of Calgary, Canada.
…….Mental illness-related stigma among youth
In the last edition, we highlighted the World Health Organisation (WHO) definition of mental health….” a state of psychological, emotional, and social well-being allowing an individual to function and cope with everyday life stressors, relate to and contribute to his community”. It is not the mere absence of a mental disorder. This definition infers that every individual is unique in how they may process and navigate life’s challenges. There is indeed no health without mental health (WHO)
An individual’s mental health status can range from having minimal challenges to significant challenges which can cause serious impairment in daily functioning. Such impairment may lead to the diagnosis of a mental disorder such as depression, anxiety, or substance abuse. The brain processes stress differently, depending on factors such as genetic vulnerabilities and environmental factors. It is important to understand no two individuals will respond the same even when faced with similar challenges.
Every young person needs a stable environment to aid brain development. Exposure to traumatic events in early life such as neglect, and emotional, physical, or sexual abuse, can cause ‘toxic stress’ to the young brain and affects how an individual navigates life. A stable environment supports a growing child in building resilience and adequate adaptation to their environment while equipping them with the skills relevant for coping with subsequent life stressors. The expression of mental health problems generally depends on the degree of impact of the stress and the stress response.
According to WHO, about 1 in 5, people will develop a mental illness, and up to 70% of these are diagnosed before the age of 25, implying that a lot of our young people are currently dealing with one form of mental illness or the other. Studies have shown that up to 85% of people with mental health disorders do not have access to treatment in developing countries which is an alarming and disheartening percentage considering the economic impact of mental disorders (WHO 2011). The good news is that early intervention can support stabilization and improve functioning.
Stigma is one of the most significant barriers to accessing and utilizing support promptly. In some developing countries, including Nigeria, this remains an issue despite civilization. It is the notion that most people living with mental illness are dangerous, possessed, or cursed, which leads to resorting to alternative means like religious or traditional interventions to deal with mental illness. The reality remains that stigma gets in the way of individuals acknowledging mental illness.
Stigma implies a negative attitude towards individuals living with mental health conditions. It is typically a result of a poor understanding of mental illness and could be institutional, public, or self-directed leading to low self-esteem. Media representation of mental illness equally plays a huge role in understanding mental health and contributes to stigma. Various aspects of stigma may include labeling, exclusion, discrimination, neglect, and prejudice, which increases the burden of living with a mental illness through fear, shame, and uncertainties. Stigma may have widespread implications, particularly for youth, as likely to impact their identity and development of a healthy sense of self. Young people are less inclined to seek support for mental health-related issues because of stigma.
A good starting point is to debunk some of the myths around mental illness, particularly in youth:
- No one is immune to mental health issues. Children are not too young to experience mental health issues such as depression, anxiety, and suicidal thoughts.
- Mental illness does not automatically make an individual dangerous or violent. Less than 5% of violent acts result from mental illness; on the contrary, individuals with mental health issues are vulnerable and possibly more prone to victimization.
- Mental illness in youth is not a result of poor parenting.
- A childhood diagnosis of mental illness does not imply an individual will not be successful or fulfilled in later years.
- Mental illness is not a result of weakness or a bad attitude.
- Young people with mental illness can benefit from treatment and are not likely to “grow out of it” without the right treatment.
- Young people are not just ‘being teenagers’ or ‘having mood swings’; they may be struggling with something more serious that needs attention.
We can all work together to minimize stigma by:
- Promoting community mental health education and awareness programs.
- Encouraging people to speak up about their challenges without fear of being ridiculed.
- Respecting confidentiality when people confide in us about their mental health issues.
- Being mindful of the language we use in addressing mental health issues.
- Calling out individuals who stigmatize others living with mental health problems.
- Being compassionate and encouraging individuals/families living with mental illness by sharing recovery stories
Alongside parents, teachers remain partners in the care of youth. Teachers can be agents of change if empowered with identifying signs of mental health conditions in childhood and minimize stigma. The introduction of mental health promotion and literacy programs in African schools will go a long way. It will help young people identify and report any mental health-related concerns, and improve understanding amongst peers to further reduce stigma. The widely used social media platforms could also be a channel for delivering education about mental illness. Recovery is a known outcome of mental illness, and early identification from a young age will undoubtedly enhance results. A recent publication by UNICEF, ‘the state of the World’s Children 2021 ON MY MIND,’ put out an action call to support parents and schools so they can better help our youth. As a nation, we cannot keep hiding our heads in the sand. Mental illness is real and more importantly treatable. Let’s join hands in destigmatizing mental illness, especially amongst youth, BECAUSE THEY MATTER!
