Book Review: Mental Health Disorders.

Topic: Mental Health Disorders {Types; Causes and Solutions}

This book is structured in eighteen main chapters. It is a book that addresses mental health disorders that occur in Ethiopia, like the rest of the world, and suggests treatment options. The three professors in Ethiopia and Prof. Samuel in the US met via Zoom to brainstorm ideas and form a book preparation coordination group to help coordinate the implementation of the idea. Thus, with Prof. Samuel as the chairperson, Prof. Solomon as the writer, Prof. Atalay as the organizing member, and Prof. Mesfin as the member and the publisher, the preparation and publication process of the book has been moving for more than fourteen months. The idea was presented to Dr. Lia Tadesse, who was the Minister of Health at the time, and found the book useful in developing awareness of mental health in our society, and with the necessary support from the Ministry, this book was published. The people who participated in the book are more than 24 in addition to the four authors.

1. Allele Psychology

Pop Psychology is a branch of psychology that presents scientific psychology in a simple and accessible way for the masses. However, it is creating a problem in mental health that is scientifically studied and studied by professionals. Traditionally, the view seen and heard about mental illness in Ethiopia is largely based on a spiritual perspective. Many citizens who are affected by mental illness wander around seeking help from institutions that have not been proven to be effective, instead of getting the right help from the right place. Sometimes, due to lack of awareness, mentally ill people are chained and thrown into dark rooms.

When families cannot find a solution for their patients in their homes or other institutions and their economic resources are exhausted, the patients take to the streets; it is common to see these patients chased away by neighborhood children shouting “Crazy! Crazy! Crazy!” with stones and shouts. Why do these and other family and social problems befall patients with mental disorders? It goes to the source. Why is it that most Ethiopians’ assumptions and ideas about mental disorders are associated with curses and evil spirits. Since the patient’s problem is believed to have a negative impact on the identity of the entire family, it is not even wanted to be known that there is a family member suffering from mental illness. Therefore, they are widely distributed in books, social media, podcasts, TV shows and self-help content. They often present complex scientific studies in simple language and with examples.

The problem is that they often promote ideas that are not scientifically proven or are oversimplified, leading people to misunderstand and cause people with serious mental health problems to rely on simple advice rather than professional help. These ideas have become popular with many people because they are easy to understand and attractive; however, most of them are not fully based on scientific evidence or are oversimplified. As a result, they can mislead people or cause people with serious mental health problems to rely on simple advice rather than professional help. This book teaches and addresses this challenge of alternative psychology.

2. Intergenerational crisis

There is an intergenerational crisis in our country. This means that a severe traumatic event (such as war, genocide, slavery, natural disasters or severe family violence) that occurs in one generation affects the psychological and behavioral crisis that follows. Mental and psychological health disorders do not occur in a neighborhood, area, nation, ethnicity, country or part of the world. Mental or psychological health disorders can occur for one reason or another. It can occur as a result of an unhealthy lifestyle of individuals, physical and psychological abuse caused by a sudden natural or man-made disaster, or as a result of a nervous system disorder that occurs after birth, brain dysfunction that occurs as a result of aging, mental dysfunction or psychological damage. This crisis does not stop only at the people directly affected; it can also be transmitted from one generation to another through hormonal changes during pregnancy, upbringing, lack of emotional communication and cultural traditions in the family. As a result, children and grandchildren may experience significant anxiety, depression, trust issues, or low self-esteem, even without direct experience.

This type of crisis can be explained by epigenetic changes in the body; that is, the traumatic experiences of fathers or mothers can change the stress response system of their children. In addition, emotional distance, overprotection or lack of emotional expression in the family are transmitted as “normal” parenting styles. As a result, the next generation can unknowingly repeat or exacerbate the suffering of the previous generation in their own lives. To resolve intergenerational crises, it is important to gain awareness, talk about family history and seek professional psychological support. Often, through therapy, the recovery of cultural systems and the building of healthy family relationships, the chain of crisis can be broken. This allows the new generation to live a healthy life free from the suffering of the previous generation.

3. Self-help testing

Self-diagnosis is the process of trying to diagnose a health problem by observing symptoms, searching the internet, or using mobile apps. In modern medicine, this process has a dual role. On the positive side, self-diagnosis helps people to become more aware of their own health. Many people go to the doctor with their symptoms in advance; this can lead to early detection of certain diseases (such as cancer, heart disease, or diabetes). It also allows patients to be more involved in the medical discussion; because they have some information about their condition, they can ask better questions. On the negative side, self-diagnosis comes with a high risk. Often, people associate common symptoms with serious diseases and develop excessive anxiety (cyberchondria). Conversely, some people underestimate serious symptoms and delay going to the doctor. Self-diagnosis can also lead to self-medication; which can lead to drug toxicity, side effects, or exacerbations. Therefore, self-diagnosis in medicine should only be considered as an initial understanding; The final decision, however, should always be made by a qualified physician based on examination and laboratory results.

4. Addiction and Psychiatry

Addiction is a major contributor to mental disorders. Often the two are linked; addiction can cause or worsen mental illness, and mental illness can lead people to addiction. Addiction directly changes the chemistry of the brain. Alcohol, amphetamines, cigarettes, drugs, and other addictive substances disrupt the balance of dopamine, serotonin, and other neurotransmitters. This can lead to depression, anxiety, psychosis, confusion, and memory problems. Long-term addiction can even change the structure of the brain; especially affecting areas of decision-making, emotion regulation, and memory. In addition, withdrawal itself can cause severe mental symptoms (such as severe anxiety, hallucinations, or thoughts of self-harm). In addition to the biological effects, addiction creates social and psychological problems. A person may experience isolation from family and friends, loss of employment, poverty, domestic violence, and legal problems. These conditions can also lead to depression, anxiety, and post-traumatic stress disorder (PTSD). Dual diagnosis of addiction and mental illness is very common in many countries, including Ethiopia. Therefore, timely prevention and treatment of addiction is crucial to maintaining mental health.

5. Mental illness and Ethiopia

The complexity of mental and psychological disorders is such that insufficient awareness among the community prevents our citizens from receiving appropriate care. To address the negative individual and societal impact of this health disorder, it is essential to ensure that citizens have a proper understanding of the problem. In this regard, the biggest solution is to educate the community by experts that mental health disorders, like any other illness, can be treated. The Ministry of Health is committed to creating awareness about mental health through a toll-free hotline and various social and formal media. Although the government has tried to integrate mental health into primary health services by issuing a National Mental Health Strategy (2020-2025), lack of funding, human resources, and infrastructure has made its implementation difficult.

The main challenges in psychiatry in Ethiopia are the shortage of professionals and the lack of access to services. The number of psychiatrists is very low (around 0.1 per 100,000 people) in a country of over 110 million people, most of whom are concentrated in Addis Ababa, particularly at Emmanuel Hospital. The number of psychiatric beds is also very limited, medicines are not always available, and services are almost non-existent in rural areas. As a result, the treatment gap has reached over 80 percent; many people turn to traditional healers or holy water treatments rather than to professional doctors. On the other hand, social and cultural challenges exacerbate the problem. Mental illness is often seen as a spiritual problem, a curse, or a punishment from God; this creates a high stigma; families try to hide the patient or prevent them from seeking treatment. Poverty, transportation problems, lack of awareness, and frequent conflicts also pose major barriers to people accessing professional treatment.

Summary

Using their accumulated scientific knowledge and experience in the field of mental health, experts from the College of Health Sciences, Addis Ababa University, have prepared this book, which is the first of its kind and in terms of content, in order to provide a national response to this national problem. This major contribution is the result of a joint effort by senior experts from the Department of Mental Health, Addis Ababa University, under the leadership of four main editors, aimed at bridging the awareness gap in our country on the issue of mental health disorders.