Last month on Long Island, New York, 18-year old Charles Okonkwo Jr. killed his 15-year old brother, Bradley, and beat his mother, a medical doctor, into a coma. He then took off with his mother’s car. When his father, Charles Okonkwo Sr., came home, he found his son, Bradley, dead in his bedroom and his wife lying on the floor inside the garage. He called 911. When arrested, Charles Jr. told police that he “hurt” his younger brother and mother.
Speaking to Newsday newspaper at the Dix Hills home of the Okonkwos, a Nigerian family friend named Lawrence Monwe said this; “This is very tragic. No one saw it coming. This was the perfect family you wouldn't expect it to happen to.”
Charles Jr. according to Newsday investigation has a history of mental illness. A neighbor of the family who spoke to the same newspaper said that police had been called to the family home several times in the last two years.
This story came up in a discussion with a Nigerian psychiatrist penultimate weekend at a social gathering. The doctor who works with the Colombia University hospital system wanted to know what psychiatrists like him could do to improve mental health services in Nigeria. He asked a group of us, including a surgeon and a diplomat what was the state of mental health services in Nigeria.
The diplomat lauded Nigeria’s mental hospitals but lamented that they were not enough and could not provide care for all those who needed help. The surgeon talked about the stigma associated with mental illness in African culture and how it prevents an honest discussion of the problem amongst Nigerians in particular and Africans in general. Everyone raised concerns over the quality of care provided to mental ill patients in Nigeria by mental hospitals, traditional healers and religious institutions. We identified the lack of interest in the welfare of the mentally ill by the government and the society at large as one of the obstacles that will face anyone interested in going back home to provide enhanced care and reform of the practice currently in place.
The day after, comedian Robin Williams died from apparent suicide.
The sadness over his death was aggravated by comments Nigerians and other Africans were making on social media. It ranged from those who expressed their perplexity over a rich and famous man taking his own life to those who made mockery of him with comments like these: “That’s white people’s wahala.” “The man should have shaken off whatever was worrying him.” “He needed Jesus.” “He must be a member of the Illuminati.” “Hanging oneself is the act of the devil.” “He was a coward.” “I lost respect for him.” “It won’t happen in Nigeria.” “Maybe he is tired of living a fake life.” “Jesus is the answer.”
Depression is not a rich or poor man’s disease. It afflicts the rich, the poor, the talented and the regular guys. It is not character weakness and certainly not a behavior of people who are not grateful for what God has done for them. Just like cancer, depression is a proper illness.
In America over 46% of people are mentally ill at one point or another in their lives. A study says that one in every four people in America has mental illness. Various treatments have been developed, from psychotherapy to cognitive behavior therapy. The field of mental health is growing with diagnostic and statistical manuals being developed and updated as new knowledge becomes available. Also preventive measures are being put in place. Some treatments, including medications are controversial but the society is doing something to improve the lots of those who are mentally ill. There is a growing recognition that psychological and emotional health are as important as physical health.
In Africa, there is widespread denial that mental illness exists. By and large, most African society is still stuck in the 18th century world where those suffering from chronic mental illness are treated like wild animals. They are chained together and marched up and down the street by traditional medicine men. Those handed over to spiritual healers in churches are not treated any better. They are basically abused and dehumanized all in the name of exorcising the evil spirits in them.
The few institutions that exist in Africa are not showing the proper way to care for the mentally ill. Inside the institutions, squalor, neglect and abuse are the order of the day. The appalling way we treat the mentally ill forecloses any hope for those with developmental disabilities like mental retardation, Downs Syndrome etc. They are in most cases treated worse. In most parts of Africa, those with developmental disabilities have no chance of living. If they are not rejected outright at birth and left to die, they are called imbeciles and treated as such. Africans of today have little appreciation that a society is measured by how it treats the disadvantaged amongst its people.
For most Africans, elderly men and women suffering from dementia or Alzheimer’s are often regarded as diabolical and are called witches and wizards. Their disjointed and unintelligible utterances are often mistaken as confessions of their past evil deeds. Some men and women who are probably bipolar are regarded as being “mean” or “evil.”
The social stigma attached to mental illness in Africa is not something peculiar to Africa. The West outgrew that pattern of thinking. Mental illness often leads to discrimination. Families with mental illness usually experience difficulty finding spouses due to the unwillingness of potential partners to marry into such a family. As society begins to accept mental illness for what it is-another illness frequently associated with chemical imbalance in the brain-the stigma will disappear.
While the rest of the world is moving away from housing the mentally ill in institutions, getting them back into communities in what is known as deinstitutionalization, Africa has not come to terms with the need to develop a moral treatment for those mentally ill. In most of Africa, governments have not assumed responsibilities for those who are mentally ill. There are no legislations to protect their rights, even when they cannot make informed decisions or grant consent.
Like Lawrence Monwe said about the tragedy in Okonkwo’s family on Long Island, New York, “This is very tragic.” And, yes, “No one saw it coming.” Mental illness can be tragic, especially when not treated. It is especially tragic when not talked about. It can happen in such a way that no one sees it coming. But, unlike Mr. Monwe observed, there is no perfect family and it can happen anywhere and to anyone.
When it comes to mental health issues, Nigerians and most of Africa are just like the character, Xi, a sho in Kalahari Desert in the movie, “The Gods Must Be Crazy.” We look at an empty bottle of Coca-Cola thrown out of an aircraft and we wonder why the gods dropped it from heaven.
Yeah, when it comes to mental health, we are all bush men and bush women.