Opinion Protecting and improving mental health in Seychelles |23 July 2022
The issue of mental health needs to be placed within the context of the transformation from physical work orientation prior to and during the most recent industrial era, and the subsequent move towards an information-based world. Some scientists argue that human beings have not evolved sufficiently to manage the kind of overload of complex virtual inputs which has become the norm for many people in the last decade.
We can refer to a great deal of research carried out in the developed world which describes threats to mental well-being posed by lifestyle changes which have been adopted by the majority of citizens. To an extent this adaptation has been voluntary, however analysts argue that there is a silent obligation for many people to engage with virtual data to an extent deemed potentially damaging to mental health. But it is not just the internet and social media platforms which are contributing to a sense of increasing isolation and alienation for many people. Rather the collective effects of 21st century living can degrade mental health, leading to feelings of anxiety, depression, dramatic mood changes, poor sleeping patterns, weight loss, self-isolation and/or abuse, substance abuse and low self-esteem.
In Seychelles we have a shortage of dedicated support for people who are experiencing any of the above problems. Our access to psychological help, counselling and therapy is critically limited, with existing inadequate facilities overwhelmed in recent years by heroin users. This means that, as with other important life issues such as physical health care and education, money enters the mix as a defining factor, with those who can afford to pay for private treatment having clear advantage over those who cannot. Mental health problems have been exacerbated by the pandemic, although it would be untrue to state that Seychellois suffered as much as their counterparts in, say, Europe. Our lockdowns and related restrictions on movement and behaviour were manageable, and highly unlikely to have caused the kind of serious mental problems experienced by families forced to remain in small and cramped accommodation for weeks on end. In such circumstances health authorities witnessed a sharp increase in domestic abuse, violence and emotional breakdowns, while being unable to spare the resources required to support those in difficulty.
There have been examples in recent years in Seychelles where unrecognised or untreated mental illness has led to tragedies, the most extreme being violence and murders committed by perpetrators who were mentally unbalanced.
Thus, the mental illness of a few poses a threat to the many, in the same way that a perpetually reckless driver threatens all other road users.
So, assuming that we are unlikely to see an influx of trained psychologists and therapists any time soon we have to assess the specific risks to society created by the inability of people to cope with pressures and obligations.
Mental health degradation will frequently lead to initial general stress which can then, if not addressed, can lead to anti-social behaviour and higher crime rates.
Within an economic context we can appreciate that mental health problems might well make a person unemployable. Even if working, employees will likely experience a drop in productivity and degradation of the quality of their inter-personnel relationships and those with clients.
Religion has played, and continues to play, a positive part in assisting those with mental health issues, however the palliative of doctrine might not solve long-term emotional problems which are rooted in chemical imbalances in the brain. Religious doctrine might also place restrictions on the type of material which both sides might feel comfortable discussing. Nevertheless, we should not discount the benefit of spiritual support, especially as for some people it will be their primary comfort.
Sport as a solution to mental health issues also has its advocates, indeed sport has been promoted as an effective response to drug, substance and alcohol abuse for many years, with limited success. The question is begging, however, as to whether this works through cure or distraction.
Cultural activity is also promoted as an effective strategy for mental unrest. Art therapy has proved effective as a synthesis of creative expression and analytical science, however this is not, as far as we are aware, available in Seychelles.
The National Council for Children (NCC) offers therapeutic support for children who are experiencing emotional problems, either reactive (for example triggered by parents divorcing, or bereavement) or inherent (without obvious cause). This is a valuable provision in Seychelles, as the young are particularly vulnerable to the negative impacts of domestic dysfunction, social media and internet over-use and unrealistic expectations set by self or others.
Questions for the future
- How can a country and society be safeguarded against risks of mental health degradation?
Once again education enters centre stage. We need to ensure that school personnel are trained to spot and report the signs of emotional imbalance displayed by a child. This needs to then trigger an effective response inclusive of psychological assessment and inclusive family counselling.
Prevention is better than cure, and this is especially true of mental illness. Other position papers in this collection touch on issues which directly relate to this. The threat to mental stability posed by new technology. A below par education system. Drug usage – the worst per capita in the world. Covid-related anxiety. Happiness, or the lack of it.
All of these issues matter when it comes to maintaining a society which supports all of its constituent groups when they face difficulties which are physical or more abstract.
- What solutions can be proposed to deliver a more balanced and effective way of managing increasingly challenging lives?
The promotion of self-awareness mentioned elsewhere can potentially deliver disproportionate (to the resources required) benefits, and this should begin in schools and be continued as a referral service thereafter. This will also mitigate the stigma potentially attached to mental illness and civilise society’s attitudes towards those unfortunate enough to suffer emotional and/or behavioural problems.
- How do we integrate new policies and regulation to ensure stable mental health?
Initiatives such as the above require funding, capital and ongoing. These fixed and variable costs should be borne by government as part of the implicit contract of care that exists between the administration and the electorate.
Existing legislation such as sectioning needs to be reviewed and revised in the light of the significant changes in contemporary lifestyle compared with that in place at the time of the original legislation. Better resourced mental health care centres need to be established. Better in terms of both physical and human resources.
Public education programmes should highlight the facts rather than the mythologies surrounding mental illness. Depression will affect, on average, at least a quarter of any population during the course of a lifetime. Seychelles is not an exception to this and the two-fold message that a) mental illness can affect anyone and b) that there is help when it does, will be both powerful and reassuring.
Contributed by Mahé Council Think Tank
Disclaimer:
The views expressed in this opinion piece are those of the author(s) and do not necessarily reflect the views of the Seychelles NATION newspaper.