03
CONTENTS
EDITORIAL BOARD
04 LETTER FROM THE EDITOR-IN-CHIEF
05 CONTRIBUTORS
06 IT'S OKAY NOT TO BE OKAY
08 MENTAL HEALTH DISORDERS: UNTOLD STORIES OF OUR HEROES AND HEROINES
10 EFFEMINATE NIGERIAN (GIRLY MAN)
13 THE IMPACT OF COVID-19 PANDEMIC ON MENTAL HEALTH OF NURSES
15 COVID-19 PNDEMIC: “THE GUARDIANS OF HEALTH” - IS THEIR MENTAL WELL-BEING GUARDED?
18 MENTAL HEALTH AND COVID-19: IMPLICATIONS ON HEALTHCARE WORKERS
IPSF AfRO Newsletter Issue 16 | 1
CONTENTS
20 PRESSURE OF NIGERIA’S ECONOMY ON HEALTH PRACTITIONERS
23 MENTAL HEALTH IN THE MEDICAL WORLD
24 UNTITLED POEM
25 AT LEAST YOU GET TO GO OUT AT NIGHT
26 HEALTHCARE WORKERS, PATIENTS AND MENTAL HEALTH: THE INTERSECTION
28 DEPRESSION AMONGST PHYSICIANS
30 THE MENTAL WELLBEING OF OUR FRONTLINE SOLDIERS
32 ESCAPE FROM DEPRESSION
36 IPSF AfRO Newsletter Issue 16 | 2
SILENT SUFFERING: ADDRESSING THE PANDEMIC OF POOR MENTAL HEALTH AMONG NIGERIAN PHARMACY STUDENTS
IPSF AfRO Newsletter Issue 16 | 3
Dear Reader, The global COVID-19 pandemic has impacted our lives greatly psychosocially. As young professionals and students in the medical and pharmaceutical field, our mental health and well-being have been of crucial concern during this pandemic era. The conversation around mental health has been ongoing via different fronts all over, and even before the COVID-19 pandemic. However, there is still more that needs to be done especially in the Sub-Saharan Africa region. This publication is intended to raise awareness on and promote the importance of good and stable mental health. It features articles and submissions proudly written by AfROers and we hope that you enjoy reading them in addition to learning different perspectives about mental health from the contributors. As Demi Lovato (American singer and songwriter) alludes, "You do not have to struggle in silence. You can be un-silent. You can live well with a mental condition, as long as you open up to somebody about it." Embrace the power of
speaking up. Editor-In-Chief Silvanus Manyala Regional Media and Publications Officer IPSF African Regional Office
MENTAL HEALTH IN THE MEDICAL WORLD
CONTRIBUTORS AISHAT DUROJAYE YUSUF RASHIDAT O. OTONO FAKHRUDEEN MUHAMMAD SANUSI ABDULQUDUS ABIOLA MAVI VAL-UGBOMA ALEX KAMANGU JIMOH SARAT AYOMIDE NWOFIA MARTIN ADEDIJI NAHEEMAH A. IBRAHIM AISHAT CHRISTOPHER MALUNDU OLOWOLAGBA SHALOM MOROLAKE I. OTITODUN GANIYAT AYILARA OLUWASEYI EGBEWANDE
IPSF AfRO Newsletter Issue 16 | 5
MENTAL HEALTH IN THE MEDICAL WORLD
BY AISHAT DUROJAYE Medical professionals have always been endowed with the responsibility of curing or preventing disease with their skills, a strong sense of duty for them involves choosing the patients first [1]. The Hippocratic Oath, one of the oldest and most important standards of ethics in medical history, gives medical professionals a moral code of behaviour to follow in order to keep doctors and patients on good terms. The Hippocratic Oath states that medical practitioners will use their skills for the benefit of the sick to the best of their abilities and judgment and that they will protect the sick from injury and injustice. It also promises that they keep their word and not break the pledge. The duty of medical practitioners is addressed in this notion of implementing actions for the welfare of the sick [2].
IPSF AfRO Newsletter Issue 16 | 6
Medical professionals, due to the commitment required of their profession, feel they are expected to provide care to patients even when they could be exposed to dangerous situations. There is always a risk of being exposed to hazardous situations, and this article aims to address situations where medical professionals intentionally expose themselves to these situations with little regard for their mental capabilities/strength in order to provide care for their patients. Medical practitioners, especially young doctors and nurses, although scared, find themselves thinking mostly about their patients because they do not wish to be considered weak or selfish. Also, peer pressure from their senior colleagues who are ready for the particular situation can push them beyond their limits. In situations where they actually need help with their mental health, they are mostly reluctant to consult another physician in the same institution. [3,4,5]
At the onset of the COVID-19 pandemic, there were no known treatment/cure options available yet medical professionals were at the frontlines, exposed sometimes without their consent to the virulent disease, sacrificing themselves [6]. Emotional, psychological, and social well-being all fall under the scope of mental health. It also influences how we deal with stress, interact with others, and make healthy choices 7]. Therefore, when a person's resources and coping abilities are stretched beyond their limits, their mental health could be impacted [8]. The mental health of medical practitioners is thus directly influenced by life-threatening situations. They are exposed to occupational stress and pressure from the public when some of them just want to be with their families to assure them that they will see through it together [9].
A high amount of work-related stress could make medical professionals more vulnerable to mental illness and lead to inadequate delivery of clinical care [10]. Post-traumatic stress disorder (PTSD), depression, anxiety, and other mental health disorders have been linked to healthcare jobs during epidemics and pandemics like SARS, MERS, and Ebola illness, according to various studies. Potential risk factors have also been identified, including being assigned to work closely with patients suspected of carrying the virus, according to a research [11].
A high amount of work-related stress could make medical professionals more vulnerable to mental illness and lead to inadequate delivery of clinical care. Medical professionals are also humans, with responsibilities to themselves and their families in addition to patients. The health of a doctor is just as important as the health of a patient, hence more attention should be placed on the safety and health of medical doctors, nurses, pharmacists and other healthcare professionals in a pandemic or epidemic. They should also be allowed to choose what is best for them, with the understanding that it is okay not to be okay.
IPSF AfRO Newsletter Issue 16 | 7
REFERENCES 1. Mccoid AH. Issue 3-Symposium on Professional Negligence Article 2 6-1959, The Care Required of Medical Practitioners. Vanderbilt Law Rev. 1959;12. 2. Acikgenc A, Zafar Afaq Ansari T, Shigeru K, et al. Imposition of Good Samaritan Laws to Improve Professionalism among Medical Practitioners. journals.iium.edu.my. 2017;37(1). Accessed December 7, 2021. https://journals.iium.edu.my/intdiscourse/index.php/id /article/download/1065/730 3. Safdar K, Palazzolo J, … JA-WSJ, 2020 undefined. Young doctors struggle to treat coronavirus patients:’We Are Horrified and Scared’. fmda.org. Accessed December 7, 2021. https://www.fmda.org/COVID/Media/YoungDoctors-Struggle-to-Treat-Coronavirus-Patients_-WeAre-Horrified-and-Scared---WSJ.pdf 4. Hey S, Macdonald EB, Mccloy EC, et al. Sick doctors. Workaholics harm families also. BMJ Br Med J. 1994;309(6963):1235. doi:10.1136/bmj.309.6963.1235 5. Beach SL. Of Heroes and Cowards. N Engl J Med. 2020;383(6):e36. doi:10.1056/NEJMP2013266/SUPPL_FILE/NEJMP20132 66_DISCLOSURES.PDF 6. Dyer G, surgery SL-TJ of bone and joint, 2020 undefined. What’s Important: COVID-19—Helpers, Not Heroes. ncbi.nlm.nih.gov. Accessed December 7, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC72246 16/ 7. Mental health: strengthening our response. Accessed December 7, 2021. https://www.who.int/en/newsroom/fact-sheets/detail/mental-health-strengtheningour-response 8. About Mental Health. Accessed December 7, 2021. https://www.cdc.gov/mentalhealth/learn/index.htm 9. Llena-Nozal A, Lindeboom M, Portrait F. The effect of work on mental health: does occupation matter? Health Econ. 2004;13(10):1045-1062. doi:10.1002/HEC.929 10. Su JA, Weng HH, Tsang HY, Wu JL. Mental health and quality of life among doctors, nurses and other hospital staff. Stress Heal. 2009;25(5):423-430. doi:10.1002/SMI.1261 11. Greene T, Harju-Seppänen J, Adeniji M, et al. Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVIDEur J Psychotraumatol. 2021;12(1). doi:10.1080/20008198.2021.1882781/SUPPL_FILE/ZEP T_A_1882781_SM3861.DOCX
MENTAL HEALTH IN THE MEDICAL WORLD
UNTOLD STORIES OF OUR HEROES AND HEROINES
Most people see Spiderman, Superman, Batman, and their likes as heroes but our true heroes and heroines are the healthcare workers; medical doctors, nurses, pharmacists, laboratory technicians - the multidisciplinary team working round the clock, giving their best to help, care for and save lives. These professionals work for long hours diagnosing patients, recording symptoms of illness, monitoring patients' health, running tests, prescribing, dispensing, and administering medicines as well as providing emotional support for patients and concerned family members and of course, after spending years studying and training in medical school. When faced with a lot of duties and responsibilities, it could be both physically and emotionally tasking. Since they spend the majority of their time at work, they have little or no time to rest, exercise, or spend time with friends and family. They witness a variety of horrific traumas, ranging from seeing people suffer physically, mentally, and emotionally to witnessing people lose their lives. Healthcare workers are under pressure to show empathy to patients rather than expressing negative emotions. They are expected to suppress their negative emotions. This is referred to as emotional labour. They also face unrealistic patient expectations, heavy workloads, stress, anxiety, and high emotional exhaustion.
All these may result in burnout. Excessive and prolonged stress can lead to burnout which is a state of emotional, physical, and mental exhaustion. When one is overwhelmed, emotionally drained, and unable to meet constant demands, it's referred to as burnout. Burnout raises the risk of depression, posttraumatic stress disorder, and suicidality, among other psychiatric disorders. They also face sleep disorders as a result of shift and night work. The stigma associated with mental health disorders discourages many people from disclosing their depression. Healthcare workers are afraid of naming and blaming, sanctions, lack of confidentiality documentation on their professional record, and job loss. Thus, depressed healthcare workers face professional and institutional stigma when trying to seek care, making them more isolated and vulnerable. Society forgets that a diagnosis of depression does not always imply a loss of professional abilities. As our heroes' and heroines' mental health declines as a result of dedication to their profession, there are little gestures we could do to help them overcome. The next time you visit the clinic, show respect to health care providers. Check in on health care workers and if you have family or friends who work in the field, see if they are okay and want to talk. A little gratitude can go a long way.
REFERENCES
1. Ann Occup Environ Med. 2018; 30: 31. Published online 2018 May 3. DOI: 10.1186/s40557-018-0244-x 2. K Outhoff (2019) Depression in doctors: A bitter pill to swallow, South African Family Practice, 61:sup1, S11-S14, DOI: 10. 1080/20786190.2019.1610232 3. Local Reg Anesth. 2020; 13: 171 – 183. Published online 2020 Oct 28. DOI: 10.2147/LRA.S240564
IPSF AfRO Newsletter Issue 16 | 9
Effeminate Nigerian I read from Facebook about the loss of a child. A mother took her son to his aunt's place. The aunt took it upon herself to exorcise this boy of this spirit of femboy by taking him for deliverance at a church. Drama began. The pastor at the church did not take it easy on him. He pushed, flogged, and did all sorts of rubbish on him. He went into a coma and before jack could be said, he passed on. A boy that was just about to begin the bitter journey of being an effeminate man. Effeminacy is the manifestation of traits in a male that are often associated with feminine behaviour, mannerism, style, or gender roles. You could define it as the state of males not being sufficiently masculine according to the expectations of their culture which could include traits like virility, emotional control,
IPSF AfRO Newsletter Issue 16 | 10
and lack of demonstrativeness. This term effeminacy carries negative connotations and feeds patriarchy fat. There have been a whole lot of causes thought to be lead to this. Endocrine-disrupting hormones disrupt the proper functioning of human hormones leading to the feminization of males. Some plants produce chemicals compounds that have a similar effect as human estrogens (female hormone) like nuts, cereals, legumes, and oilseeds. It is thought that frequent consumption of these phytoestrogens contributes to male feminization. This knowledge isn't common. You behave like a woman, man up. No excuses.
There is this guy that resides close to my street. He wears tight jean trousers. The times I've seen him, the colours of his polo are usually in the bright colour spectrum; pink, yellow, burgundy, you name them. It offensively looks good on him and you will just love the colour combo. That's not where his magic ends. The way he sashays as he walks down the streets unapologetically, his gesticulations as he speaks, and the curious disappointed looks on the faces of the onlookers as he struts down the street. A friend of mine told me a story of how he was sexually assaulted. He was coming late from work that day and was stopped by this group of guys. They forced him to orally pleasure them and took turns to sodomize him. He cried and begged all through. This young man was molested and probably scarred for life and the perpetrators justified this evil with "e dey do like a woman". Should we talk about how many jobs he has lost because of something he has no control over?
want to be heard. Being seen is pretty risky. I just want to go unnoticed. In a school full of testosterone hormones, you must be noticed. "Ome ka nwaayi" "onye ntu" "sissy". Labels! Labels that are not true. Labels that do no justice to the magic I make daily. Labels that downsize my achievements. My friend talked about how he was called up before his class to prove he was a man by his college lecturer. He told him to pull down his shorts and show the class his penis. I mean, the lecturer might be right, he must have tapered his breasts to his chests. How bad can it be? How comfortable can it be living in an uncomfortable body? His parents do not help. His mum does not like him being out of his room when her coworkers swing by at home. The dad? He only talks to him in the confines of their house. You have parents but it seems like you are a dejected orphan. Two failed suicidal attempts spiced with long episodes of depression. Beat that reach!
Effeminate men are not disabled, they are not handicapped, and they are not dunce. They are men in their complete regalia. I remember speaking with a group of friends about their thoughts on effeminate men. They ignorantly said that effeminate men are like that because they chose to be. I was taken aback and shocked. These are future parents with no idea of how these things work. They think solely that they woke up and started behaving like that.
It was at a party. His first and last. These girls took turns sexually assaulting him. They said he needed to man up. Having sex was the easiest way to prove it. They wanted to explore the flavour of a sissy in bed. Report? Excuse you! We are contemplating whether you are a man or gay and the only proof to say you are the former and not the latter is to rape you and you want to make a fuss about it? Unbelievable! Sadly, he has been on his HIV regimen for 3 years now. No one wants an HIV+ sissy. Boy, no one.
At some point in my life, I blamed God because the Bible made us understand that he is the creator of all. I was filled with anger, resentment, and hatred. How could preachers paint him white while I get to see the mistake of a creation that I am? You have the male genitalia, chest, and some very few attributes of men but the characteristics are borderline feminine. Callistus, one night taught me how to walk like a man. Painstakingly, I took lessons. Spread your legs while walking, your butts are shaking so much, slow down, your arms are swinging too much, that's attentionseeking. I practised day and night, I lost my voice in meetings, school, and church. I don't
Oh, me? How am I coping with the effeminacy? I have a very small group of friends that I am extremely vulnerable to. They see behind the charade I present externally. The mask I wear every day pretending that I am okay is glued to my face like to what water is to fish. You cannot believe that I have had a failed suicide attempt. This is a never-ending pattern for me and my kind out there. I see young boys who are effeminate. I feel pity for them. The hate will hit them below the jaw real quick. You better be prepared and the only preparation you will have is a loving, accepting, and adjusting family. I pray you never succumb to thoughts
IPSF AfRO Newsletter Issue 16 | 11
of ending it all thinking it is the easiest way out. You are always the second option. There are no manners on how effeminate men should be treated. There are no set methodologies or guidelines on how they should be treated. They are humans, treat them like one. Being a Nigerian man is hard. Being an effeminate Nigerian is harder. Nwofia Martin.
THE IMPACT OF COVID-19 PANDEMIC ON MENTAL HEALTH OF NURSES By Otono Fakhrudeen Muhammad the
Intensive Care nurses. Nurses have been
global society, the physical health and
confronted by unprecedented traumatic
mental well-being of Nurses and other
experiences
healthcare professionals are at risk for
pandemic,
some negative well-being outcomes due to
countries that have not experienced similar
their
epidemic outbreaks in recent years.
As
COVID-19
roles
continues
as
care
to
impact
providers.
Nurses
during this
is
the
more
COVID-19
particular
to
worldwide have been facing mental health challenges before the COVID-19 Pandemic
At the beginning of the spread of the virus,
and the outbreak only seems to have
hospitals
escalated the situation, especially for the
personal protective equipment, and
guidelines or treatment were not well-
Assessing and preserving the mental health
established,
state
causing
confusion
and
of
had
limited
nurses
infected with this deadly virus. Exposure to
importance for optimum disease control.
such cases with no training beforehand,
There is a need for psychiatric interventions
longer
the
to address the mental well-being of nurses
growing health care demand, stigma, and
treating COVID-19 patients. This can be
loneliness from constant exposure to the
through
ravaging disease are among the factors
increasing
which caused burnouts among nurses. The
psychological and mental support services,
continuous stress nurses are facing could
e-learning
trigger post-traumatic stress symptoms,
communication skills, case handling skills,
occupational
poor
and problem-solving skills to deal with
delivery service, suicide imagination, and
likely psychological problems that may
suicide.
arise from dealing with COVID-19 patients.
burnout
IPSF AfRO Newsletter Issue 16 | 13
to
manage
syndromes,
organizational social to
is
healthcare
professionals,
hours
general,
all
of
hesitancy in the treatment of patients
working
in
and
availability
utmost
interventions,
support, educate
of
providing nurses
on
IPSF AfRO Newsletter Issue 16 | 14
MENTAL HEALTH IN THE MEDICAL WORLD
COVID-19 PANDEMIC: “THE GUARDIANS OF HEALTH” IS THEIR MENTAL WELL-BEING GUARDED? BY SANUSI ABDULQUDUS ABIOLA
Like every other pandemic in recent history (e.g. the
Healthcare professionals encounter unanticipated,
SARS outbreak of 2003 and the Ebola outbreak),
life-threatening
COVID-19 has taken its toll, not only on the physical
pandemic, especially those on the first line. A cross-
well-being but also on the mental health of people
sectional study of 1,257 healthcare workers who cared
worldwide, not excluding the "guardians of public
for COVID-19 patients in several places across China
health"- healthcare professionals.
found that poor mental health symptoms were quite
circumstances
by
the
COVID-19
common. Depression (50%), anxiety (45%), insomnia (34%), and psychological distress (72%) were all
What is Mental Health?
reported by healthcare personnel. Using an agematched comparison group, healthcare providers
Although the definition of mental health varies, it
were significantly more depressed and generally
describes the state of a person's mind. It includes
anxious than the non-healthcare providers during the
psychological and social well-being; how we think,
first months of the pandemic across the United States.
act, relate with people and make healthy choices. The indicators of poor mental health include but are not
The high level of infection, mortality, lack of sufficient
limited to depression, insomnia, and anxiety. Mental
personal protective equipment, fear of the disease,
health problems are often associated with stress.
intense fears that their family and friends might die of the disease, grief and helplessness when these deaths
It is not unknown that public health emergencies
occur, all negatively impact the mental health of
(such as the COVID-19 pandemic) cause mental
health professionals.
trauma, mounting a burden on the mental well-being professionals.
Another cause of mental strain is the heavy workload.
Coronavirus was identified first in Wuhan, China
Healthcare providers now have to work longer hours
December 2019. Since then, the world has plunged
than usual, resulting in tiredness and extreme stress.
into panic, and healthcare professionals included.
As a result of understaffing and over-stretch of
of
individuals
and
healthcare
hospitals with COVID-19 patients, they now have to work more than they used to.
IPSF AfRO Newsletter Issue 16 | 15
MENTAL HEALTH IN THE MEDICAL WORLD
Underlying conditions like diabetes and hypertension
The public can help by following the COVID-19
coupled with the fear of contracting the virus have
protective protocols, such as wearing nose masks and
heightened the tension of some healthcare providers.
keeping a safe distance from others. These protocols
Research of dentists in Israel showed increased
significantly reduce the spread of the virus among the
psychological distress, heightened fear of infection in
population, lessening the workload of healthcare
those with a history of diseases. Rumours at the onset
providers.
of
the
pandemic
conditions
are
say
people
generally
more
with
underlying
vulnerable.
It
heightened their fears.
Employers
and
the
government
should
pay
healthcare professionals better to reduce brain drain and strengthen the health workforce. For instance, in
Working in hospitals overloaded by COVID-19 patients,
Nigeria, about 12% of the total number of nurses in
with a lack of efficient therapies and equipment
Nigeria had emigrated as of 2000. At least 2,000
shortages such as ventilators, has posed ethical issues
medical physicians are estimated to leave Nigeria
for healthcare personnel in Italy. They try to balance
each
their safety with the need of patients and families and
currently employed by the British National Health
also make decisions that might go against their moral
Service in the United Kingdom. Better remuneration
beliefs.
can prevent this.
So, is the mental well-being of our heroes guarded?
Employers and the government should ensure the
The answer is - NO!
provision of sufficient personal protective equipment.
year,
with
5,407
Nigerian-trained
doctors
It will reduce the fear of infection among health professionals, especially those at the front line.
How can they be helped? It is imperative to keep our heroes in a positive state of Healthcare providers are motivated when they see
mind, enabling them to continue to guard public
their efforts being recognized and rewarded by
health and help us through these trying times.
employers, patients, and the government. Individuals should appreciate their efforts, and offer help when needed.
IPSF AfRO Newsletter Issue 16 | 16
"It is imperative to keep our heroes in a positive state of mind, enabling them to continue to guard public health and help us through these trying times."
REFERENCES
IPSF AfRO Newsletter Issue 16 | 17
MENTAL HEALTH AND COVID-19
IMPLICATIONS ON HEALTHCARE WORKERS By Olowolagba Shalom
Coronavirus has rampaged through the world, leaving harsh consequences behind. Everyone had their fair share of bad experiences from the pandemic, and our health care workers were not left out. They have endured quite a lot as they were the ones on the front lines during the pandemic. According to the Oxford Dictionary, mental health is the state of the psychological and emotional well-being of people. It is the state of well-being in which individuals are able to cope with the normal stresses of life. "Good mental health is absolutely fundamental to overall health and well-being,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization [1]. IPSF AfRO Newsletter Issue 16 | 18
Many healthcare workers were damaged mentally by what they faced during the pandemic. The public believed they were well paid, forgetting about the healthcare workers' state of well-being. Healthcare workers suffered mostly from depression and anxiety [3]. Most healthcare workers were separated from their families and the things they loved, causing them emotional distress because they were confined within the hospital. Also, healthcare workers form strong bonds with their patients, so when those patients experience near-death events (or even die), it affects the healthcare workers negatively. Healthcare workers became personally and emotionally unstable [3]. They could not sustain relationships outside their work, leading to poor interpersonal relationships. Most healthcare workers find it hard to interact with the outside world because their perceptions are drastically different, due to their experiences. During the pandemic many pharmacists, medical doctors and nurses had to work around the clock, leading to mental stress because they are not machines. Most healthcare workers were not prepared and adequately trained to combat the virus [2]. Healthcare workers became addicted to drugs and alcohol. They used drugs and alcohol to suppress their fear, anxiety, depression and they also used them to stimulate and boost their energy, leading to drug and alcohol independence [2].
Healthcare workers went through a lot of physiological and emotional distress during the pandemic. They were the heroes of every nation, not just because they were at the front lines, but because they had to neglect themselves while taking care of others.
References
1.
COVID-19 disrupting mental health services in most countries, WHO survey.
2. Claidia Carmassi, et al. PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic? psychiatry Res. 2020 Epub 2020 Jul 20. https://www.ncbi.nlm.nih.gov/pmc/ar ticles/PMC7370915/ University of London 3. City, Institutional RepositoryCitation: McManus, S. ORCID: 0000-0003-27110819, Bebbington, P. E., Jenkins, R. andBrugha, T. (2016). Mental Health and Wellbeing in England: the Adult Psychiatric Morbidity Permanent repository https://openaccess.city.ac.uk/id/eprin t/23646/
Many healthcare workers suffered from bipolar disorder caused by recurring depression. Others have been very aggressive during the pandemic because they were depressed, sad and they felt emotionally detached from people [3.]
IPSF AfRO Newsletter Issue 16 | 19
PRESSURE OF NIGERIA’S ECONOMY ON HEALTH PRACTITIONERS By Morolake I. Otitodun
"The state of mind always reflects on our daily activities. Heavy and unsettled minds give rise to cloudy and unproductive ideas. Hence, a sound and healthy mind are important for productivity." IPSF AfRO Newsletter Issue 16 | 20
Man is not God, a common statement people make to portray the imperfection of man. So health practitioners who we look up to as gods have flaws just like any human. The term "health practitioner" is diverse and includes doctors, pharmacists, nurses, dentists and many others.
Health practitioners maintain health in humans and animals through the application of principles and procedures of evidence-based medicine and caring. The process of maintenance of the health of others often leads to work-related stress, which impacts their mental health negatively. Most often, health practitioners do not subject themselves to mental health evaluations or even admit to mental health problems because of fear or about damaging job prospects and being looked down upon by other colleagues.
Generally, People have different ways of dealing with stress, some exclude themselves from the world, and some take a walk, and listen to music while other people turn to substance abuse as a means to let it all out. In Nigeria, where so many misconceptions as regards mental health continue to bud makes people with mental disorders feel less confident of themselves or fear being labelled as a mad person. Economic factors rank as one of the major factors that can negatively affect the mental health of health practitioners. The impact of the poor economy on the mental health of health practitioners lead to burnout and mental ill-health which in turn lead to medical errors, poor quality of care, poor judgments and poor relationships with patient, staff or family. Some of the economic factors affecting health practitioners in Nigeria include and are not limited to the following: High standard of living: Everyone wants a comfortable life, who can judge that. Standard of living is often referred to as the level of wealth, comfort, material goods and necessities of life available to a certain class or area. In Nigeria, the average take home for a resident doctor working with the government is about ₦235,000:00 from which he is expected to pay for rent, personal income tax, settle contributory pensions, pay professional association levies, feed the family and other responsibilities. The combination of these monthly responsibilities cum high cost of daily needs caused a decline in living conditions for Nigerian citizens without the exception of health practitioners. The cycle of the rich getting richer and the poor getting poorer never cease.
High living standards coupled with income decline, high inflation rate, incomplete incentive payment and uncertainty of payment often led to industrial action (strike) in some cases. For example, the Nigerian Association of Resident Doctors (NARD) embarked on a labour strike on the 2nd of August 2021 because of a pay dispute and breach of the agreement by the federal government but the strike was suspended on the order of the court on 23rd August 2021. Also, the income decline weighs negatively on the mental health of health practitioners leading to low productivity, poor service delivery, poor judgments and poor health outcomes for the patients. As earlier stated, no man is God. Who would not want to increase the prices of drugs or services to meet their pending needs? At least man needs food to survive and apart from that, good health is also a necessity leaving patients with no other option but to adhere.
Lack of adequate health infrastructure: The lack of adequate health infrastructure has negative implications on the health care delivery system and reduces motivation for performance by health workers. Abandoned projects by past administrations and lack of basic health infrastructure have led to work-related stress and exhaustion. Instances where patients had to be turned away from a health facility due to inadequate infrastructure decreased the will of health workers to adequately perform their duties.
MENTAL HEALTH IN THE MEDICAL WORLD
IPSF AfRO Newsletter Issue 16 | 21
Unavailability of drugs and equipment at health facilities lead to demotivation of health workers and increasing burnouts as they believe their efforts are futile due to lack of necessary equipment to foster their work. They are unable to perform their professional duties adequately and accurately, thereby not seeing their patients happy and fulfilled. This act on its own breaks down their morale and pushes them into mental stress due to the fact of being occupationally handicapped and not being able to offer more of their services to save lives.
Poor road infrastructures: Health workers do not only offer services in the hospitals, pharmacies amongst others but also offer their professional services at home during home visits to patients. Poor road networks and sometimes lack of means of transportation could be a hindrance to this process. Some health practitioners have been unable to participate in home visits due to fear of road accidents as a result of the poor road network. This has made them turn down requests from patients who are unable to personally transport themselves to health centres due to their health conditions and so many other reasons. All these affect their overall performance, thereby negatively affecting their mental health due to the fact that their potentials are not being put to maximum use. The impact is low productivity and the inability to offer professional services to the fullest, which in turn lead to poor health outcomes for the patients.
The state of mind always reflects on our daily activities. Heavy and unsettled minds give rise to cloudy and unproductive ideas. Hence, a sound and healthy mind is important for productivity.
REFERENCES
Yewande kofoworola Ogundeji., Cath Jackson., Trevor Sheldon., Olalekan Olubajo., Nnenna Ihebuzor (2016). Pay for performance in Nigeria: the influence of context and implementation on results. Health policy and planning, 31(8): 955-963. https://doi.org/10.1093/heapoi/czw016 Joseph Afamefuna Nduka., Amalachukwu Chijindu Ananwude., Charity Ifunanya Osakwe (2019). Expenditure of the Federal Government of Nigeria: Effects on the standard of living of her citizens. International Journal of Academic Research in Accounting, Finance and Management Sciences, 9(4): 57-64. Baba Awoye Issa., Abdullah Dasliva Yussuf., Ganiyu Toyin Olanrewaju., Olatunji Alao Abiodun (2015). Mental health of Doctors in a tertiary hospital in Nigeria. Pan African Medical Journal, 19(178): 178. DOI:10.11604/pamj.2014.19.178.3642.
MENTAL HEALTH IN THE MEDICAL WORLD
IPSF AfRO Newsletter Issue 16 | 22
MENTAL HEALTH IN THE MEDICAL WORLD BY GANIYAT AYILARA
“You don’t have depression,” Dr Bola told herself as she passed the therapy ward of Grey Sloan Memorial Hospital, Chicago. How could she fathom the idea, she had just given birth 6 months ago and this should be the happiest time of her life as people have constantly told her and besides, she was Nigerian and Nigerians do not have mental problems. “A penny for your thoughts?” Dr Jackson invaded her thoughts and she realized she had been standing still in the hallway. “What are you thinking so intensely, are you missing your baby?” he asked. Why does everyone ask her about the damn baby, it's like her whole identity changed after giving birth, she's no longer the super smart and pretty doctor who had a bright future ahead of her, she had been reduced to someone's mom, someone who has kept her up all night since he was born and doesn't seem to like her touch as much as his father made her irritable and of course, she has dropped 20lbs since he was born. “Yes I miss my baby”, she replied and smiled courteously as expected of her and moved to the elevator to take her to the underground garage. She had just completed an 18 hours shift and was on her way home. On entering her car, she had a mini crying session which came as no surprise, she had been doing a lot of that these days but was grateful for the privacy of the quiet garage. Tap tap, she jerked up from her thoughts and saw Dr Jackson again. What is the problem now she thought but smiled up at him? “Do you know doctors make the worst patients?” he asked, and she looked confused. “You haven't been yourself today Dr Bola, you were often lost in thoughts, you were super hard on your residents today and now I find you crying here, are you ok?” It was the first time anyone had asked if she was ok since giving birth and like a trigger, it opened the floodgates and she opened up to Dr Jackson about all she had been feeling since giving birth. “I have read about this and it seems to me like you have postnatal depression. Have you thought of seeing a therapist?” he asked. “Don't you think it's weird for a doctor to see a therapist, what will my patients think of me?” she countered. “First of all, seeing a therapist is confidential and even if your patients find out, they will think you’re human and NO HUMAN IS PERFECT” moreover, it's your health you should not care about people's opinions. IPSF AfRO Newsletter Issue 16 | 23
Untitled By Mavi Val-Ugboma
Maybe If I wasn't I wouldn't Maybe I don't know But I am and my mental health matters Health student keys
Sleep alot Eat alot Don't sleep alot But eat alot Health student keys
Classes are on Meetings and Prayers Discussion, School groups Friends and Colleagues Health student keys
Assignment Work Study Succumb to sleep Health student keys
Well rounded Everything positive I foster Everything learned fostered I am a health student And these are my keys To peace and mental wellness
IPSF AfRO Newsletter Issue 16 | 24
Every time I walk past Stephen’s locker, the doctor that died from COVID as many know him, my heart does a little dance reminding me that this white coat doesn’t make me a superhero. But at least I get to go out at night.
BY ALEX KAMANGU
My nephews cannot go to school anymore, too young to understand why. They cannot go out to play with their friends which I am sure feels like an unfair punishment. To make it worse their ever so loving, ever so playful uncle now "does not even want to see them." He is barely at home and when he is he is always locked up in his room, cannot even sit with them at the dinner table. But at least he gets to go out at night. ‘Please put on your mask mami’ always sounded bitter the fifth time I had to repeat it. But never before had I been this worried about my safety when trying to cater to my patients. The front
MENTAL HEALTH IN THE MEDICAL WORLD
line never made this much sense. But for god and our country, we still went outside every night to fight an enemy we couldn’t even see. But let alone that, being sent to war without the appropriate ammunition must have been the worst feeling ever. Oh, wait, the sword behind our backs was to learn that funds to buy protective equipment were embezzled by the government set to protect us. But still, we overcame. However, every time a patient completely recovered from what they may have thought to be their end, every ‘Asante sana daktari’ and every battle successfully won made everything almost worth it. Almost. Rest in power to every soul we lost in battle. I also want to wish healing from all the trauma those of us who survive have to live with.
IPSF AfRO Newsletter Issue 16 | 25
HEALTHCARE WORKERS, PATIENTS AND MENTAL HEALTH
"There is a need to pay adequate attention to the mental health of healthcare workers as they face significant stressors, burdens, and mental health challenges as a result of their work.
The mental health concerns of healthcare workers have gotten a lot of attention in recent years as a serious public health concern and a challenge to quality care delivery. Healthcare professionals are exposed to a variety of stressors at work, which can negatively impact their physical, mental, and emotional health (1). Heavy workloads, long shifts, a high pace, a lack of physical or psychological safety, chronicity of care, moral conflicts, perceived job security, workplace bullying, or a lack of social support are all variables that lead to increased stress among healthcare employees. Burnout, depression, anxiety disorders, sleeping difficulties, and other ailments might occur from the associated psychological anguish. All this affects the delivery of care to patients which is their primary function. A good relationship between the health care worker and the patient is an important key that helps in the recovery of most patients (2, 3). Patients’ mental health, not just their physical wellbeing, should be prioritized by health care workers. Burnout among healthcare professionals can have a negative impact on patient care. Burnout has been associated with substandard patient care practices, as well as a doubled risk of medical error and a 17 percent increased chance of being named in a medical malpractice claim, according to a crosssectional study (4). Burnout, depressive symptoms, and a reduction in quality of life were also linked to self-perceived severe medical errors. This shows the the intersection among mental health, health professionals, and patient care.
Furthermore, patients are exposed to multiple factors during their time of sickness or recovery. Patients on admission are separated from their families and as a result, feel lonely which can lead to them being depressed and anxious. Healthcare workers who are already stressed can contribute more to the mental health of a patient or how to relate with the patient. Patients interact with health care providers in crisis or high-stress situations, and if health care workers do not have a positive attitude toward them, their stress levels may rise. High levels of stress in patients can lead to unneeded overthinking or high blood pressure, which in turn can lead to depression and, in some cases, suicide thoughts. In the long run, it could lead to slower recovery or even loss of patients. Positive practices of health care providers towards its patient will not only receive appreciative feedback but will also earn the respect and trust of their patients by implementing an efficient patient service approach. Medical workers must be well-trained and well-mannered, or they may suffer the repercussions. The overall effect of both the patients' and healthcare providers’ attitudes will improve communication between them, resulting in better outcomes in the mental and physical well-being of the patients. Conclusively, there is a need to pay adequate attention to the mental health of healthcare workers as they face significant stressors, burdens, and mental health challenges as a result of their work.
IPSF AfRO Newsletter Issue 16 | 26
E-learning platforms for mental health should be developed and they should be made available and affordable to both healthcare workers and patients. Mental health services specific to healthcare workers should be incorporated into the pandemic response and it is important these services continue to run during and after the pandemic.
1. Hayashino Y, Utsugi-Ozaki M, Feldman MD, Fukuhara S. Hope modified the association between distress and incidence of self-perceived medical errors among practicing physicians: prospective cohort study. PLoS ONE. (2012) 7:e35585. doi: 10.1371/journal.pone.0035585 2. Mannava, P., Durrant, K., Fisher, J. et al. Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review. Global Health 11,36(2015). https://doi.org/10.1186/s12992-0150117-9 3. Gallard, L.M., Shattell, M.M., &Thomas, S.P. (2009). Mental health patients’ experiences of being misunderstood. Journal of American Psychiatric Nurses Association, 15, 191-199 4. Balch CM, Oreskovich MR, Dyrbye LN, Colaiano JM, Satele DV, Sloan JA, et al. Personal consequences of malpractice lawsuits on American surgeons. J Am Coll Surg. (2011) 213:657–67. doi: 10.1016/j.jamcollsurg.2011.08.005
https://www.vanguardngr.com/2011/09/how-poorattitude-of-health-workers-is-killing-healthcare-deliveryin-nigeria/
MENTAL IN THE MEDICAL WORLD
DEPRESSION AMONGST PHYSICIANS A BATTLE TO BE WON!
BY IBRAHIM AISHAT
It’s no news that the mental health of the health care workers is at stake. According to the Center for Disease Control and Prevention (CDC), the leading cause of death in the age of 15 to 34 years old is unintentional trauma, while the second cause is depression. Looking into the medical world, at the American Psychological Association (APA) annual general meeting, it was stated that physicians die by suicide at a rate of 28 to 40 per 100,000 per year. This would amount to about 300 to 400 physicians per year, these figures are higher when compared to any other profession. In addition, a study carried out on Iranian medical students also claimed that medical students had a greater level of depression compared to the general Iranian population (Mental health of Medical Students in Different Levels of Training, Najmeh Jafari). In another study carried out, on 2193 medical students and residents, 21% had mild to moderate/major depression, while 5.7% had suicidal ideation. NOMADIC
|
24
IPSF AfRO Newsletter Issue 16 | 28
These days, the word depression is greatly misused. Depression according to the MerriamWebster dictionary of contemporary English ‘is a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way’.
Post-traumatic stress disorder (PTSD); could be a result of loss of patients' lives, fatal accidents, or an expensive error that was committed. Also the switch in their work; one moment you are cutting through the internal organs, another you are being compassionate over your patient.
There are various categories of depression which range from; mild to moderate to severe. Some of the warning signs are; a sudden change in personality, frequent sadness, eating too much or too little, general loss of interest in daily activities, etc.
Another factor could be the nature of their job. The fact that their work is time-consuming, leaving no room for social lives, some do not even keep track of their families. This makes it even more difficult to seek help when needed, this could even aggravate their condition.
What exactly is the cause of this menace? Depression has no particular cause. From my point of view, stress could be the leading cause of depression in the medical field; this could be in the form of mental, physical, emotional trauma. Looking at the physicians, they have a very tight schedule, from the theatre to the wards, to lectures. They barely even have time for any other thing in their entire life asides from this profession. This could be the major reason the rate of depression is particularly higher amongst them compared to workers in other fields. Another cause would be errors committed, doctors have a very strong will of being perfect, excellent in what they do. The fear of losing what they cherish the most can lead to depression. In situations when these errors are committed and are at the expense of their medical license, the thought of this could ruin them. Pressure is another factor as most often the competition is coupled with the stress and desire to outshine the others when one does not meet up with all these depression can set in. The high sense of responsibility, fear of losing it all. We cannot underestimate the effect of pressure, as this is very high right from medical school to practice. Panic or fear of losing one’s life as we saw during the pandemic; medical professionals are often highly exposed to various hazards ranging from first-hand exposure to deadly viruses, working environment, or even loss of one's patients.
Since most times they are fully occupied with their works and disconnected from reality, I’ll take this as the bottom line of it all, this is the very reason they fail to seek help and might be the reason for the high rise in suicide rate amongst physicians. They barely have interest in any other thing and the fear of losing their profession is enormous. However, most of these cases go unnoticed, the majority of those affected do not speak up or seek help which might eventually lead them to have suicidal thoughts. I have concluded with these solutions. All healthcare workers should attend a therapy session at least once in the timeframe of one to three months. Therapy should be made normal to overcome losses. There should be some sort of physically-engaging activity to relieve stress, there should be a maximum time duration that one must not exceed be it a 32-hour shift. People should be encouraged to speak up as this will help other people too. It is very normal to feel down and the best solution is to seek help. There are a lot of consequences which may include a drawback to loss of professionals as the figures keep rising from day-to-day. Individuals who are intending to go into the profession are likely to be discouraged, due to the fear of eventually becoming suicidal. It will be a gigantic step if physicians can start looking out for themselves while looking out for others. Imagine if all our doctors become suicidal, who will eventually take care of us? So, the need to tackle this problem comes in.
IPSF AfRO Newsletter Issue 16 | 29
By Oluwaseyi Egbewande
Depression,
and
Medical professionals can suffer from mental diseases
eating disorders are common examples among the list
anxiety
as a result of seemingly overwhelming situations, such
of mental illnesses that thrive among people in society.
as severe workloads, lack of support, lengthy shifts,
Concepts
and
like
interpersonal
disorders,
thoughts,
schizophrenia,
feelings,
protective
equipment,
to
delivery, efficiency, and general quality of life can all
classified
as
be harmed by work-related stress [7]. Therefore, these
home
more
population,
with
than more
middle-income 85
per
than
cent
80
per
define
personal
name a few [6]. Competence, the accuracy of care
and
help
insufficient
an
low-
can
and
individual’s mental health status [1]. The 153 countries
to
relationships,
actions,
countries
of
the
cent
of
are
world's
issues
must
be
addressed
to
restore
order
to
the
these
process of delivering health care services. The outburst
people suffering from mental illnesses or substance
of COVID-19 posed huge threats to global wellbeing,
abuse [2].
but one threat, though not as publicized as the others, is the mental health issues health workers developed
The term "mental health" relates to the state of one's mind,
behaviour,
and
emotions
[3].
It
dictates
during the pandemic [5].
the
outlook of individuals as it determines how they cope
There are, however, effective therapies and techniques
with normal stresses, how they appreciate themselves
to
and their society and yield productive outputs. It is
conditions [1]. One of these treatments is self-care.
vital to emphasize that mental health extends much
Health professionals and workers do not always focus
beyond the lack of mental illnesses and diseases [4].
on self-care. They are often considered to input their
As
humans,
the
our
mental
by
mental
health
and proper body functioning of the patients. Self-care,
feelings
on the other hand, may be necessary to cope with the
conscious
is
caused
entire medical prowess to help resuscitate the normal
Therefore,
health
suffering
very
survive.
of
the
important as it enables us to think, interact, express and
state
alleviate
efforts
should be applied to synchronize a healthy mind with
stress
every human.
protect their health, well-being, and general
and
demands
of
their
career,
as
well
as
to
IPSF AfRO Newsletter Issue 16 | 30
contentment with their work and life [7]. Taking breaks
REFERENCES
when possible, getting enough sleep, eating healthy food, exercising and so much more are helpful ways by which
health
workers
can
practice
self-care
which
1.
World
Health
Retrieved
from:
Organization.
(2019).
Mental
Health.
https://www.who.int/news-room/fact-
sheets/detail/mental-disorders. Accessed on 08/12/2021
would, in turn, boost the quality of their outputs.
2. Jacob, K. S., Sharan, P., Mirza, I., Garrido-Cumbrera, M.,
In
view
world,
of
curbing
mental
need to take care of their mental health. Sometimes,
https://doi.org/10.1016/S0140-6736(07)61241-0
strong
that
it
often
have
clouds
for
their
their
minds
can
Seedat, S., Mari, J. J., Sreenivas, V., & Saxena, S. (2007).
Lancet
workers
webinars
medical
Mental
these
or
the
organized among health workers to remind them of the
passion
seminars
in
be
the
informative
illnesses
job
is
making
in
some
cases,
or
even
take
breaks.
systems
(London,
in
countries:
England),
where
are
we
370(9592),
now?
1061–1077.
so it
impossible for them to see the need to slow things down
health
These
seminars would come in handy to help them realize
3.
Adam
Felman
(2020).
Mental
Health.
Retrieved
from:
https://www.medicalnewstoday.com/articles/154543#defin ition. Accessed on 08/12/2021
4.
World
Health
Organization.
(2019).
that only at a good mental health state can they give
strengthening
their best to the service.
https://www.who.int/news-room/fact-
our
response.
Mental
Health:
Retrieved
from:
sheets/detail/mental-health-strengthening-our-response.
Furthermore,
we
need
to
note
that
there
is
an
Accessed on 08/12/2021
important relation between mental health and basic human rights [1]. An individual in a society where rights and freedoms are not hampered will enjoy a good state of mental health. Sometimes, health workers are not given the right accolades, even to their normal earnings
and
this
can
greatly
contribute
to
5. Spoorthy,
M.
S.,
Pratapa,
S.
K.,
&
Mahant,
S.
(2020).
Mental health problems faced by healthcare workers due to the
COVID-19
pandemic-A
review.
psychiatry,
Asian
journal
51,
of
102119.
https://doi.org/10.1016/j.ajp.2020.102119
mental
related issues. The government and the society on their
6. Cai, H., Tu, B., Ma, J., Chen, L., Fu, L., Jiang, Y., & Zhuang,
part can help reduce the illnesses that generate from
Q. (2020). Psychological Impact and Coping Strategies of
this
Frontline Medical Staff in Hunan Between January and March
end
by
providing
the
right
support
to
health
2020
workers.
During
‑
(COVID 19)
Finally,
as
personnel
a all
considerable
result
of
around stress,
their the
profession,
world
problems,
are
and
healthcare
International
the
in
Outbreak
Hubei,
medical
of
China. journal
Coronavirus Medical
of
Disease
science
experimental
2019
monitor:
and
clinical
research, 26, e924171. https://doi.org/10.12659/MSM.924171
experiencing
mental
health
7. Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S.,
issues. They work a lot to ensure our safety and it is,
Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing
therefore, our responsibility to meet the mental needs
the Mental Health and Well-Being of Healthcare Workers: An
of health workers around us [7]. Mental health teams
Urgent
can also be set up to deal with mental health issues
health,
that arise in the medical world [5].
Global
Public
Health
Priority.
Frontiers
9,
in
public 679397.
https://doi.org/10.3389/fpubh.2021.679397
IPSF AfRO Newsletter Issue 16 | 31
PAGE 32
IPSF AfRO Newsletter Issue 16
BY CHRISTOPHER MALUNDU
CHARACTERS: JOSHUA AND MR. PHIRI(HIS FATHER)
PAGE 33
IPSF AfRO Newsletter Issue 16
Scene 1 Cont.
Joshua: It's my dad
Joshua: Dad, today is the last day for paying school fees, you
Ze Mwa: I know Mr Phiri is a problem, but anyway I have a fast
promised to give me money today.
binee (business)
Mr Phiri: young man, get out of my sight. I used the last money
Joshua: What business Ze Mwa
I had to buy food for you and beer for myself. Do you want to kill me with stress the way you did to your Mum?
Ze Mwa: Fast binee young man
Joshua: But Dad,
Joshua: Just tell me what it is
Mr Phiri: shut up! We are not debating, I said I don't have
(Ze Mwa removes a pack of marijuana from his handbag)
money. Ze Mwa: Mwaiche (young boy) you have to know that the (Joshua starts crying sorrowfully while breathing forcefully and
world is corrupt these days and it's only the violent that will
stammers)
take it by force I'm sure you read the Bible.
Joshua: But why diiiidddd you take me to school, if you cannot
Joshua: Is this not marijuana?
pay for my school fees. Ze Mwa: Young man grow up, this is fast money be sharp. Mr Phiri: I said get ooouuut, (he throws a bottle of beer at Joshua, who misses it and runs out of the house)
Joshua: How? Ze Mwa: All you need to do is deliver to Juntae your classmate and boom K100 is yours. Joshua: Just like that? Ze Mwa: Yes my boy, I like you; just like that. You will have
CHARACTERS: JOSHUA AND MR. PHIRI(HIS FATHER)
money to buy anything you need.
(Joshua walking to school slowly and depressed, out of nowhere
(Joshua gets the marijuana and hides it in his sock)
Jack a local street drunkard shouts at him) Jack: Iwee Joshua!! Joshua: Ehhhhehhh(frightened) Ze Mwa: Don't be scared young boy, it's me Ze Mwamwae, what are you thinking about? What's wrong my boy?
PAGE 34
CHARACTERS: JOSHUA, MR. MAGABA, AND 30 CLASSMATES
(In class, the teacher, Mr Magaba is giving out maths test results, then Joshua knocks at the door) Mr Magaba: Joshua, you're late again? Joshua: Sorry sir, I'm late. Mr Magaba: Great timing though. As I always say (the whole class speaks in unison with him), "latecomers always eat bones". Mr Magaba: this paper I'm having is yours, you're last in class again. (The whole class burst into laughter) (Joshua forces himself through the closely packed class desks and sits at his middle desk while everyone is laughing at him) Mr Magaba: silence, please! Let's go to our next topic. (No sound. Mr Magaba continues speaking while Joshua is just staring at him with a lost face till the class ends.) Mr Magaba: All right, class, see you next week.
IPSF AfRO Newsletter Issue 16
CHARACTERS: JOSHUA, MR. MAGABA, JUNTAE, MATEO, AND THREE OTHER CREW MEMBERS
(As soon as Mr Magaba leaves class, Joshua gives Juntae and his crew; four other boys the backbenchers to follow him to the toilet.) Juntae: Kiddo, what's up? Joshua: Relax, I have a delivery for you (The whole crew starts laughing) Mateo: Oh, you have chocolates for us Hahaha Joshua: Wait and see. (he looks around and removes the marijuana from his socks) Juntae: Who gave you this? Joshua: It's Ze Mwa from our place. He said you should give me K100. Juntae: That nigga has finally decided to pay my credit. Joshua: I don't care, are you getting it or not? Juntae: No problem, but first before I give you the money, you have to smoke it and prove to me that it's OG. (Joshua tries to excuse himself)
PAGE 35
Scene 4 Cont.
IPSF AfRO Newsletter Issue 16
(We see Joshua coming out smiling and confident from the counselling room)
Mateo: Yes, do it. Otherwise, I'll beat you. Joshua: All I needed was someone responsible whom I can talk (In awe Joshua wraps the marijuana in a paper and gets matches
to and now I have managed to escape from depression. Talk to
from Juntae)
someone responsible before you make that wrong decision.
Joshua: I don't have to do this guys. Juntae: Do you want the money or not? (Joshua puts the cigarette, in between his lips and lits a match while looking at all the guys, Juntae smiles) Mateo: Go on! (Joshua inhales no sooner as he exhales the smoke out and then Mr Magaba sees them) Mr Magaba: Joshua!!! (Everyone runs except Joshua who is holding a long roll of marijuana and is shivering) Joshua: I can explain, sir. Mr Mugabe: Explain what? (Joshua starts crying as Mr Magaba is talking to him) Mr Magaba: Joshua I know you're going through a hard time after the death of your mum, but I know you're a good child. (They both walk together into a guidance and counselling office)
Mental health encompasses our emotional,
In pharmacy school especially, students are
psychological
faced
and
social
well-being.
It
with
many
with
mental health can be compromised. While
prepare
for
a
lot
university
of
that
their
no one was prepared for what the COVID
expectations, and enthusiasm. They believe
19 pandemic will bring, an already existing
student
life
problem seemed to have escalated: what I
personal
and
an
with
surprise
great
offers
life
students
no
and
pressures,
Often,
it's
demands
affects how we think, feels, acts and cope stress.
so
so
opportunities
all-round
for
development,
call
the
silent
which sadly is not always the case. Life in
poor
tertiary
students [2].
institutions
including from
change
family
obligations students
of
and
and
often
is
so
full
challenges,
residence, friends, on.
struggle
mental health [1].
of
to
mental
suffering, health
the
pandemic
among
of
pharmacy
isolation academic
Amidst
these,
maintain
their
In addition to the usual stresses of training to
become
pharmacy
medical
students
professionals,
experience
additional
social problems due to poverty, income
IPSF AfRO Newsletter Issue 16 | 36
inequality, insecurity, social and economic
these
instability.
sabotaging the efforts put in place.
on to
their one
All
these
mental
a
well-being
descriptive
among
have
medical
study
direct [3].
of
impact
505
health
medical
Many
pharmacy
because
completed
employers
questionnaire.
socio-demographic
are
believe
that
of
fear
in
the
of
stigmatization
future.
Mental
from
health
is
received mental health diagnoses prior to
is not an anomaly for pharmacy students to
medical
experience
29
were
(5.7%) of
but
when
anxiety
The
prevalence
was
54.5%
received study
the in
and of
and
number
school.
conducted
increased
Most
depressive
less
assistance
distress than
[4].
seven
5%
Another
not
it.
his/her UN
work
with
on
Disabilities
disabilities
students,
disabilities).
depression,
against
anyone
efficiently.
Convention
schools in Nigeria showed that out of 408 of
employers
should
with
any
mental condition so far he/she carries out
framework
prevalence
Legally,
discriminate
pharmacy
the
among
cases
disorders.
psychological
shockingly,
medical
(1.8%)
students
common among the general populace so it
school
students
health
had
to
Nine
mental
mental health can hinder career prospects
students from 25 Nigerian medical schools a
about
According
mental
students:
myths
the
Rights
(CRPD)
to
Article
support
Persons a
global
people
with
psychosocial
recognizes
that
work, should be treated equally, and to be
promotes
discriminated
falls
behind
in
against,
with
support
has
the
“Every
35% respectively [9]. Ironically, a field that all,
disability
the
person
for
a
of
anxiety and stress was 44.6%, 63.5%, and
health
with
of
provides
(including It
27
and in
right
should
the
to
be
addressing the issue of poor mental health
provided
workplace”.
among its own students [1].
[10]. The mental challenge is not a barrier to working if one seeks medical help early.
DEMYSTIFYING
SOME
COMMON
MYTHS
ABOUT MENTAL HEALTH AMONG PHARMACY
Many
students
about
STUDENTS
their
weakness Factors from
that
prevent
accessing
include;
fear
of
pharmacy
mental having
students
health mental
services health
whereas
also
feel
mental
[6]. they
health
They
feel
that
try
broken
is to
opening a
sign
act
inside.
up of
tough Seeking
help is the strong and right thing to do. The pharmacy
schools
of
course,
also
want
record and their impact on a future career,
their students to perform well. Their efforts
fear of the stigma associated with mental
can
health
willingly open up about their mental health
and
other
misconceptions.
In
battle against mental health conditions,
the
be
made
impactful
when
students
conditions.
IPSF AfRO Newsletter Issue 16 | 37
Pharmacy students have busy schedules so
Nigeria
they
fellows, the possessed... Most of the time,
find
their
it
difficult
studies
for
to
rest.
take
time
However,
out
they
of
can
they
-
psychopaths,
are
treated
negatively
mind so pharmacy students can freely seek
beings.
help without fear of being stigmatized.
their
mental
a
positive
society.
they are truly concerned about their wellmake
have
in
mad
Society
should
to
beings,
and should take time out of their studies if
They
has
crazy
change
of
health a priority too.
CONCLUSIONS AND RECOMMENDATIONS Many
also
believe
mental
health
recover
fully.
mental
This
is
not
Not
result
in
is
have
can
true
all the
they
they
problem
[6].
conditions
once
problem
health
sentence"
that
never
because
not
a
mental
public
a
"life
health
depression,
display
of
conditions(stress,
anxiety
disorder,
etc.)
recover
from
and
disorder, many
them
panic
people
with
hands
fully
pandemic
Some believe that mental health problems do
not
concern
the
pharmacy schools [7]. However, a problem shared
is
a
problem
half
deck
mental
to
stem
health
the
among
Interactive sessions should be organized by pharmacy
and
medical
students
should
lectures
focusing
take
schools.
part
on
in
The
interactive
addressing
stress,
anxiety and depression.
should
where
and
of
on
healthcare students.
There
personal
be
adequate
treatment.
are
must
health
madness. More so, there are many types of mental
All
solved.
The
gone
be
students through
support
to
traumas
[7].
efficient and
the
doctors
support
that
experience
students Their
peer
can
experiencing
colleagues
have give
mental
should
also
avoid stigmatizing them.
pharmacy school needs to know about any conditions
that
performances. measures studies.
to If
can It
can
help
they
affect then
them
keep
its put
excel
on
students’ in
place
in
their
bottling
the
problems within themselves, they may end up losing their sanity.
Moreover,
students
recreational studies.
engage cooking
activities
The
recreational in
should
faculty centres
such
as
participate
outside
of
should
establish
for
students
recreational
competitions,
in
trivia
their
to
athletics,
and
games.
They shouldn't lose their humanity because
A lot of spiteful words are used to address people with mental health conditions in
they
want
to
be
pharmacists;
rather,
they
should maintain personal relationships and make mental health a priority [8].
IPSF AfRO Newsletter Issue 16 | 38
Most importantly, the best thing to do is to seek
professional
help
[1].
They
should
share their burden with the right one and save themselves from silent suffering.
REFERENCES 1. Anita Vulic-Prtoric, the University of Depression in University students, 2012. Available online at https://www.researchgate.net/publication/262313859. 2. Leah
Komar,
University
College
Cork,
Ireland,
2020.View
of
COVID-19
amongst
the
pandemic of medical students mental health. http://dx.doi.org/10.5195/ijms.2020.501 International Journal of Medical Students| 3. Oluyomi Esan et al. Int Rev Psychiatry. Nov-Dec 2019.Mental health and wellbeing of medical
students
in
Nigeria:
a
systematic
review.
https://doi.org/10.1080/09540261.2019.1677220.Pubmed| 4. Olayinka Nigerian
Ayinde
et
medical
al.
A
descriptive
students
study
of
mental
health
and
burnout
https://doi.org/10.1177/00207640211057706.
among
International
Journal of Social Psychiatry| 5. Sani Salihu Suraja, et al Prevalence and Factors Associating with Depression among Medical
Students
in
Nigeria.
https://www.npmj.org/article.asp?issn=1117-
1936;year=2021;volume=28;issue=3;spage=198;epage=203;aulast=Suraj#Nigerian Postgraduate Medical Journal 6. Medical
News
Today.
¦
July-September 2 2021.
Medical
Myths:
Mental
Health
Misconceptions,
2020.
www.medicalnewstoday.com 7. General
Medical
Council,
UK.
Supporting
Medical
Students
with
Mental
Health
Conditions, 2013. 8. Cheri
Dijamco,
Addressing
MS4
the
at
UT
School
Growing
of
Medicine
Concern
of
at
San
Mental
Antonio. Health
Staying In
Sane:
Medical
Students,2015.https://www.amsa.org/staying-sane-addressing-the-growing-concernof-mental-health-in-medical-students/ 9. Deborah Oyine Aluh, University of Nigeria Ndukka et al. Prevalence and correlates of depression,
anxiety
and
stress
among
undergraduate
pharmacy
students
in
Nigeria,
https://doi.org/10.4652/pe.2020.201.236248 10. WHO. Mental health and substance abuse use.Available online at www.who.int
IPSF AfRO Newsletter Issue 16 | 39
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IPSF AfRO Newsletter Issue 16
“What mental health needs is more sunlight, more candor, and more unashamed conversation.”
GLENN CLOSE