in this issue… Monthly Theme Features World Mental Health Day Know your Service Provider The International Kite Festival Mental Health Features What do you know about mental health? How to do a mental health check-up Personal Feature: Steveria Kadangwe Featured Story: Phillipa Lilford Health and Wellness Features Mental Health and Relationships: Intimate Partner Violence (IPV) Personal Feature: Violet Mengezi Family Health: Nutrition and Health in the Elderly Resources Suicide Intervention in Malawi Phone Apps for Wellness
ctober is almost over! Can you believe we are two months’ shy of 2022? Many Malawians have been expecting the usual unbearable heat, dry air, and dust storms that October is known for. However, this year has been very different. The temperatures are much cooler and less intense than the previous years. Climate change is real! October is also known for World Mental Health Awareness Day held on the 10th. This day gives the mental health world a chance to raise awareness, raise funds, and promote better practice towards healthier lifestyles. An example of such an initiative is the International Kite Festival held in Cape Town by the Cape Mental Health Project. I hope that we can come up with something just as fun and effective in mental health promotion in Malawi someday. I have taken advantage of this month long awareness spirit to include information on the basics of understanding mental health, self-care, and more importantly; knowing who to approach for the mental health service that is right for you. Relationship problems are one of the most significant contributors to poor mental health in the world. We look at intimate partner violence in an effort to highlight some of the challenges that people are facing, and how to be more aware. Another packed issue for our readers. God Bless and happy reading! Julie Soko Managing Editor
Julie Soko Managing Editor
Mtendere Kishindo Sub - Editor
Thandi De-Jong Editorial Assistant
Naomi Msusa Editorial Art and Design
Submit to essentialgrace@zoho.com
Monthly Feature
2021 ? Organized and hosted every year on October 10th by the world Federation of Mental Health, the World Mental Health Day is meant for spreading awareness among the general public. It is designed to make people aware of the measures that can be taken to heal people with mental health issues. It is all about driving the society into taking steps that can help people with mental health issues to live life of dignity.
World Mental Health Day Speech by the UN Secretary General, 5th October, 2021. Around the world, the COVID-19 pandemic is taking a terrible toll on people’s mental health. Millions of people face grief over lost family members and friends. Many more are anxious over unemployment and fearful of the future. Older people may experience isolation and loneliness, while children and adolescents may feel alienated and distressed. Without determined action, the mental health impact may last far longer than the pandemic itself. We must act to redress the glaring inequalities exposed by the pandemic – including the inequality in access to mental health services. In high-income countries, over 75 percent of people with depression report that they do not receive adequate care. And in low- and middle-income countries, over 75 percent of people with mental health conditions receive no treatment at all. This is the direct consequence of chronic under-investment, as governments spend an average of just over 2 percent of their health budgets on mental health. This is unacceptable. At long last, we are beginning to see recognition that there can be no health without mental health. Member States have endorsed the World Health Organization’s updated Comprehensive Mental Health Action Plan. The United Nations family, together with partners across the global mental health community, are introducing new guidelines and developing new tools to improve mental health. These are positive steps – but we have a long way to go. On World Mental Health Day and every day, let us commit to work together with urgency and purpose to ensure quality mental health care for all people, everywhere. Antonio Guterres Secretary General of the United Nations 7
The field of mental health is one that is rapidly growing as more classifications are developing. We are often confused with the variety, for example there is often confusion between a psychiatrist and a psychologist and most people cannot tell the difference between the two. In this issue and in the coming months we will be featuring the different types of mental health workers that can be found in Malawi while giving you a thorough description of their services. There are different kinds of experts who
behavior. Psychiatrists are doctors who
specialize in different areas of mental
specialize in psychiatry; they have
health. Each of them plays a key role in
completed an MD (Doctor of Medicine) in
identifying and treating psychological and
psychiatry after an MBBS (Bachelor of
psychiatric health issues.
Medicine and Bachelor of Surgery) course.
Some of these types of mental health professionals found in Malawi are:
Who is a psychiatrist? A psychiatrist is a person who has
Psychiatrists
Psychologists
Clinical psychologists
Counselors
Psychiatric Social Workers
and managing various mental disorders
Psychiatric Nurses
which affect emotion, cognition, and
Lay counsellors
completed an MBBS (Bachelor of Medicine and Bachelor of Surgery) and has gone on to specialize in psychiatric medicine. Psychiatry is the branch of medicine that deals with assessing, diagnosing, treating,
behavior. They specialize in the diagnosis and treatment of mental health issues.
We will look at the differences between a
During their specialized training,
psychologist and psychiatrist first.
psychiatrists study the brain's functions and the complex relationship between the body
Psychiatrist
and brain. They are qualified to distinguish
What is psychiatry?
between physical and psychological causes
Psychiatry is the branch of medicine that
of mental and physical distress.
deals with assessing, diagnosing, treating,
They are also the only type of mental health
and managing various mental disorders
professional who are licensed to prescribe
which affect emotion, cognition, and
and monitor medication.
8
Psychologist What is psychology? Psychology is the scientific study of the human mind and behavior. All aspects of thoughts, feelings and emotions that motivate our actions are scientifically evaluated through various assessments and tests. Psychological knowledge is applied to understanding and solving problems in different spheres of human activity, and is also used in the assessment and treatment of mental health issues.
Who is a psychologist? Psychologists have a degree in psychology and are experts in human behavior. They use scientific methods to study the factors
In the past, Malawi had very few psychiatrists and almost no psychologists to speak of. Thanks to the growing number of tertiary institutions providing training for this field both within the country and abroad, the number of qualified mental health workers is rising. However, we still have a long way to go in this area. Psychiatrists are still very few and have a huge workload to cover because of this. Most psychologists are not employed in public hospitals and clinics, and are rarely accessible to the general public. So, although the field is growing not many people can afford to pay for the services of private mental health practitioners.
that influence people's thoughts,
The key is to know the unique services that
perceptions, emotions, and actions.
are being provided so that you can decide
They use evidence-based strategies and
which one will work for your situation. Not
interventions to help people overcome
everyone needs to see a psychiatrist, and
challenges and cope with life issues such as
not every mental health problem can be
relationship problems, parenting issues
solved by a psychologist. Often, these
challenges in adolescence, lifestyle effects
professions work well together rather than
on health, chronic illness, and grief.
in isolation.
Psychologists use their clinical skills to work with people who have mental health issues
The following graph details the variances
like anxiety, depression, eating disorders,
within psychology. As always, should you
panic disorder and substance abuse.
need to contact a mental health
There are several different types of
practitioner, please see our resource section
psychologists, refer to the table on the next
at the end of the magazine. And be sure to
page to understand how each type works
ask what type of service they are offering,
and which one is best suited for your
and whether they will be of help to you.
problem.
9
Type of psychologist
Area of practice
Specialization
Examples of mental health issue
Reducing psychological distress, enhancing and promoting psychological wellbeing in people who have been diagnosed with a mental health issue or a mental illness.
Anxiety Depression Addiction or substance abuse
Private clinics or hospitals
Treating underlying problems that may have caused an imbalance in people who may not have a mental health issue or a diagnosis of mental illness. Helping people learn to change attitudes or conduct their lives in a more meaningful manner.
Bereavement Issues with past and present relationships Behavioral problems Quitting smoking
Schools, educational institutions Government
Working with children and adolescents to facilitate learning and development. Working in the area of educational policies.
Private clinics or hospitals
Dealing with the relationship between the brain and its neuropsychological functions such as vision, memory and smell.
Rehabilitation of people from brain injuries and neurological or brain degenerative diseases such as Stroke Dementia Tumors
Occupational psychologist also known as a vocational psychologist (eg. Julie Soko, Zomba)
Workplaces Psychiatric hospitals, private clinics
Helping organizations get the best from their workforce and improve the job satisfaction of individual employees. Helping people with mental illnesses build or maintain their careers.
Build strategies on how to motivate staff Recruit the best people for the job Help individuals gain new skills Help with transition back to work Help people find a suitable career
Forensic psychologist (also known as a criminal psychologist, legal psychologist, or criminologist)
Research and assistance in crime and justice
Dealing with the psychological aspects of legal processes and applying theory to criminal investigation
Understanding psychological problems associated with criminal behavior Psychological support to those who are incarcerated
Clinical psychologist (eg. Dr Private clinics Nkhalamba, Zomba) or hospitals
Counseling psychologist (Chilungamo M’manga, Lilongwe)
Educational psychologist (eg. Dr Dixie Maluwa, Zomba)
Neuropsychologist
Some information in this article is sourced from www.whiteswanfoundation.org
10
: The Annual International Kite Festival is a project of the Cape Mental Health organization. Cape Mental Health, the oldest mental health organization in South Africa, is an initiative that works through various projects to address those with mental disability to function within the community through counselling, support, and rehabilitation. The organization runs 24 different projects and programs that focus on promoting, facilitating and providing proactive mental health care services through the mental health umbrella. The annual Kite Festival is one of their outreach and fundraising programs. As a student living in the Western Cape (South Africa), I was often drawn to festivals and pretty much any family friendly event that took place in Cape Town. My top favourite were the Navy Festival held in Simon’s Town, and the Kite Festival held at Zandvlei Nature Reserve. Coming from the small town of Zomba, these events were the highlight of the year and I would look forward to them with so much excitement.
11
When you think of Kites, I’m sure the image that comes to mind is a small rectangular contraption held together by two pieces of wood. That was my idea anyway, until I saw the huge flying creatures myself. There is a lot of creativity and planning that goes into these designs as you can see. Many of these kites come from different countries around the world and they are incredibly impressive. The event is usually a few weeks long, and it includes many other activities, games, food stalls, and fun for the whole family. There are also information booths for the Cape Mental Health team, some for people to donate blood, to check their blood pressure, and even access VCT services. However, the most important thing about this event is that is raises funds for the mental health efforts that are being carried out in the city. There are many people who depend on the services provided by Cape Mental Health which are mostly freely accessible. I believe that being able to reach financially challenged people with such services is really commendable, and something that can be emulated by our own mental health organisations in Malawi. Do you have some ideas? Why not start working on them while partnering with mental health professionals in the country. A great example can be found here.
12
Mental Health
“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.” — Elisabeth Kübler-Ross
13
… …the term ‘mental health’ is often misrepresented in Malawi. Whether it is on television interviews, newspaper articles, or in conversations, this term has become synonymous with mental illness. Let us be sensitive to the improper use of this term and begin to correct others as we go along. Mental Health – the description of mental, emotional, and even behavioural health. It is how we think, feel, and behave Poor mental health – when someone is struggling to cope with their thoughts, emotions, or behaviour Mental illness – a term used to describe a wide range of diagnosable mental disorders and health conditions
14
? Why do we need to know the state of our
Why do most people know very
mental health? Well, one of the most
little about mental illness? There is still
obvious reasons to be consciously aware of our mental health is that something goes wrong, we can get help before the condition becomes unbearable. Poor mental health and/or mental illness can lead to some very negative results.
What is mental illness? To put it simply, mental illness is a condition of the brain that causes disturbances in thought, behaviour, energy, or emotion; which makes it hard to cope with the ordinary demands of life. Mental illness is
a lot of stigma associated with mental illness. Most adults do not want to associate themselves with any type of
madness label and will rather not get help due to this fear. Sometimes it is a cultural expectation for people to be as normal and high functioning as possible. This may be one of the reasons why most adults, especially males, will avoid reaching out for help sooner since they feel the pressure to conform to the high expectations of society.
diagnosable and treatable by qualified
Another reason may be fear of exposure.
professionals in the psychiatric field of
Living in a small country like Malawi
medicine.
means that it is very difficult to live a
The most common mental illnesses
completely private life. At some point or
amongst adults are …
another, your personal life details will be
Anxiety disorders – such as post-
known by people, sometimes this is out of
traumatic stress disorder (PTSD), obsessive
your control. This can also be due to
compulsive disorders (OCD), panic
social media and the tendency to over
disorders (including panic attacks),
share private issues. Choosing to trust
generalized anxiety disorder (GAD), and
others with your mental health concerns
certain types of phobias.
can be intimidating because of this. Even
Mood disorders – such as different types of depression, bipolar depression
sharing with a professional or a trusted friend can seem too much to consider. Ignorance is still a very powerful stumbling
15
block to mental health initiatives in
not those of depression and their source is
Malawi. The less we know about a
not qualified to do a complete evaluation
problem, the harder it is to find solutions
and give an accurate diagnosis. When it
for it. As a people, we focus very much on
comes to treatment, how can we expect
many social issues such as gender-based
such a person to receive the right
violence, economic instability, political
intervention when they have been
issues, and even early child marriages. We
misdiagnosed?
Self-medicating – many people
can see many commendable initiatives targeting these issues and the hard work
self-medicate instead of investigating and
being done to find solutions. Yet how
treating their poor mental health/mental
much can we say about mental illness?
illness. There are many people who are
How many people can define mental
aware that something is not right with
illness and give even the most
their mental health, and for
basic understanding of what it
The less we
means especially when relating
know about a
ready to get help. Self-medicating
to their own lives and to those
problem, the
includes but is not limited to:
around them. Ignorance also applies to not knowing the services that are
harder it is to find solutions
already available out there.
for it.
Read more on this in the Monthly Themes section.
Lack of mental health awareness may lead to … Misdiagnosis – often this is done by inadequately trained people. You may
whatever reason they are not
over-working, extreme exercise, promiscuous behaviour, substance abuse, alcoholism, over eating, obsessions that go beyond the normal hobby or
personal interest activity. Most selfmedicating behaviour is done to distract
the person from their problem, is done excessively, and often with the person choosing to engage in it rather than to find a solution or help for their problem. Self-harm or harm to others – this
hear someone say they were diagnosed
is a common thing to see amongst adults.
with depression by a random medical
I personally believe that when a person is
professional, a friend who knows about
not equipped to find healthy and lasting
psychology, and often - Google search
solutions for mental health problems, the
results. When you question them further
next step is often to ignore it or try to
you will discover that their symptoms are
suppress or destroy it. Since mental health
16
is a problem of the mind, what better way
problems for a lot of people across the
to destroy this problem than to harm the
world. Although highly stigmatised and
body in which it resides. This is where you
misunderstood, suicide is often an
find behaviour such as alcohol and
attractive solution for someone who has
substance abuse, reckless and
been suffering from difficult life
risk-taking behaviour,
The best
promiscuous or unprotected
tool any
sexual behaviour, poor self-care,
person can
healthy lifestyle choices, and
have is
What can you do?
knowledge.
In other contexts, people who
physical conditions and chronic disease.
avoiding healthy people, and suicide.
situations, along with mental illness,
The best tool any person can have in any situation is knowledge. Get to know yourself, learn as much as you
are not doing well mentally
can on what a healthy, positive mind looks
choose to hurt others often their loved
like. Learn about mental and emotional
ones or people close to them. You can
check-ups and begin to do these atleast
see this in the case of violent drunks.
once a month.
Consider a person suffering from
The best place to start is to learn about
depression, they are not getting any
your family background. How do people
treatment for it, nor are they reaching out
in your family handle stress, trauma, and
to people around them for help and
difficult life events? Is there a history of
support. They choose to drink heavily to
mental illness? Knowing these themes will
stop feeling or numb the pain. The result
give you an idea of what you can expect
is that they become even more frustrated
in your own life.
and begin to lash out in violent outbursts
Another idea would be to find out what
and frequent fights. They become even
your particular coping style is, do you
more isolated and feel guilty for their
have one? If not, it’s time to start
behaviour, which leads to more self-
developing one. As the saying goes,
medicating and even more harm to
knowledge is power, so take the time to
others.
learn about yourself and your mental
Suicide – one of the more obvious
health.
results of untreated and unresolved mental health problems. This has grown
Bing aware of your mental health will help
into one of the go-to methods for solving
you to notice positive or negative
17
changes, warning signs or triggers, pre-
However, when you become
dispositions (such as being pre-disposed
overwhelmed and struggle to cope, it is
to addictive behaviour or angry outbursts),
wise to reach out to someone who can
mental growth, and changes in behaviour.
help you find your way again.
Things to be aware of. Our mood and
For feedback, questions and comments,
emotions are never constant, therefore do
please get in touch with us through the
not expect yourself to feel the same all the
details provided in the Resources section.
time. Ask yourself some of these questions; how does your mood change? who and what are around you when this happens? if you are a female, does your menstrual cycle have something to do with it? Are you physically healthy? are things going well at work? are you simply lonely? There could be so many reasons for you to feel down and experience poor mental health. It would not be fair to write yourself off because you are going through a hard time, it would be fair to give yourself some empathy and compassion, and to look for a solution. ‘Your mind is like a garden – unless you Not every person who is experiencing poor mental health needs to see a
cultivate flowers, weeds will flourish. To keep your mind positive, substitute
professional. Sometimes it is a matter of
positive thoughts for negative thoughts’
changing your lifestyle and learning how
Brian Tracy
to treat yourself when you are struggling.
18
Now that you have a clear understanding on what a Psychiatrists is, as well as the services they are likely to offer, here are some of the symptoms that could guide you on the need to see one.
Significant thoughts of self-harm or suicide
Violent thoughts
Delusions
Hallucinations
Unstable moods
Social isolation
Significant changes in behaviour
Cognitive decline and poor functioning that is getting worse
Eating and body image problems
When other interventions (such as counselling) are not helping
Doctor or physician’ s intervention is not helping
Remember, Psychiatrists treat mental illness while Psychologists and Counsellors deal with mental health in general. If you are experiencing some of the symptoms mentioned above, you need to get an evaluation with a psychiatrist as soon as possible. In Malawi, you need to go through a specific process in order to see a Psychiatrist. You must be examined by a doctor, psychiatric clinician, or psychiatric nurse at your nearest district hospital. Once they assess your symptoms and if it is necessary, they should be able to refer you to a Psychiatrist. Most referral hospitals have atleast one resident Psychiatrist whose services are free as they work for government institutions. Once you are in this system, you can receive consistent care, supervision and support from the psychiatric team either at your local hospital, referral hospital, or the main Psychiatric Hospital in Zomba. The only alternative Psychiatric services in Malawi are offered by the St John of God Hopsitals in Lilongwe and Mzuzu. These services are not free as this is a private institution. Their referral process does not work in the same way as the government one.
What happens if you contact a psychologist, counsellor of social worker for a problem that requires psychiatric attention? Ideally, you should get referred to the right place right away. Most mental health workers will know when a case needs to be referred, and they have a collaborative connection with psychiatric services to provide you with the correct intervention. If you are worried that you are not getting the right mental health service, please speak up and ask for it.
19
A psychologist is a mental health practitioner. As you have already noted, there are many types of psychologists catering to different mental health conditions. Here are some general symptoms that should alert you to the need for their intervention. Intense emotions or the lack of emotional experience A traumatic experience Unexplained physical aches and pains, and poor immune system Self-medicating behaviour eg. Substance abuse Negative feedback from work or school A feeling of disconnection from yourself and others Strained or broken relationships There is still a lot of stigma against seeking help for mental health problems. However, one needs to be very careful with self-care especially when it comes to mental and emotional health. Do not neglect yourself, it is worth it to get help. Thankfully, Malawi has a rising number of trained and qualified psychologists working in different fields. Our resource section has some contact details of a few of these, please make sure to ask what type of service they offer and whether they will be able to help your situation.
20
Try this doing a mental health check-up on yourself or people around atleast once a month to keep up to-date with the state of mental health. The following are just suggested questions, you can add and adapt more as you see fit. Have I been getting quality sleep with regular bed times and getting up times? Have I been isolating myself from others at work, friends, or family? Do I have more worries or anxiety than usual? (Maybe use a scale of 110). Have I lost interest in activities and pursuits that usually held my attention? Have I felt more sad than happy lately? Do I feel at ease with myself and my surroundings? Do I feel that life is appropriately balanced between work, fun, friends, family, self-care, exercise, and other meaningful pursuits? Do I have trouble concentrating? Have I been experiencing significant mood swings, crying, or thoughts of suicide? Am I overly fatigued or tired at the end of the day? How about at the end of the week? Have my appetite or eating habits changed in any way recently? www.mypsychnetwork.com
It would be a good idea to keep a record or journal your monthly check up so that you can keep up with changes and track lingering moods. Being aware of what you are experiencing will help you to be more empathetic towards yourself, as well as take better care of your overall health.
21
www.mindfullivingnetwork.com
Start on the Right Foot Begin your check-up by mindfully reflecting on your daily schedule, your mood, and your spiritual or religious health. Write down your findings and use it as motivation for accomplishing your goals. You can also make changes, if needed, in order to move forward and improve your mental health. Evaluate Your Relationships Sit down and reflect on how arguments, challenges, or other aspects of your romantic relationship have impacted your emotional health. To strengthen your romantic relationship, consider conducting a relationship checkup with your partner. Also, reflect on key moments in your friendship, both good and bad. If a friendship you have is toxic, find possible solutions. Consider Your Finances Financial worries and fears can weigh heavily on your mind, affecting your emotional health. So, for your mental health, review your saving and spending habits in order to make betterinformed decisions in the future. Also, review your investments, retirement plans, credit score, and debt status. The more you know and understand the less you’ll worry about your finances. Assess Your Career Work stress can wreck your emotional health. So, it’s important to reflect on the good and challenging aspects of your job. Start by reviewing positive things like the goals you’ve accomplished or the bonds you’ve formed with coworkers. Also, reflect on the things that have caused you stress like long commutes, office politics, or unreasonable bosses. Come up with plans to reduce your work stress or start finding a new job. Monitor Your Physical Health A physical check-up is important for emotional health. Consider getting plenty of sleep and exercise. It’s also important to have a balanced diet and to avoid excessive amounts of alcohol, cigarettes, and caffeine. By staying physically healthy you can prevent insomnia and feelings of helplessness, which can impact your mental health. Evaluate Your Self-confidence A high self-esteem is important for everyone’s mental health. When you’re confident you don’t have to worry so much. Try to avoid having negative thoughts as it can weigh on your mind and lead to stress, anxiety, and poor mental health.
22
This is a reflective essay about the time I spent volunteering in mental healthcare in Malawi, prior to commencing my psychiatry training. The burden of illness I saw was enormous and the resources very limited; however, I describe some particular experiences where we were able to deliver excellent care, and which made me reflect about mental health services in low-income countries in general. Details of the patients discussed in this essay have been fully anonymized.
A few years ago, before starting my psychiatry
the Queen Elizabeth Hospital in Blantyre. This
training, I travelled to Malawi to volunteer in
was a walk-in clinic which was officially held in
psychiatry for 3 months. On the way there,
the morning, 3 days a week. In reality, it lasted
feeling that I was at the start of a great
most of the day from Monday to Friday. The
adventure, I started reading the 2007 Lancet
clinic was staffed by three psychiatric nurses, in
Series on Global Mental Health.1 This would be
addition to the two permanent consultant
the first time since medical school that I had
psychiatrists. They were supplemented by
undertaken a post in psychiatry. I had visited
variable numbers of elective students and
Africa numerous times before and
consultant psychiatrists who were volunteering
experienced medicine in South Africa during
with the Scotland Malawi Mental Health
my elective, but I felt nervous at the challenge
Education Project. Each day the corridor
that lay ahead. Malawi is one of the poorest
leading to the clinic would overflow with
countries in the world and, with a population
patients and their guardians.
of 16 million, had just two qualified
Guardians are family members that have taken
psychiatrists; neither doctor was Malawian. I
on the task of looking after a patient when
was based in the out-patient department of
they are unwell. I had imagined that stigma
23
would be rife, and that patients would have
adherence. The available medication could
been ostracized and left to attend clinic alone.
vary from week to week, depending on
To my surprise, the majority of patients
governmental supply and private donations.
attended with a guardian who provided a
Some weeks, we would have a range of
collateral history, ensured patients took their
atypical antipsychotics, selective serotonin
medication and provided a safety net that
reuptake inhibitors and tricyclic
allowed patients to be sent home. If patients
antidepressants.
were admitted to the Queen Elizabeth
The supply of diazepam and chlorpromazine
hospital, a guardian remained with them on
fortunately remained abundant. A small
the ward. The guardian would sleep on the
proportion of patients could afford to pay for
floor or outside, and they would cook for and
their medication, in which case a prescription
clean the patients for the duration of their
could be written for an alternative medication
admission.
supplier by a private pharmacist close to the
Around 40 patients would arrive at the clinic
hospital. In my first week, I received a referral
daily, many walking for hours from distant
from my friend who was working as a registrar
villages. There is very little public transport in
on the medical ward in the Queen Elizabeth
Malawi, and patients from further afield would
hospital. I went to see the patient with one of
come by small private vans. The clinic and
the psychiatric nurses. We turned the corner
medication are free and are funded by the
into the heaving ward and easily identified our
government or by private donors. However,
patient. A mattress had been placed on the
transport costs are borne by the patient and
floor in the corridor, and his arms and legs
their families, and those costs often meant that
were tied together with rope. He was spitting
patients could not return as often as the
and shouting ‘fire’ repeatedly. When I
service required. Most patients could speak
walked towards him, he started rolling in my
only the Malawian language, Chichewa, and
direction trying to bite me. He had been an in-
so it was necessary to obtain their complex
patient for a week, but he had been placed in
psychiatric stories with the assistance of a
the corridor between two bays where neither
translator.
medical team was required to take ownership
The nurses had many skills. For example, they
of him. He had not been referred to
would administer intravenous diazepam to
psychiatric services, nor had he been given
very agitated patients who had been brought
benzodiazepines. He had not been given any
in by the police, and the next day I would see
food and had barely drunk any liquid.
them conducting a session on
No physical observations had been performed
psychoeducation to improve medication
or any blood drawn. His father told us he had
24
become acutely agitated over a few days. He
how to take psychiatric histories and perform
had stopped making sense and started talking
mental state exams. There are only 250, which
about religious topics.
must be reserved for the most seriously unwell
He did not have a significant history of alcohol
patients. Interestingly, another common
intoxication. His father did not think he took
reason for detention arises when a patient’s
drugs and there was no mental illness in his
mental health is interfering with their physical
family. His blood test results were
health.
unremarkable, and his HIV status was
For example, many patients are admitted so
negative. We started him on regular diazepam
that regular antipsychotic therapy can be
and chlorpromazine. He became calm and
administered in order to increase adherence
compliant and he was discharged on
to their anti-tuberculosis and antiretroviral
chlorpromazine. I saw him in clinic a week
medication. Most patients on the ward were
later. He had clear psychotic features and no
naked, and they were often showered outside
side-effects from the medication. I increased
with a hose. A very large number had notable
his dose of antipsychotic medication and saw
extra-pyramidal side-effects from their
him again 2 weeks later. He remained floridly
medication. The nurses based on the ward
psychotic and he had attempted to hang
were remarkably integrated with the patients.
himself. I spoke with my consultant and we
I went onto one ward with a group of students
agreed that he required admission under the
and saw a nurse playing football with a patient.
Mental Health Act.
I returned 4 hours later, and they were still
There are many criticisms that can be made
kicking the ball around, having recruited more
against the Malawian version of the Mental
patients into their game.
Health Act, for example, the length of
There was a disco held every week, and there
detention can go unchallenged, but at least a
was no obvious division between staff and
legal framework to detain people against their
patients, who danced together for hours.
will does exist. He was admitted to Zomba
Often, our psychiatric service was the last
Mental Health Hospital, the only state-funded
option for families who had exhausted their
in-patient psychiatric hospital in Malawi, which
use of faith healers. I saw one lady who had
is situated about an hour’s drive from
developed postnatal psychosis 2 years
Blantyre. Zomba Mental Health Hospital is run
previously. I started her on a low dose of
by clinical officers who have studied for 3 years
chlorpromazine and her symptoms quickly
and then undertaken a Bachelor of Sciences in
resolved. Her older children were delighted
Mental Health. I spent a week in that
that their mother had recovered from her
psychiatric hospital teaching medical students
mental illness. I wondered what effect this
25
remarkable improvement in her condition
and on individuals, was every bit as great as I
would have on her husband, who had been
had anticipated. Resources are incredibly
the driving force behind her previous
scarce and mental health is not a prioritised
consultations with traditional healers.
service in Malawi, or in most other countries in
He too was struck by the difference, but he did
sub-Saharan Africa. Despite this reality, I am
not feel ashamed about her disease, nor did
left with a feeling that is there is still promise for
he express any reservations about their
the future.
attendance at our clinic; he was only
The interventions that I witnessed do work so
remorseful that he had not brought her earlier.
effectively in the clinic I visited, and they are
This made me reflect on the role of traditional
low cost. The psychological and
healers. It was not financial expediency that
pharmacological therapies that were delivered
had driven the family to seek the traditional
need to be scaled up and taken out of the
route, since healers charge for their services
clinic and into the community.
and the clinic did not charge patients.
Perhaps liaison with traditional healers could
There is much debate in low- and middle-
have a role in this extension of services. The
income countries where traditional healers are
social structure I observed, where patients
still practicing widely about whether traditional
were ‘allocated’ a family member to care
medicine could act as an access point to
for them in times of illness, is an immensely
mainstream medical facilities, and whether
positive and useful resource for therapy and
their liaison with mainstream medicine could
rehabilitation in terms of mental healthcare. I
be enhanced.2
am delighted to report that there are now two
On my journey, while I was reading the Lancet
recently qualified Malawian doctors who are
Series, I thought I would be left feeling
working as consultant psychiatrists in that
hopeless and frustrated at the lack of care I
country. Exploring how people with mental
would be able to offer. Of course, many of the
health problems present in Malawi and the
features of care in societies that lack modern
role of traditional healers continues to be an
medical facilities, which were highlighted in the
interest of mine, and I hope to return at some
series, did resonate with my experience. The
point during my career and explore this
burden of mental illness, both on the country
further.
© The Author 2019. This is an Open Access article, distributed under the terms of the Creative Commons Attribution license (http://creativecommons.org/ licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. ST5 Psychiatry, Severn Deanery. Email: p.lilford@nhs.net
26
: By Steveria Kadangwe
One cannot go through cancer treatment without having mental health issues. I was lucky I had a lumpectomy because chemotherapy was a success. A lumpectomy is where they remove only the tumour and reconstruct both breasts to make them look the same. There is the surgery and the painful recovery after. There is chemotherapy and watching your body get ravaged, your stomach rejects all food and your taste buds completely disappear. You can taste nothing, you want nothing, not even water. Yet you must eat something. You have two weeks of a miserable existence every time you have chemo. If you are unfortunate, you have nausea and constant diarrhoea. It’s like your body disappears. All the hair on your body falls off. Sometimes you lie down and wish you never have to get up again, because your bottom burns from the diarrhoea that goes on for fourteen days straight, your stomach is a mess and nothing about you feels right. Some go through chemical menopause with hot flushes and all, and some years down the line, go through the real menopause again. For me, I looked in the mirror and I didn’t recognise the person looking back at me. My mind was struggling to grapple with the truth that I had cancer. The hair that was growing back on my head was spiky and sparse, yet previously I had a full head of thick hair. Yes, I had a breast reconstruction, but the breast that had radiotherapy applied had darkened and the scars were more prominent. I could not find myself, and that is where I needed therapy. Therapy helped me to firstly acknowledge what I had gone through. And come to a realisation that asking why me? was futile. To make peace with both the pronouncement that I had the disease and the reality of the battered body at the end of it all. Therapy helped me to acknowledge that I was a different person, and that is okay too. I had different priorities in life, and that was fine. I could not ease back to the hamster wheel of busy busy busy. I had the opportunity to reflect about my relationships with friends and family and figure out what I would prioritise. Therapy helped me get rid of some of the unhealthy hang ups from my childhood that were driving my behaviour and conduct and to embrace the new normal. Therapy helped me to see myself in front of the mirror instead of a stranger I did not know, to understand the changes I had undergone physically, mentally and emotionally because of
27
the year of treatment. Therapy and counselling helped me make peace with having been a teen mother in the nineties and process the shame and guilt I felt back then, as well as to cope with the mockery and ridicule I went through (and still experience). Therapy helped me to get a grip at one time when work stress was so bad I was literally falling apart. Therapy gave me coping skills for the depression and anxiety that I experienced – when I lost my job, when I heard I had cancer, when I finished treatment as an unemployed person. Until you start naming those feelings and facing that stuff you have gone through that you never talk about, and until you recognise and process your traumas, it all builds up inside and manifests in different ways that often end up hurting other people. Therapy and counselling have given me tools to recognise the triggers, the signs and to deal with things. I actually had my therapy online and did not meet the psychologist. The one thing I appreciate about it is that even if they do not agree with or approve of your choices and decisions, they are a ready listening ear. That helped me to arrive at certain decisions at certain points of my life. Or to recognise the triggers for anxiety and stress, and to be able to gain control without, as my therapist called it, catastrophizing. Life is difficult. Dealing with loss, rejection, childhood trauma, abuse and other issues is something that having someone walking alongside can help you stand stronger and move forward. When it comes to triggers, we need to be aware of the things that set us off. When you find yourself wallowing, always being angry or living with bitter, nerve wracking anxiety; those may be signs that you need to reach out to someone. If you find yourself unwilling to get up or do anything for prolonged periods of time, that may be a sign of something like depression, and seeing a mental health specialist would help unravel the issues that you are carrying so that you can heal. Most times the mistake we make is to wait until we are completely broken or someone we love is completely shattered before seeking help. That should never be the way to go. Reach out to someone today.
28
Health and Wellness
‘He who cures a disease may be the most skilled, but he that prevents it is the safest physician.’ Thomas Fuller.
29
: By Julie Soko
Intimate partner violence (IPV) is a definition for many different forms of violence within relationships both heterosexual and other. It includes physical, psychological, emotional, and even spiritual abuse, stalking, control and manipulation, etc. you may wonder why this term is not just called domestic violence since it has very similar factors to it. Domestic violence is what happens
The International Day of Non-Violence falls on the 2nd of October. Violence is universal. In whatever shape or form, every person on the planet is familiar with violence. One area where violence seems to have taking rot is within intimate relationships. In this article, we look at some factors that may lead to intimate partner violence and how to be mindful of one’s role in that context.
within a home towards any family member, where-as IPV is what happens between two people who are connected romantically. Although it is mostly women who may report IPV, they are not the only victims. Many men experience some form of violence from their partners and many do not report or share their story.
Types of IPV Physical Violence. This includes intentionally hitting, punching, kicking, and any other method used to inflict physical harm on a partner. Sexual Violence. This can involve a wide range of intrusive and unwanted sexual behaviour including forced intercourse (rape), control over one’s body through making unwanted sexual demands, restricting and/or with-holding sex, and controlling a partner’s choice of birth-control methods. Financial Violence. In this context, one partner may have full control over all finances and may deny any financial independence on the other. Another form of this type of violence may be in one partner preventing the other to work or have any independent source of income with the purpose of creating a dependent relation, where they will not be able to leave because they have no income, savings, or income of their own.
30
Emotional/Psychological Violence. This type of violence often makes use of words and actions to manipulate, control, instill fear, and humiliate the partner. As you can see, the root of IPV is usually an issue of control. Where one person in the relationship feels inferior or deeply insecure within themselves for some reason and makes a decision to act in ways that force the other to be submissive and easily controlled. It is important to be aware of the manner through which IPV operates in order to put a stop to it.
The IPV Cycle Tension Building Stage. During this stage a partner may begin to experience pressure from different factors such as work, health, of tension within the relationship. Due to their inferiority or insecure personality, they may begin to feel powerless and out of control. The victim may recognize these signs of growing tension and may try to reduce their distress through pacifying behaviour, to keep the peace. Abuse Stage. In this stage, the abusive partner acts out in ways that exert their perceived control on their partner through one or more types of IPV. Reconciliation Stage. The abusive act is usually followed by a period of calm. The abusive partner may be remorseful and apologise for their behaviour, or they may buy gifts to make up for it and try to move on from the incident. Calm Stage. In the final stage of the cycle, the abusive partner may begin to justify their actions, making excuses or blaming their partner with phrases such as you make me do this
to you, or if you just do …I wouldn’t have to hurt you, or the commonly used I made you, what would you be without me? All this is done in an effort to but the responsibility of their action on anyone else but them, while promising to change their ways. Unfortunately, once the pressure starts to build up in their life again, the cycle will soon repeat itself.
Know the Signs of IPV It is often not easy to tell when you or someone you know is experiencing IPV, aside from physical violence. However, the signs are there once you know what to look out for. Signs
31
With the growing number of qualified mental health workers in Malawi, there is no longer an excuse to live in a dysfunctional family structure. If things are not working, get help! You owe yourself that much. See our Resource section for more.
such as unpredictable moods that can quickly lead to aggression, excessive monitoring and control over the partner’s movements, conversations, and relationships, extreme jealousy, isolating their partner from close connections, blame and responsibility for their negative behaviour is often placed on the victim, the abuser never wants to hear or understand their partner’s feelings. Ending IPV Although it may be impossible to help some couples with coming out of their IPV cycle, there is hope for those who want to work on a better partnership. One of the most effective ways to do this is through knowledge. I personally believe that those intending to marry
must be taught about IPV so that they do not become victims or perpetrators. This issue must be part of pre-marital counselling. Other prevention factors may include ensuring that both partners are financially secure, as this reduces the chance of financial abuse; building self-confidence and addressing negative self-concepts in both partners, teaching healthy coping skills for stress and anxiety – coupled with building awareness on the dangers of falling into an IPV cycle. Working with couples in addressing their problems early in the relationship is always a plus, and it will go a long way in building resilience in their relationship. ‘Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.’ Attitudes Towards Mental Illness in Malawi: A Cross-Sectional Survey. Crabb, J. Stewart, R. & Krishnadas, R. (2012)
32
By Violet Mtali much pride, evil, and selfishness within homes. Instead of enjoying a heavenly experience, most married people endure Intimate Partner Violence is an undeniable
hell. A big part of the problem is societal
hidden truth that exists in many homes.
pressure for couples to fake a perfect
On the outside, many marriages appear to
“façade” of happiness. Frequent reports
be picture perfect. Most couples seem
from the media often state that abused
happy at first glance and go to great
partners in a couple-hood will either suffer
lengths to keep up appearances.
in silence or, worse, are turned away when
However, I have found that when I talk to
seeking help.
most married people, all is not as it seems.
There is a need for awareness of Intimate
Many marriages are struggling. The rate
Partner Violence so that individuals can
of divorce is high all over the world, even
recognize the signs of toxic relationships.
among Christian marriages. It is a very
One thing to look out for is red flags or
sad, bleak, and hopeless situation.
warnings in a relationship. Unfortunately,
However, I personally believe as a married
most couples are so infatuated during
person that if all married people seek
courtship that this does not happen.
God, repent, and obey principles written
Oxytocin, popularly known as the love
in the bible, then all marriages would
hormone, blocks out reasoning and the
succeed.
ability to see the abuse for what it is. By
Whenever we stray from God’s way of
the time the couple is married, it is too
doing things, we suffer. Marriage is the
late and, abusive patterns are normalized.
union of two imperfect people, and
There is often a lot of pretending and
unfortunately, in marriage, we take out
faking during the dating period. Partners
our imperfections, hurts, and weaknesses
tend to give the best impression of selves,
on each other. Instead of giving and
often hiding their weaknesses to attract
receiving healing through a mutual
and maintain their mate.
exchange of redemptive, unconditional
Partners may lie during dating, keeping
love, most married people experience
significant negative behaviours or bad
abuse at one time or another. There is so
habits hidden. I am often confused and
33
puzzled by this trend. Once married, the
that this is not Christ-like, very damaging,
abuse thrives because there is the
and unfair. I think that there must be a
mentality of ownership over the spouse
more balanced approach. Many times,
and partners believe the can do whatever
women are suffering under the
they want. Even when abuse occurs, few
justification that they should be
people on the outside of the marriage are
“submissive.” As a result of this archaic
willing to get involved. Even people of
mentality, many women endure physical,
authority are afraid to take on cases
emotional, verbal, sexual, and financial
involving an abusive husband or wife.
abuse from their partner within a
There is an attitude that a husband and
relationship.
wife need to resolve their issues alone. I
Many men in Malawi suffer in silence too.
agree that a married couple ought to
Men have experienced verbal, emotional,
learn to manage conflict and be adults.
mental, sexual, and even physical violence
However, what should happen when a
at the hands of their intimate partner. In
couple behaves like children who are
our society, men often find it difficult to
bullying one another? Should they be left
ask for help. When men share with others
alone to tear each other to pieces? It is a
details about their abusive relationship,
sensitive area, and although I’m not an
they are perceived as weak. Some people
expert and I have been married for four
will even ask the victims how they can
years, I can safely say that I think many
allow a woman to abuse them? It shows
changes need to be made by the couples
that most people in society have very little
within marriages and the community in
understanding of what abuse truly is. The
which they dwell.
Bible teaches us that God hates violence
I thoroughly enjoyed pre-marriage
and that we are to love our neighbor as
counseling. However, I noticed that there
we love ourselves. Marriage is a reflection
was no teaching on abuse within
of the relationship between Christ and the
marriage. During times when my marriage
church. How can we achieve God’s
was struggling, I asked for help but, I felt
purpose for our lives if we are hurting one
turned away. I strongly feel that there is a
another? What legacy are we leaving for
bias towards men. Even when the woman
our children, and what lessons and
is crying out for help, she gets blamed for
behaviors are we teaching them?
most of the problems. It is as if there is an
For feedback, comments and questions
expectation that a woman should be the
please get in touch with use through our
solution in the marriage. I strongly feel
contact details here.
34
By Julie soko
Malnutrition in the elderly can occur from many factors such as changes in perception, physiological make-up, and general age-related challenges. Changes in perception Loss of hearing and or sight can make it hard for conversation and social interaction, especially around food and mealtimes. It may cause the person to feel isolated and to avoid eating with others. The loss of smell may make enjoying food difficult once
Everyone needs good nutrition in order to keep a healthy thriving body and mind. There are differences in nutritional needs across the age gap and even the gender gap – think childbearing and nursing. In older adults (60+) nutritional needs change naturally due to many factors. When these needs are not met efficiently, malnutrition may result.
the person cannot smell and appreciate their food. A loss of taste, just like the loss of smell, the inability to taste the food is off-putting and makes eating a mechanical rather than enjoyable event. The natural loss of taste buds in the elderly makes it difficult to discern between sweet and sour, which means they may find most foods sour or bitter. Physiological Changes The elderly may experience a loss of energy due to aging as the body’s metabolic rate slows down and they become sedentary. It may mean the person’s normal appetite for food has lessened. People around the age of 60 and above may eat less often or in smaller amounts. Functionality is a challenge among the elderly. With age, there is a redistribution of fats, body tissue which is sometimes are evident in a large stomach and smaller limbs. Fat that builds up around the middle of the torso may be associated with medical conditions such as heart disease and diabetes. There is also a lowered function in the kidneys and the nervous system, leading to nutrition complications. General age-related changes
35
Dentition is when the teeth become
Women in rural areas mainly the elderly
weak, loose, or replaced with ill-fitting or
live in fear of their safety. Recently, more
inadequate dentures (false teeth).
and more cases of elderly victims were
Sometimes access to efficient dental care
reported by the Malawi Network for Older
is not an option for those who have poor
Persons’ Organizations (MANEPO). In
finances or access to a dentist in their
one instance, an elderly woman was
area. Digestive problems like
accused of practicing witchcraft then
constipation, gas, acid and gastritis
stoned to death. Women fear the
problems, ulcers, and diarrhea are regular
consequences of an unfairly settled land
among the elderly.
dispute which often results in loss of
All these factors may lead to a negative attitude towards food and make it easy for the elderly to become malnourished.
property. Vulnerable elderly women also fear family conflict, physical and sexual assault. Fear and anxiety related to these themes may make it difficult for elderly
Malnutrition occurs when the body is deficient in vitamins and nutrients, leading to poor body function, loss of appetite, general malaise, frequent illness, and infections. Vitamins that necessitate health in adults are vitamins A, B, C, D, and E. Supplements such as folic acid, calcium, and niacin are also recommended for good health as we get older.
women to enjoy food or follow a balanced diet. Lack of adequate medical care. Many people in rural and hard to reach areas of Malawi may struggle with accessing high quality medical care. Due to this reason, they may not be diagnosed with malnutrition in good time, or they may spend time and money treating the symptoms of this condition rather than
Malawi being a developing country means that some socioeconomic factors negatively impact the elderly, especially those isolated and have little to no support from family or caregivers. Let's consider the following factors:
the condition itself, often with over the counter painkillers and antibiotics. Financial problems are limiting when accessing a wide variety of fruit, vegetable, and proteins. Therefore, the elderly often suffer from malnutrition.
36
Loneliness
Signs of malnutrition in Adults
and isolation.
Feeling tired and irritable
Some people struggle with the
Loss of appetite
concept of
Loss of fat, muscle mass, and body
cooking and
tissue
eating alone. Especially in the elderly who
Vulnerability to infection
may feel there is no point in making an
Taking longer to heal from illness,
effort. It may lead to snacking, skipping meals, and relying heavily on beverages
injury, and wounds
such as tea and nutrient empty foods, for example, cassava. Death and bereavement. With age comes the loss of loved ones and even family members. Grieving, in itself, is enough to reduce appetite, and make it difficult for the elderly to enjoy food. Illness and disease. Certain
Depression and/or general low mood Stress and anxiety Feeling cold often, if not always What can be done? Because malnutrition is a subjective experience, there is no one size fits all
conditions such as diabetes or heart
approach to the interventions given to the
disease, cancer, or stroke may limit the
elderly in Malawi.
types of food one can eat. If there is no attempt to replace the missing nutrients through supplementation, then the result is often malnourishment. Ignorance. While some elderly people have financial security, good familial support, and access to a healthy diet. However, they may not know the right foods to eat or avoid to be healthy, resulting in malnourishment.
Here are a few suggestions that can help to improve the nutritional lifestyles of elderly Malawians: Clinical intervention may include screening and monitoring of the elderly who present in medical centers. Malnutrition among the elderly is preventable through education and public awareness. However, in terms of the elderly, efforts have to be towards local
37
and accessible interventions. An example
available in most medicine stores, so
of this can be locally made juices like
access is not much of a problem as much
Malambe Juice which is full of vitamin C.
as the knowledge and awareness of this
Malawi has seen a rise in qualified nutritionists. The development implies that
problem. Our elderly family members are
more people in the country can now
valuable as they have contributed to the
consult these professionals and educate
health and well-being of their families but
their families and caregivers about eating
are now in a vulnerable position. Let us
a balanced diet and having a good
educate ourselves to return the favor by
nutrition plan for their elderly loved ones.
providing a healthy and fulfilling future for
Most people do not know any better and
them. By being aware of nutrition in the
end up depriving their elderly due to
elderly, we can help to promote their
ignorance and not because they cannot
physical, psychological, emotional, and
provide for them.
spiritual health.
Food supplements, herbal alternatives, multivitamin tablets/syrup are all readily
For any health-related challenges that may be evident in your family, especially in your elderly family members, please get in touch with your nearest medical practitioner and be sure to ask whether the symptoms they are experiencing may be due to malnutrition and a poor diet. These problems can be sorted out very quickly before they lead to more complicated health conditions.
38
Resources
Most of us have seen the posters on the next page going around on social media, they are catchy and straight to the point. We approached one of the people involved in order to find out more about this initiative. Pastor Chris Suya is the Senior Pastor at the Assemblies of God, Berachah International Assembly Church in Nkolokoti. He tells us more in this short interview. Please tell us more about the project and who is involved The End Suicide for Good Campaign is an initiative that seeks to curb the prevalence of suicides among young and old people by providing free counseling services for those in need. To ensure trust from the concerned individuals, we conduct an anonymous call-in service. Currently, we have 4 Counsellors situated in The Northern, Central and Southern Regions and with those, we have managed to “save over 340 lives” from 31st May to date.
How did you develop this concept? The concept was developed after being deeply concerned with the rising number of people going through mental health issues leading to depression and often finding a solution in committing suicide. It was founded by Mr Harris Chiwalo, who brought in board counsellors among them pastors and professional mental health experts. Posters started being designed and circulated on social media offering a free phone call counselling service to the public. What would you want people to know about the project? We are encouraging opening up, raising awareness that mental health problems are issues that need treatment just like any other physical and societal issue. We are encouraging people to support each other and help to find a solution for everyone going through psycho-social problems. Personal statement Let's end stigma! If you would like to join the movement then get in touch, we are calling for and welcoming resources to run this project country wide, and beyond social media.
39
40
I cannot say that I am a tech-savvy person. However, I am someone that loves apps. There is an app for absolutely every topic on the internet. It’s very hard not to find a relevant app especially for mental health. Over the years I have discovered some pretty useful ones that I often share with clients and encourage them to use as additional support. The reality is that most people live pretty isolated lives, busy and rushed with no time to be around calm, soothing environments. Some have many responsibilities and can never truly find the time for self-care activities. Well, here are some apps that may be helpful for you to use in a small part of your daily life.
If you are looking for a way to improve sleep, reduce stress and anxiety, improve your focus, engage in some self-improvement, and work on better breathing techniques – this is the app for you. This is one of the very first self-care app I was introduced to some years ago. It is a great tool for those who have lost touch with themselves and wish to reconnect in a healthy way. My personal favourites are the master classes, the stretches for relaxation, the soundscapes, and the breath work. There’s something for adults and children, I would rate this app as one of the best out there. Find out more at Calm - The #1 App for Meditation and Sleep
A personal favourite, this app does just what it says on the box. Unlike other meditative practices, the goal is not to empty your mind or focus on your breathing. It is rather to focus on the Words that Jesus’ spoke as it is being read to you, reflecting on it and listening for God’s inspiration for your life. Each time you listen to scripture feels like you are hearing it for the first time, and you have a chance to really think deeply about Jesus’words and how they relate to your daily lived experience. Examples for scripture meditations to choose from include Who is Jesus, Spirit and Life, God the Father of Good
Gifts, and many more, all read from the Bible – the actual words of Jesus. The app is available on the Apple Store and Google Play Store. Find out more at Jesus Words Meditation - Apps on Google Play / Jesus Words Meditation on the App Store (apple.com)
41
Built on theories of behavioural science from Duke University, this app is a useful tool in helping you make smart changes and build heathy habits through guided programs. The goal is to help you make the most of your life while providing solutions to help you follow through on your own good intentions. Whether it is learning how to practice deep work focus, learning to love-self, managing addiction, or improving sleep. You can achieve your goals with this dedicated coach on your phone. You can also join groups of people pursuing the same goal as you are and get the encouragement you need. The app is very encouraging and has a personalized feel to it. It is easy to use even for the most tech averse people out there. I would recommend it for anyone wanting to regain some motivation, routine, and inspiration in their lives. Find out more at The Fabulous - Build better habits & achieve your goals
Much like Jesus Words Meditation, this app is focused on values of truth, love, and peace. Using the scriptures, mainly the Words of Jesus Christ, the app offers daily 5 minute meditations, soul-care, specific topics such as anxiety, peace, healing, rest, and acceptance. It also offers help with falling asleep, scripture readings, songs, and lullabies for kids. The app is suitable for those with little time in their day, and those that have stressful or demanding jobs. Spare five minutes here and there and get a Bible based boost to give you some hope to brighten your mood. Find out more at Soulspace Christian Meditation | Home
Some of you have heard about the app called Wysa. I have not used this app very long, however I have found it to be very useful. If you have no reservations with chatting to an AI (Artificial Intelligence) chatbot about your mental health concerns, then this is the app for you. The AI has a warm persona and seems to say the right things at the right time which many people find very helpful. It makes use of Cognitive Behavioural Techniques to make you feel heard, available 24/7. If the idea makes you uncomfortable, you can always opt to speak to a therapist instead. Find out more at Wysa - Everyday Mental Health
42