Why is the reluctance of people to treat mental illness?

Many do not disclose or seek treatment for a person suffering from a mental illness out of concern for family honor. Many people think that blowing cures this disease; many do not consider it a disease. The attitude towards these patients should be changed.

A responsible man who has great love for his family also suddenly commits suicide. People do not think about this departure. However, they could not be with him during his time of trouble. Since then, the pain has become a mountain! A couple of months ago, I had to see such an event from close quarters. Parents were blaming themselves—why did they not find the bottom of the child’s mind?

Jahangirnagar University student Kazi Samita Ashka always talked about her parents and younger brother. However, family members, relatives, and friends could not find an answer to the question of why Samita chose to commit suicide on September 1. Irfan Sadiq Samin went to study in Malaysia with many dreams. His body was recovered from a river in that country on September 18. The family claims that he had to choose the path of suicide due to physical and mental distress due to the ragging of his classmates.

I talked to a young man who was confined to bed for a long time due to a mental illness. He had to lose his job. The English-medium student of a prestigious educational institution in the capital blames a traumatic childhood memory for his severe mental illness. In a school incident, the teachers humiliated him in front of everyone. He tried to commit suicide several times.

Psychiatrists and medical psychologists give various advice to identify mental illness and take care of the mind, but many do not consider it a problem in the social context of this country. As a result, they do not feel when the mind is consumed by illness. If alone, the illness sometimes pushes the person in a terrible direction; sometimes, even in a crowd, it completely isolates the person. The man begins to think that there is no one to listen to his thoughts.

Psychiatrists and medical psychologists have come to know how many people continue to deteriorate mentally without being able to talk about their troubles and problems. Fears hold them back from seeking mental health care. Without finding a solution, the problem becomes more serious. Vitality decreases, and interest in work disappears. And increasing anxiety and insomnia puts life at risk. Mental illness is sometimes considered incurable and costly. All thoughts are sometimes thought to be irrational. Problems are nothing; they just get better.

Mental illnesses include schizophrenia (schizophrenia), bipolar disorder (depression and depression), and OCD (obsessive-compulsive disorder).

Where are the barriers to treatment?

According to the latest National Mental Health Survey 2018–19, about 17 percent of adults suffer from mental illness. This rate in the city is 18.7 percent. Anxiety disorders account for about 5 percent and depressive disorders for about 7 percent. 92 percent of people are out of medical care. Rates of mental illness are relatively high among women in urban areas as well. The rate of mental illness in children is about 14 percent. 95% of children are not treated.

The Nasirullah Psychotherapy Unit of Dhaka University conducted a study on 216 people to find out why people do not want to get mental health treatment. The problems were raised in 33 group discussions and 23 interviews with men, women, and children of different ages from 12 years old in 8 divisions of the country.

The study was conducted in three phases from March to May 2022, with the financial support of the UK Comic Relief organization and the collaboration of Action on Disability and Development (ADD) International Bangladesh. The report titled ‘Outstanding the Impact of Stigma on People with Mental Illness in Bangladesh’ was published in September 2022. The main researcher of the study was Pradyut Roy, a PhD student at Universiti Putra Malaysia, and it was supervised by Professor Kamal Chowdhury, Department of Clinical Psychology, University of Dhaka.

Some who suffered from mental illness in the study reported negative attitudes towards them. Many people do not want to bring the issue of mental illness to the public for fear of losing their family’s honor. So don’t even show the doctor. Especially if it is a girl, the idea of ‘no marriage’ works. In the workplace, it can be difficult to maintain a job after being diagnosed with a mental illness. In the case of children, it is difficult to get them admitted to school. Many men and women suffering from mental illness do not want to seek treatment for fear of losing their dignity. Fear of what people will say. If people think crazy!

A patient said that the family suffers from an inferiority complex with a member who has mental problems. You don’t want to introduce yourself in front of people.

A female patient said that even after recovering, she often hears negative words. You have to hear questions like, ‘You were crazy; what is your condition now?’ People remind them of their previous condition by asking this question.

Another male patient said, “Getting married is the biggest challenge.”

Many patients do not want to admit their illness. Many people also say, ‘Why should I go to a mad doctor? Am I crazy?’

Apart from this, there are no government service institutions at the district-upazila level. As a result, many families do not go to the doctor due to financial difficulties.

A female patient said, ‘The existence of mental problems must be accepted first. Otherwise, treatment is not possible.

Misconceptions about mental illness:

According to the study, many people in society think of people suffering from mental illness as’scary’. They believe that people suffering from mental illness can attack from time to time. Some think the disease is contagious.

A working woman who participated in the research said that mental illness can also be transmitted to the child through the mother. So it is difficult to marry girls suffering from mental illness. As a result, the family kept the girl’s problem a secret. Many people think that people suffering from mental illness are unfit for work.

According to the study, many people think that mental problems are not really illnesses. It’s already good. There is no cure for mental illness. The problem can be solved through marriage. Many people think that this disease is cured by blowing the bush.

In the study, a psychiatrist highlighted his own experience and said, ‘Only 5 percent of patients come to me without any dust-blowing. Educated or uneducated, the remaining 95 percent consider mental illness to be a ‘demon’.

Age-related problems differ:

Blaming each other and backstabbing went to the point where a couple was on the verge of separation. Some wives suffer from depression due to their husband’s estrangement, not having a good relationship with the in-laws, not giving leave to the husband in his professional life, not giving time to the family, etc.

A seven-year-old child became extremely violent. Couldn’t stand anyone. He was inattentive to his studies. At first, the parents thought that the boy might be a victim of bullying by his classmates at school. The clinical psychologist, speaking to her in private, learned that she was regularly sexually harassed by a male relative at home.

A teenager’s cell phone addiction has reached its peak. Parents used to take away the mobile phone first. In this, the teenager started vandalizing things.

A boyfriend subtly takes nude photos of a teenage girl. The girl tried to commit suicide when her boyfriend started blackmailing her by showing her that picture. parents
Later, the girl started seeing a psychiatrist. Patients come with such different problems depending on their age.

On October 7, when Nasirullah went to the psychotherapy unit in Dhaka University’s Kalabhaban, it was seen that people of different ages were coming to seek services. Middle-aged parents were waiting with a teenage girl. The look of annoyance on the girl’s face is obvious. It was understood that his parents brought him by force. When asked, the girl’s mother said with discomfort, “The girl is inattentive to studies.” There is a little problem. That’s why I came.

Another parent came with a 14-year-old son. The son attends an English-medium school. A younger couple was also waiting to be served.

Medical psychologists can serve an average of five people a day at the Nasirullah Psychotherapy Unit from Saturday to Thursday from 10 a.m. to 4 p.m. Fees are charged at Tk 800 per session for individual services and Tk 2000 for family and couple services.

Zohra Parveen, clinical psychologist of the unit, said that the problem is different according to age. In the case of couples, even two years ago, it was seen that only the wives came. Now husband and wife are coming together. Family counseling is good at this.

In the case of students, they say, parents do not understand them. Students also come with broken love relationships and anxiety about studying. Students between 11 and 19 years of age tend to self-harm out of depression.

Damage caused if not treated:

Professor Kamal Chowdhury of the Department of Clinical Psychology at Dhaka University told Prothom Alo that if the mental illness is not treated, the person gradually loses their work efficiency. In the long term, mental problems are aggravated. At times, the patient may become aggressive, increasing suicidal tendencies. Depression and frustration may appear in the whole family around him.

Professor Kamal also said that the negative attitude towards patients suffering from mental illness should be changed. As with other diseases, you should go to the doctor. The patient should be allowed to speak openly. Initiatives should be taken to create workers at the community level outside Dhaka. Workers will sensitize people to seek appropriate treatment for mental illness.

Low-cost services are available at 37 Government Medical College Hospitals in the country, Pabna Mental Hospital, Bangabandhu Sheikh Mujib Medical College University (BSMMU), and the National Mental Health Institute and Hospital in Dhaka.

Helal Uddin Ahmed, associate professor of the child-adolescent and family mental health departments of the National Mental Health Institute and Hospital, told Prothom Alo that 8 to 10 percent of patients are treated in government hospitals. It is not possible to make psychiatrists and clinical psychologists overnight. In this situation, the doctors of the district-upazila-level hospitals can be trained in psychiatric treatment according to the guidelines of the World Health Organization. If the disease is not diagnosed and treated quickly, mental illness will become a major burden on society.