Environment and mental illness : a study of the effects of social-economic factors in the relapse of the mentally ill at Chainama Hills Hospital, Lusaka
Mtonga, Rose M.
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There are many factors that have been said to play a part in the cause of mental disorders. However mental illness in Zambia is largely influenced by socio-cultural factors (Msoni, 1990).Mental Health Services in Zambia were established twenty six years ago but to date, only 20% of the estimated population suffering from mental disorders has been covered. Understanding the disease, identification, treatment and rehabilitation of those affected by mental disorders and many more. The available records indicate that m.ore people seek psychiatric treatment nowadays than before. In 1962 when the hospital opened only 281 cases were recorded. Over the years more people sought psychiatric treatm.ent and the numbers increased as follows; 1986 fourteen thousand, 1987 eighteen thousand, 1989 eighty two thousand and in 1990 one hundred and eighteen thousand people were treated for various disorders (Annual Mental Health Report).Frequently, patients who had been previously discharged end up being re-admitted presenting different symptoms from, the previous admission or having similar manifestations but in a deteriorated state. For instance in 1990 total annual admissions v/ere 118,457 of which only 29,485 were new cases but the rest were re- admissions. The figures show; that the number of people seeking treatment for the first time is less than that of those who had been previously treated. On the basis of the above, it is fair to assume that proper rehabilitation is lacking within the community v/here patients live after discharge. The study is an attempt to establish whether socio¬economic factors have an effect on the relapse of the mentally ill. This study is also intended to enlighten those who may not understand the problems of mental disorders. The study is confined to Chainama Hills Hospital and the compounds of Lusaka urban district due to limited resources. It is an exploratory survey with a sampling frame comprising 40 male and female patients in the ratios of 25 to 15 respectively who have been admitted to Chainama Hills Hospital more than six times within the past four years. 40 relatives of patients and 20 professionals added up to make 100 respondents. A simple random, sampling technique was used so that every respondent had an equal opportunity of being chosen. The data v/as collected by personal interviews using a question guide and also by use of a structured questionnaire to the professionals. Data analysis included the use of percentages, frequency tables and cross-tabulations.The findings of the study reveal close association between socio-economic factors and frequent relapses of the mentally ill. In terms of incidence, the findings reveal that 37.5% of the total sam.ple were between 15-35 years while those between 35 to 40 and above years accounted for only 12.5%. This indicates that generally it is the youth that experience more problems of mental disorders. Secondly, this is due to the fact that 80% of the Zambian population is dominated by the youth. To a large extent the findings have shown that socio-demographic variables contribute to the relapse of the mentally ill With regard to public attitudes, it has been confirmed from, the findings that social stigma hinders effective rehabilitation. The situation is aggravated by cultural and traditional beliefs about the causes of mental illness. To this effect 47.5% of the relatives sampled indicated that mental illness is caused by witchcraft and magic. On the other hand the majority of the professionals were of the opinion that negligence by relatives caused patients to relapse. 32.5% of the patients sampled also indicated that they relapsed often due to social problems.As far as rehabilitation is concerned, the professionals cited lack of resources, inadequate staff, lack of clear policies and negative public attitudes as being responsible for hindering effective rehabilitation programmes for the mentally ill As a result of the above findings it is recommended that first and foremost effective clear policies regarding the prevention, treatment and rehabilitation of the mentally ill go a long way in making the public are aware of mental health problems. Only then will the public be willing to change attitudes. Secondly, these policies should be backed by large sums of money and material resources to make the programmes a reality.