The Nous, The King and I

On 5th March, 2016 I participated as a panelist in a workshop hosted by The Nous. The topic of the workshop was “Breaking down barriers: understanding depression”.  I suffer from depression as a secondary diagnosis.  I work in Social Services for a community mental health team and as a new consultant I was grateful to share my experiences and thoughts from the different roles I play.  My primary diagnosis is Fibromyalgia/Chronic Fatigue syndrome which is now recognized as a central nervous system disorder diagnosed in October 2015.  There is no cure.
Depression is defined by symptoms: low mood for an extended period, sadness and hopelessness, loss of interest in life, not taking care of oneself, loss of concentration, appetite and can include suicidal thoughts.  This can be through life events, stress or illness.  It can be treated with psychological talking therapies and/or medication. 
Nous is the Greek word for the mind.  The Nous is an organisation headed by Lade Hephzibah Olugbemi who also works in the public sector in a different role, giving her insight at  policy and service funding levels.  Lade and I met in 2015 and I  shared my vision, “to empower women who have experienced abuse, alcoholism and depression and facilitating discussions to demystify mental health”. We clicked ? I made the decision to work under the umbrella of The Nous as collaboration would strengthen our effect.  In brief some of our common objectives are:

 

  • To demystify mental health in the Black, Asian and ethnic minority groups ((BAME).
  • To join The Nous to form an advocacy group to ensure that the identified group of people in the UK are afforded fair treatment and care in line with the Equalities, Health and Social Care legislation.
  • Together with the project board which includes: Ms Lady Boss,  other organizations and professionals who support families and children, give legal advice to disenfranchised families; facilitate workshops and engage all stakeholders in mental health care including politicians.
  • To facilitate sign posting and information to members of the public via social media.
  • To explore consulting work to support countries in Africa in creating robust laws, policies and social and nursing services for mental health sufferers through the diaspora by importing knowledge.
  • To establish a database of professionals from BAME communities.
In attendance were 80 people. In terms of equal representation: ethnically there was a larger proportion of West Africans 80% and a mixture of Asian, Afro Caribbean and other Africans making up the remaining 20%.  The gender representation was  70%, male and 30% female: and included disabled persons, consultant psychiatrists, mental health professionals church leaders and the Traditional ruler  His Royal Highness Oba Dokun Thompson, King of Eti Ona Nigeria.
It was clear from the attendance that there was a great need to demystify mental health, create support groups in the community and engage church leaders.
The panel discussion included The King, 2 male consultant psychiatrists and 2 women was reflective of the role of men in the African society. The 2 women had direct experiences of depression, my peer whose husband recovered from a mental health illness and was no longer on medication.   We are both leaders of our own organisations.   I wondered whether there was a thought depression was a female disease?  It was noted from the floor that mental health professionals who deal with service users on a day to day basis were not in the panel and Lade assured participants it would be a future consideration.
The panel was informative and addressed myths on mis-diagnosis of BAME members and sectioning by the panel consultant psychiatrists.  It is a historical concern that BAME members are misdiagnosed by Caucasian psychiatrists and in my research to understand why, the reasons were bigotry and failure to understand different cultures. On questioning other professionals it was clear in social care, nursing and psychiatry training modules dealing with people of other ethnicities and cultures was not in-depth. There seems very limited understanding on the differences in cultures.
My thoughts after the successful workshop are the work needed to be done is humongous from the grassroots.  I am a believer that the strength of a movement starts from the grassroots.  It is more than likely that the workshops will extend to a full day.  The need to engage respectable and knowledgeable clergy is imperative.  One of my personal agendas is how do we address the issue of language.  Looking at the ICD10 code, which is the universal coding for illnesses, they use dOn 5th March, 2016 I participated as a panelist in a workshop hosted by The Nous. The topic of the workshop was “Breaking down barriers: understanding depression”. I suffer from depression as a secondary diagnosis. I work in Social Services for a community mental health team and as a new consultant I was grateful to share my experiences and thoughts from the different roles I play. My primary diagnosis is Fibromyalgia/Chronic Fatigue syndrome which is now recognized as a central nervous system disorder diagnosed in October 2015. There is no cure.
Depression is defined by symptoms: low mood for an extended period, sadness and hopelessness, loss of interest in life, not taking care of oneself, loss of concentration, appetite and can include suicidal thoughts. This can be through life events, stress or illness. It can be treated with psychological talking therapies and/or medication.
Nous is the Greek word for the mind. The Nous is an organisation headed by Lade Hephzibah Olugbemi who also works in the public sector in a different role, giving her insight at policy and service funding levels. Lade and I met in 2015 and I shared my vision, “to empower women who have experienced abuse, alcoholism and depression and facilitating discussions to demystify mental health”. We clicked ? I made the decision to work under the umbrella of The Nous as collaboration would strengthen our effect. In brief some of our common objectives are:
To demystify mental health in the Black, Asian and ethnic minority groups ((BAME).
To join The Nous to form an advocacy group to ensure that the identified group of people in the UK are afforded fair treatment and care in line with the Equalities, Health and Social Care legislation.
Together with the project board which includes: Ms Lady Boss, other organizations and professionals who support families and children, give legal advice to disenfranchised families; facilitate workshops and engage all stakeholders in mental health care including politicians.
To facilitate sign posting and information to members of the public via social media.
To explore consulting work to support countries in Africa in creating robust laws, policies and social and nursing services for mental health sufferers through the diaspora by importing knowledge.
To establish a database of professionals from BAME communities.
In attendance were 80 people. In terms of equal representation: ethnically there was a larger proportion of West Africans 80% and a mixture of Asian, Afro Caribbean and other Africans making up the remaining 20%. The gender representation was 70%, male and 30% female: and included disabled persons, consultant psychiatrists, mental health professionals church leaders and the Traditional ruler His Royal Highness Oba Dokun Thompson, King of Eti Ona Nigeria.
It was clear from the attendance that there was a great need to demystify mental health, create support groups in the community and engage church leaders.

The panel discussion included The King, 2 male consultant psychiatrists and 2 women was reflective of the role of men in the African society. The 2 women had direct experiences of depression, my peer whose husband recovered from a mental health illness and was no longer on medication. We are both leaders of our own organisations. I wondered whether there was a thought depression was a female disease? It was noted from the floor that mental health professionals who deal with service users on a day to day basis were not in the panel and Lade assured participants it would be a future consideration.

The panel was informative and addressed myths on mis-diagnosis of BAME members and sectioning by the panel consultant psychiatrists. It is a historical concern that BAME members are misdiagnosed by Caucasian psychiatrists and in my research to understand why, the reasons were bigotry and failure to understand different cultures. On questioning other professionals it was clear in social care, nursing and psychiatry training modules dealing with people of other ethnicities and cultures was not in-depth. There seems very limited understanding.

My thoughts after the successful workshop are the work needed to be done is humongous from the grassroots. I am a believer that the strength of a movement starts from the grassroots. It is more than likely that the workshops will extend to a full day. The need to engage respectable and knowledgeable clergy is imperative. One of my personal agendas is how do we address the issue of language. Looking at the ICD10 code, which is the universal coding for illnesses, they use of descriptive terms for each diagnosis would need translation to national languages understood by all.  This would ensure people are able to understand care plans, treatment plans and diagnosis in mental health. Words like schemas, schizophrenia or depression can only be understood by clear language and no jargon.

Africa has 2000 languages and 54 nations. Each ethnicity has its own cultural norms which trickles down to family and then the individual. One cannot ignore the influence of colonialism. The evolution and loss of cultural practices and way of life, rural urban migration and the introduction of Christianity is something one has to grapple with. In some communities the pastor has more influence than the doctor. Religion can be a deterrent to healing or managing mental health illness, however understanding individual beliefs could enhance acceptance of the illness.  Africa was divided between the British, Belgian, Italian German and Spanish colonialists. Some countries have these languages as part of the national culture and with development languages like sheng, pattwa, creole or pidigin new languages and words have been born. These languages mix the foreign, the national language and mother tongue and change almost yearly and very from region to region. 

The main groups are Bantus, Nilotes and Cushites. You will find that the Bantus  originated from Central Africa moved North towards Kenya and South towards Zimbabwe and South Africa. They remained close to central Africa and the great lakes. They are agriculturalists. The nilotes moved north west and across and further into north of Africa. I hope my history is still good ? ?.  You will find common words in Bantu languages, some mean the same others don’t. I can understand some Shona (Zimbabwe) and kinyarwanda (Rwandese), Kiganda (Baganda, Uganda) words and vice versa. The importance of translating psychiatry language into understandable descriptive symptoms will go a long way in removing stigma. With the Traditional ruler present to explain how they could help communities with mental health, I realized in a country like Kenya traditional rulers no longer exist. In Uganda there could be traditional rulers, however in Kenya, elders of tribes or clans would need to be involved. It would also be important to lobby governments through ECOWAS, COMESA and EAU or The African Unity to ensure the rights of mental health sufferers is on their agenda when discussing improving health care.

Why is language important? I remembered a discussion with my father who is now 80 years a while back. Listening to his symptoms which he decided was malaria: he felt tired, the joints ached, he wasn’t sleeping well for an extended period and his concentration was not good. Being the FBI agent, I probed further and realised the more he spoke, he was missing his children around him. I told him he was depressed, he said “no” he had malaria. To associate oneself with a mental health problem was sacrilege. The aha moment was that in order to explain to BAME members their illnesses, creative language solutions had to be found. On my Facebook group I asked 250 members who represent 16 nations what the word was for depression and abuse, no one knew.

Understanding the current cultural environments now, one would have to take into account issues like war and economic growth of a country. Africa’s economic power is growing with mineral, oil and gas reserves discoveries, technology and communication is improving, however only a small percentage have access to proper health care. Medication is very expensive. My thoughts would be to look at the hub and spoke system to integrate mental health care in mainstream hospitals. My only fear is if funding were to be identified, the management of this would have to very strict to avoid loss through corruption. Then I look at the benefits together we can create jobs both in the UK and Africa.

Another workshop will be held in June 2016, I will endeavor to bring my family from our end of the equator and we can pool skills and knowledge and start in the UK.

Waīrīmú

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