The First Episode of Mental Illness.

The first time mental illness is diagnosed in a member of the family by the mental health team, it is usually a major life event laden with devastating emotional   experience for the patient and even the family members. Mental illness unlike others invariably get reported by the family members  unlike in  other diseases where certain signs and symptoms may readily lead the patient to seek medical attention  clarified  through  history taking, clinical examinations  and investigations . Mental illness occurs when an individual comes up with a pattern of behavior that is causing distress to such an individual as observed by the close relatives who may organize some form of attention but in our worldview when it comes to mental illness, orthodox medical practitioners are not of immediate consideration. Although the patient may explain the distressful behavior away as normal but the obvious distress is not only noticeable but constitutes a very devastating experience for the patient enough to impair his or her basic responsibility to self, immediate members of his family  and  the society at large. Most times, at the onset the relatives no matter how educated some could be, may support the patient to sustain the denial. At this point, close relatives may collaborate with the patient to put forward cultural and religious explanations for the distressful behavior, which invariably undermines the help- seeking strategy in the direction of the orthodox medical intervention. Majority of the first episodes of mental illness do not get to the hospital since the alternative practitioners are usually the immediate contact of intervention even for the educated ones. The patient can only receive proper orthodox intervention  as promptly as the significant others  can snap out of  the denial, accept the symptoms as due to mental illness  and come up with empirical strategies of intervention. Our cultural software overrides our empirical understanding of the illness and leads us into many other places before we snap out of the cultural hypnotism to seek orthodox medical intervention.

I think the denial that leads us in the waiting hands of culture and religion is traceable to the painful, not easily admissible experience of having a loved one come down with mental illness. Mental illness alters and dislocates the behavioral pattern of the patient that relatives have been acquainted with over time.  It is a nightmare to discover that someone you have had a wonderful relationship with over time is now estranged and can no longer interact intelligently again. It deals a painful blow to the overall experience of companionship with that individual. This becomes more traumatic when the illness is directed against the loved ones through   persecutory ideas and delusion. It is not a pleasant experience for a mentally ill husband to accuse a faithful, committed wife of infidelity in a very graphic and extremely persistent manner although without a rational basis that may require a professional clinical experience to identify. A good number of our untrained, religious marriage counselors may have been misled by delusions from mental illnesses in a marital conflict. Unfortunately, our culture feeds our religion with paranoia that invariably spill into our daily life experiences. Some wonderful and extended family relationships have been destroyed on this premise. Beyond the personal painful experience is the shame that the stigma of having a loved one with mental illness confers. Deriving from the sick role, there are certain embarrassing sanctions and discriminations that the family, apart from the patient, experiences. There are implication for marital and occupational opportunities where the discovery of history of mental illness may halt a marriage plan in our African culture. Other leadership conferment may also be jeopardized as a result.

All these reasons and many others affect the type of intervention that relatives organize for the first episode of mental illness in Africa. Relatives and other stakeholders in the care of the mentally ill wriggle through strong cultural software that distracts from seeking orthodox help early enough and promptly. Mental health advocacy should be directed towards this tendency of misdirecting the first episode of mental illness into the wrong hands. The earlier the orthodox medical intervention; the better is the outcome for such patient. Great populations of our mentally ill patients are locked up in spiritual homes and herbalist dens in sometimes dehumanizing conditions. When there is no prompt intervention; symptoms of mental illness impact adversely on the personality  leading to a poor sense of self, loss of  motivation and extreme withdrawal from social interactions such that such the individual becomes a ghost of his or her past which should not have been so  if prompt and orthodox  intervention has been promptly  instituted at the first episode.            

Dr. Adeoye Oyewole

adeoyewole2000@yahoo.com

+234 803 490 5808 (WhatsApp only)