Alone, struggling to pay course fees and often hungry, Favour Umar was 18 when she tried to kill herself. She was studying at the University of Malawi against the wishes of her parents, who wanted her to marry or get a job.
“I couldn’t see any way out of my situation,” says Umar, one of an increasing number of young Malawians feeling isolated and struggling with their mental health.
While no official figures exist, health workers and support groups have noted a dramatic rise in cases over the past two to three years.
A recent study by researchers from the Wolfson Institute of Population Health at Queen Mary University of London and Millenium University in Blantyre reported a “vicious cycle of poverty and mental health problems” for young Malawians.
“There is a lack of youth-friendly mental health services in the country,” says Mercy Mkandawire, founder of the youth organisation iMind. “It is difficult for young people to visit mental health institutions because they do not want to be labelled as being ‘mad’.”
“Most youth therefore keep their struggles to themselves. Poverty and unemployment are common factors contributing to mental health problems among the youth,” she said.
Established in 2018 to support those aged between 10 and 30, iMind offers referrals to the few support services available and campaigns for greater awareness of mental health and funding for services.
In 2020, it launched Fresh Minds, a radio show covering issues such as depression and eating disorders. Experts are invited on and volunteers share their experiences of anxiety or substance abuse. The programme has more than 35,000 listeners, most under 30, says iMind.
Umar, who graduated this year and now works in marketing, says the show “saved my life”.
“The programme also opened up my mind [to] how I can know someone is about to commit suicide and how I can help that person,” she says. “It really changed my life and I’m now an advocate.”
Chiwoza Bandawe, professor in psychology at Kamuzu University of Health Sciences, said mental health problems were often regarded as “part and parcel of life”, but “if it is not treated, it reaches a particular point where people really give up and feel that they just don’t have further hope.
“For the parents and the older generation, the problem is that they themselves don’t take mental health issues seriously because of their own upbringing. Young people are very tuned in to mental health issues [in part] because of social media. Parents have to be educated.”
St John of God Community Services provides mental health services for young people in the capital, Lilongwe, and the northern city of Mzuzu. Since last year the charity has seen the number of young people admitted to its rehabilitation programme jump from 25 a month to 40.
Charles Masulani, its chief executive, says more young people are resorting to drink or drugs when faced with tough challenges in life.
“In places like Lilongwe, you find young girls drinking alcohol or even using cocaine. In the [city’s] main market, some young people take pethidine [opioid pain-relief] that we use in hospitals, they are accessing it over the counter. Over a decade ago, those drugs could only be accessed by matrons of the hospitals. They give you a good feeling and you easily get addicted,” he says.
Masulani says Malawi needs more trained counsellors and psychologists.
The country, home to 20 million people, only has one public mental health facility; the hospital, in the town of Zomba, has one psychiatrist. St John of God has a residential mental health facility in Lilongwe with two psychiatrists, and two more work at the University of Malawi’s medical school.
“These days we’re encouraged to treat [mental health] without medicine because the [causes] are more psychological … but we need more counsellors and more psychosocial therapists,” he says.
Chilungamo M’manga, a lecturer at Kamuzu University of Health Sciences says the number of girls seeking support from her organisation, Mentor to Mentor, rose from less than four a week before 2020 to 15 a week during the Covid pandemic.
“And when school started back, the numbers coming to us started rising,” she says. “The number of people who are seeking help in terms of failing to cope with some psychosocial issues is a lot.”
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