This essay is taken from Brainstorm’s second e-book, (In)Sanity: What “Crazy” Looks Like, which is on mental health in Kenya and is available for free. DOWNLOAD IT HERE to read more such essays.
by Kevin Rigathi
In Kenya, we want the best for the mentally ill. It’s not a debate. It’s not controversial. We all agree that they should have our support. Ask anyone and you’ll get the same answer. We should help them.
Unfortunately, we don’t all agree on how we should go about giving that help.
Even more unfortunate, we don’t even agree on what classifies as a mental illness.
If you’re screaming and ripping apart your clothes in the street then you pass the social test fully certified. Your credentials have been verified. You may be on your way you mad naked man. You are indeed mentally ill.
However, if your condition is not quite so obvious then you’re going to run into some resistance. You will find that people have a list of expressions in store just for you. A language for the mentally ill. Are you depressed, bipolar or suffering from some other form of anxiety disorder? Then you can count on some phrases working their way into the conversation.
It’s all in your mind. It’s not that big a deal. You just need to ignore it.
Worse still, if you have the temerity to actually have an eating disorder like anorexia or bulimia, then not only will you not be considered mentally ill. You’re…
An attention seeker. A spoilt brat. Ungrateful for what you have.
The prevalent opinion seems to be that if it is not plain and clear then it is not truly mental illness. It is not an issue about your health but, at the most charitable, something you can overpower with nothing more than will. Because it is in the mind, it is less real. Less harmful. Less in need of real attention. And when you try protest this point of view that’s when they will trot out the next phrase in the list.
Just get over it!
Every time I hear someone say this I’m tempted to grab a shovel, whack them over the head and (quite sympathetically) say “don’t worry about it. It’s all in your body. Just ignore it. You’ll get over it.” Unfortunately, shovels are never lying around when you need them and I don’t have that kind of courage anyway. Also, that’s not the right way to deal with things (or so I’m told).
I understand that this reaction to mental illness is a lot less sinister than it comes across. It is not moustache twirling villainy that leads people here. It is the consequence of bad lessons. Cultural assumptions that have shaped who we are more than we’d like to admit. When they say these things they actually think they’re helping. It’s just tough love. I know this because I was once one of those people.
It’s not that hard to understand when you think about it. Every one of us has picked up habits and mannerisms without knowing where we got them and we all hold some things to be true without knowing why. It’s part of life. I’d even go so far as to say that it is not the problem. The problem comes about when it’s time to let go of those false beliefs. We talk a big game about wanting change (ask Obama) but when it’s time to actually walk down that road we’re a little more hesitant.
When it comes to mental health, the reason many of us are so reluctant to change our minds can be chalked down to how we see ourselves. We’re the good guys. To admit that some of these people have legitimate problems is for most of us an admission that we’ve behaved poorly. An admission that we may have failed them. That we may have been cruel. That we may have made things worse. In the end, it is so much easier to imagine that they are either weak or spoilt isn’t it? Even the simple things, like admitting many of us use the word ‘retarded’ offensively, become a massive problem. We could easily change how we talk but the effort of arguing that it’s not offensive seems worth never facing the implications that we’ve been wrong all this time.
It’s called the Semmelweis reflex. The stubborn refusal to acknowledge fault because it supplants what we’ve always known and done, especially if it means you’ve been at fault. The reflex is named for Ignaz Semmelweis, a doctor from the 1800s. His claim to fame was discovering and putting forward an idea that seems so obvious to the modern mind that it’s almost impossible to imagine that it was ever controversial. His radical belief was that doctors should sterilize their hands before performing medical procedures. In fact, it was even more obvious than that. What he was actually saying was that “if you’ve been handling dead bodies, you should wash your hands before you attempt to help a woman give birth.”
Can’t argue with that, can you?
Apparently, you can. Doctors were outraged by the mere suggestion that the deaths in question could have been their fault. After all, anyone could clearly see that a gentleman’s hands could not possibly transmit disease. What more evidence could they need? Even after Dr. Semmelweis demonstrated the efficacy of his theory there was still opposition. In the end, his measures were not even adopted within his life time. To bring this full circle, the good doctor died in an asylum.
While the above case certainly had more nuance than I’ve presented (this was before they even knew germs were a thing) the major cause of the conflict was that it was against what was understood at the time. Even after successful experiments, people did not want to let go of what they had always known. How they had always acted. The cost for this stubbornness was paid in lives
Fast forward to today. Physical health is much less of a problem. It’s still got its flaws but now concern about it is ubiquitous. It’s not restricted to hospitals anymore. Almost everyone accepts that you need to be healthy all the time. It’s almost impossible to avoid hearing about what to eat or what exercise you should be doing. I know of a certain organic food stand with a tag about being part of the “health fashion trend.” I’ve always found it an odd choice for a slogan but you can’t help but admit that there’s some accuracy to it. Healthy living is now fashionable.
Here’s an illustration to demonstrate just how far the health initiative has seeped into society. I once admitted to a friend I had eaten fries for lunch every day for a week. She was horrified to say the least. She, who I have never heard say more than two consecutive sentences without a joke, sat me down and gave me a lecture. It was a pretty comprehensive one too. All the “whys” “whats” and “hows” were covered in great detail. She even bought me (a healthy) lunch. I was touched, slightly bothered and if I’m being entirely honest wondering if I could pull this off with different people and never pay for lunch again.
That case is slightly more than you get ordinarily but it’s not all that surprising. People don’t just care about their own health, they care about the health of those around them. Sometimes so much that it creates new problems with diets and fat shaming but that’s a discussion for another time. This all leads me to the inescapable conclusion that many of us don’t consider mental health to actually be a part of health. We don’t treat it with that level of seriousness. We aren’t willing to be so helpful or even to put that much work into its prevention. If anything, we foster a climate that seems almost designed to make things worse.
If you’re mentally ill in Kenya, it would probably seem to be in your best interests to shut up about it. You don’t want to appear weak. You don’t want to be mocked and scorned. You don’t want the stigma associated with it. All of which will without a doubt be accompanied with no help whatsoever. So you hide it. You keep it to yourself and that’s not a safe place to be. You might need support. You might need counselling. You might need medication. The lack of these things will in all likelihood make your condition worse and worse until it can no longer be concealed anymore. By then, it is more difficult to deal with and sometimes the necessary measures aren’t pleasant to any of the parties involved.
So what can we do? For starters, you don’t have to do much. The first step, which is both easier and harder than it sounds, is to starting to take mental health seriously. In the same way you wouldn’t immediately dismiss a child complaining of some persistent pain, do not do so with depression or anxiety. These conditions are not, contrary to popular opinion, habits teenagers are picking from “the west”. If you stop and think about it, a Kenyan child has a lot to be stressed about.
Whenever I think back on my own primary school life it never ceases to baffle me. The whole time I was convinced that KCPE was the most important thing I had ever encountered in my existence. In my mind, failure meant that my life would be over. I didn’t study to learn, I studied to pass exams. I strained to achieve what now seems to be a fairly minor (and particularly useless) accomplishment. When was the last time anyone even wanted to know what I got in KCPE? I don’t think I could even tell you what my individual grades were now. Three months. That’s entire span of time that grade held any value for me. Was it worth all the stress it caused me?
For all that, I had it a lot easier than some. Unlike many children in this country, I wasn’t considered the lucky ticket. The entire community wasn’t counting on me to pass that exam and indicating that I was the one who was going to save them. That was not a burden I had to carry on my 13 year old shoulders. I can’t even imagine what that’s like. Seeing as this is the climate that we raise children in, Is it really so surprising that so many of them commit suicide after receiving their results? And even when they don’t, exactly how much damage is being caused here? If you have some pre-existing conditions already, what does that do to you?
My parents tell me they sometimes have recurring nightmares when they’re stressed. There’s different ones but the worst has to do with exams. Sitting in that room and realizing you don’t have a geometrical set or your pencil breaks and you don’t have a replacement. More than thirty years have passed, they’ve been through so much but their minds still associate stress with exams. Exams that were used to get college degrees they don’t even use anymore (or do anything related to what they studied in the first place). That’s what has them waking up with a fright.
This, to me, is a large part of the problem. Schooling in Kenya takes negatives and frames them as positives. Unbelievably tired? You’re supposed to be. Stressed? You’re supposed to be. Panicking? That’s normal. You’re not allowed to complain about these things. I compare it to being in some (hypothetical) athletics program and you sprain your leg. You talk to your trainer about it and he blows up in your face. “You’re a track star. Leg injuries are to be expected. What are you whining for? Get back to practice. Do you see your friends whining? You think they have it any easier? Get over it.” So you run on that leg and to no surprise, it gets worse every time, but now you’ve learnt not to say anything. You just bear the pain silently until you can’t do it anymore. As for your companions, the ones without injuries? They learn an important lesson too. Don’t speak up. A lesson they carry on to their careers. For themselves and for others. It’s all part of the job right?
I’m talking about schools because change has to start somewhere. If we’re going to spend such a significant portion of our lives in them don’t they owe us a little something in return? Something besides a multiple year course on how to pass exams? I believe that schools right now not only make existing mental conditions worse, they encourage attitudes that cause a lot of the problems I’ve pointed out in this article. Not only is there little useful learning on the academic front, the social attitudes being learned are damaging.
Now, I don’t believe that schools can “fix” mental illness. That’s way beyond their purview. But part of what makes being mentally ill so difficult is that people believe that it’s somehow your own fault. That because of some weakness in you, you called this upon yourself. You’re not sick. You’re weak. School has a lot to do with this line of thinking. If we can fix that attitude, then we’re already halfway there.
It’s all in your mind? Then raise the alarm.
Kevin Rigathi is a writer, artist, blogger, programmer and professional mad man