Pathway to full Recovery from Mental Illness



Our society is very primitive both in terms of infrastructure and leadership development. Evolutionists assist us in rationalizing our mediocrity in this part of the world by staging the reason of an endowed, conducive geographical environment as the basis for our complacency. Despite our oil wealth; leadership over the years in Nigeria has not been able to transcend itself. Locked up and imprisoned by primitive appetites, the political elites of this country from independence till date have not been able to develop a robust and functional social welfare system, especially for the vulnerable. 

Having experienced both the military and democratic systems of government, it is very clear that our problem as a nation is not the system of government but the thieving elite class that got fixated at the survival plane of the hierarchy of needs resulting in poorly developed social welfare facilities. Massive looting and corruption by the leadership class diverted funds that could have been used for sound social welfare programmes into private pockets to build houses they may never live in while thousands are homeless and mentally ill. 

Apart from the paucity of social welfare programs which could have taken care of the mentally ill upon discharge, potent factors that could reenact illness, precipitate and perpetuate it are epidemic.
Unemployment, poor socioeconomic condition, poor housing, insecurity are a few of those factors that our stable mentally ill patients that have recovered insight are discharged into which invariably guarantees a relapse. This may answer the question folks ask about whether psychiatric patients actually get well since the recovery from mental illness is not just a clinical event alone in a sheltered environment but a continuous process of reclaiming lost grounds from the mind with respect to the emotional, social, economic and physical dimensions of their lives. Even for those without the history of mental illness, our present socioeconomic circumstance is capable of collapsing the most adaptive coping mechanisms and tilt folks into mental illness. 

Borrowing strongly from the clinical paradigm, relatives are tempted to think that once the patient recovers from an episode of mental illness, behaves normally and takes the prescribed drugs then we can relent. Paradoxically, this is the beginning of another therapeutic process in the journey of recovery. In the developed countries, community based psychiatric practice is robustly developed where competent social workers and duly trained community mental health practitioners follow up discharged psychiatric patients into the community. Through this service, drugs are promptly served and early signs of relapse are noted for immediate intervention. Beyond the clinical services; the social workers who are also part of the team usually help to sort out varied socioeconomic difficulties that are capable of inducing relapse in the patients. Issues of housing, employment and economic sustenance are effectively taken care of in this programme.

In Nigeria, even folks who are fully engaged in a relevant job in the civil service may not be paid for 8 months without any social welfare package talkless of the mentally ill who are still being persecuted at work and being daily threatened to be laid off since they are viewed as unproductive and economic liabilities apart from other forms of discrimination in the society at large. The relatives of the newly discharged patient must take responsibility for providing the social welfare facilities for the ultimate recovery of the patient. Unlike patients discharged from other medical units where drug compliance and clinic attendance are the major issues, families of discharged psychiatric patients in a country like Nigeria must hold meetings to formulate a strategy to empower the patient. Socioeconomic factors, marital stability for those that are married, marital prospects for those not yet married, returning to a place of employment after being discharged, decent housing are part of the factors that promote ultimate recovery. 

It is obvious that our governments cannot immediately provide all of these as it is done in the developed countries through a robust community mental health programme, families therefore in our present circumstance should fill in this gap and institute a robust and effective rehabilitative programme. The acquisition of insight by the patient at discharge equips the patient to engage his / her world afresh assisted by adherence to other clinical prescriptions and advice. Insight into the illness provides a rational interactive template between the patient and the therapeutic community with the ultimate goal of recovery. This should be the responsibility of the family making creative use of the cultural value of our sense of kinship in the extended family system while we encourage, persuade and assist our governments at all levels to institute a robust community mental health program. 

Dr Adeoye Oyewole

adeoyewole2000@yahoo.com

+234 803 490 5808 (WhatsApp Only)


Comments

  1. It's like something is wrong with our part of the world. Virtually everything we're not getting right, how won't someone owed several months of salary arrears go into relapse after discharge. We're just contributing to the erroneous belief that once mentally ill patient cannot fully recover .

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  2. Hey, very nice blog. I came across this on Google, and I am stoked that I did. I will definitely be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment. Thanks for sharing.

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