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Monday 21 January 2019
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Shifting the focus to mental healthcare provision

The Ministry of Health and Social Services (MHSS) Psychiatry Department is lamenting over the shortage of hands in its section mainly due to lack of qualified social workers, clinical psychologists and interested practitioners who are willing to pursue in psychiatry.
I am wondering as to what this entails when we have a lot of graduates from University of Namibia (UNAM) in psychology and counselling hoovering around the streets without jobs.

 
I understand that Psychiatrists are at the forefront when it comes to mental health related problems but they cannot do it alone without the help of social workers, counsellors and clinical psychologists.

 
The country has only two specialised mental health service provider available at Windhoek Central Hospital- mental health care centre and Oshakati Psychiatric Unit for public mental health patients, while the rest are dominated in the private health practice. I once attended the commemoration of World Mental Health Day and learned that, out of two Psychiatrists based at WCH, one of them is a foreign specialist and one in Oshakati, the entire Namibia. In Oshakati, there is no clinical psychologist , while in Windhoek there is one, two social workers and another in Oshakati. The outpatient clinic in Windhoek provides services to a minimum of 45 patients between Mondays and Fridays, while the outreach clinic provides an average of twenty patients per day from Mondays to Fridays.

 
It is estimated that, only a small percentage of mental health patients are receiving appropriate evidence –based mental health services because of this gape in shortages of practitioners. A lady from Windhoek, who is a mental health patient complained on World Mental Health Day commemoration regarding high doses that she normally gets sometimes at WCH but to my surprise nobody from the chairing team was able to give her concrete answer that I could also understand myself. I certainly attribute this to limited skills and inability to accurately diagnose mental health problems.

 
I think it is now time for Health Ministry to start lobbying with Ministry of Higher Education to offer free courses in Psychiatry in order to attract more medical students, that way it will go a long to bridge up this gape of shortages in mental health specialists.

 
There is need to decentralise and integrate the mental health services into the existing primary health care, schools as well as developing community –based services. My point still stand on the university graduates in psychology and counselling area who are wondering the streets helpless without jobs. Why not employ these graduates in schools to offer counselling and relevant training to pupils who happen to suffer mental problems at early age?

 
Children who experience mental health related problems requires high demand on education and social care system, otherwise it will persist to adulthood. The same applies to middle age and elderly people. We see our elderly people who stay at Old People’s  Homes, are likely to suffer depression due to social exclusion and loneliness. It is for this reason that, The Health Ministry together with Ministry of Higher Education must engage themselves and come up with a green light resolution to make jobs available for these graduates in questions than to continue lamenting on the shortage of mental health specialists. It has become a song where government, particularly the MHSS that I am referring to, continues to point out fingers on shortages of skilled staff yet they can do something in their capacity.

 
Further, MHSS continue to refer to mental illness as an area being neglected and stigmatised. My question is by who? The answer to that is: the government itself is responsible. Does it mean that these two ministries needs advise on how to formulate a national policy to curb unemployment of social and medical health graduates in the country?

 
*Itai Zviyita is a graduate of BA in Media Studies with Zimbabwe Open University.




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