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Dr. Davendra Sharma
Professor Behavior Sciences
Texila American University
A distinguished lady expressed great distress about how she was treated by medical personnel when she experienced a mental health crisis and was admitted. She recalled the inappropriate humor, the talking down to her, the use of force for her to take medications and the general lack of sympathy for a condition she suffered which was no fault of hers. Her mental illness was a result of the genes she inherited in her generation line which contained influences from Europe, Africa and India. She felt humiliated and would not wish to be seen seeking treatment for her condition at a mental health clinic.
Across the globe stigma for mental illness is high and leads to shyness for seeking treatment, ridicule and discrimination and a lack of true understanding of the cause and nature of mental disorders. In Guyana, articles support the notion that many families believe that mental illness are because of the influence of evil spirits and persons are often taken first for spiritual help rather than medical help. Younger family members suffering from genetic disorders are often discouraged from seeking psychiatric help and admonished to not take medications and instead to pray away their perception and thought disorders. Herbal medicines from naturopathic “doctors” are often viewed more favorably than psychiatric care and medications.
Clinical experiences of four cases at a hospital offer direct evidence that the concept of an evil influence is held to be the cause of the disturbed behavior, by families. The clinical disorders included two dissociative disorders, one psychosis and one conversion disorder. Treatment and outcome were significantly affected by the attitudes of relatives who insisted on having exorcism only for their ill family member.
There are many causes for the inappropriate understanding that mental disorders are neurobiological disorders of the brain. The terms used for describing mental disorders including the word mental itself are often difficult to define and understand by medical persons themselves. Terms like “Schizophrenia” make no sense when converted to their original meanings. This genetic disorder, by a breakdown of the word becomes a “Split Mind”. Telling a patient that their mind is split is as demeaning as was done when children were called “Mentally Retarded”
The experience with medical and nursing students show that definitions of terms are inconsistent and confusing. Students with no prior medical training would often define schizophrenia as a splitting of personality, derangement of the mind, a mental illness or madness. Students who have knowledge would provide a definition of the term psychosis as a break from reality. However this does not represent the cause of the disorder rather a description of the behavior. With the advent of the PET scan and genetic studies, the neurobiological nature of these disorders is clearly evident. The definition of good health considers mental health as separate from physical health compounding the confusion for students, practitioners and the general public.
The reality is that mental disorders are all physical disorders of the brain. Naming the disorder in a manner which represents the biological cause has been shown to reduce the negativity and studies show that families prefer more modern terminology. This is evident from the change of the term mental retardation to neurodevelopmental delay. Trials for changing the word schizophrenia have shown promising results in several Asian countries which have moved to make the term biological. Reports show that the public, the medical teams and the patients find the new terms less demeaning and result in greater compliance with treatment. There appears to be much stigma associated with the condition Schizophrenia in Guyana.
This disorder has its basis as neurochemical and genetic and should be better termed a neuro-cognitive disorder of the brain. Describing this and other “mental” disorders as disorders of the brain would improve the understanding by families in the same manner that many have come to understand that epilepsy and seizure disorders are not because of demon possession but because of changes of electrical activity in the brain.
https://guyanatimesgy.com/a-modern-approach-to-overcoming-the-stigma-of-mental-health-disorders/
References
Seek Help. Remove the Stigma of Mental Illness: feh.uog.edu. gy 4.23.2018
Superstition in health beliefs: ncbi.nlm.nih.gov. pmc 7266200
Guyana mental illness, witchcraft and the highest suicide rate: The guardian.com. June 2015
S. M. Razali. Belief in supernatural causes of mental illness among Malay patients pubmed.ncbi.nimh.gov1996.
Possession by evil spirits: The Guyana Chronic. April 23. 2010
S Teferra Perceived causes of severe mental disturbance: bmcpsychiatry biomedcentral.com 2012
H. Jung. Belief in supernatural and mental health : Online library. Wiley. 2020
Stamping out superstition from our society: Guyana Chronicle .April. 5 2010.
Addressing mental health issues. Editorial Guyana Chronicle June 2016
Overcoming Stigma by changing antiquated ambiguous nomenclature
D. Sharma
