Witchcraft Fears Cause Mental Health Crisis in Chad

Mental health services are already woefully scarce in the Central African nation of Chad with only a single psychiatrist for a country with a population of more than twelve million.   With widespread poverty and a history of civil wars, it is hardly surprising that the United Nation's Human Development Index ranks Chad at near the bottom of the list of countris.   And the situation is even worse for people experiencing psychiatric problems.    For most of them, their condition is being undermined by the widespread belief that mental illness is caused by witchcraft and demonic possession.   As a result, many sufferers are afraid to speak out even to family members due to fear that they might be believed possessed or even guilty of witchcraft themselves.   The stigma against mental illness remains common in many African sub-Saharan countries and the presence of numerous self-styled healers and exorcists means that anyone identified with a mental illness can be shunned and/or persecuted.  There are numerous reports of mentally ill people being subjected to torture, starvation, beatings, and forced exorcisms to "drive the demon out".

According to Dr. Egip Bolsane, Chad's lone psychiatrist, "Going to see a psychiatrist in Chad is a difficult thing for many people.   Public opinion here thinks that it means something is really wrong in your head, it might be because you're possessed.  We need to demystify the more or less diabolical image of psychiatry."    Dr. Bolsane has noticed a high number of cases of undiagnosed schizophrenia and other mental illnesses which he believes to be linked to Chad's violent history and the stigma of mental illness.   Despite Chad's newfound oil wealth, little of the new revenue has gone towards improving mental health care or making services more accessible to those who need it.  Due to the rising influence of pentecostal and charismatic churches, islamic mullahs and saints - known as marabouts,  belief in demonic possession and witchcraft is more widespread than ever.  

While traditional healers remain popular, they face stiff competition from Christian and Muslim healers promising miraculous cures.   When dealing with mental illness,, particularly psychosis,  the lack of available medical resources makes the message spread by faith healers more tempting.   With diseases such as malaria, polio, and measles still endangering lives and with one of the highest infant mortality rates in Africa,  mental health care has the lowest priority of all  forms of healthcare.   In most developing countries including Chad, overburdened health care budgets rarely devote more than a tiny percentage of scarce health care dollars to mental health treatment.     Providing psychiatric medication on a regular basis to more than a small handful of patients remains impossible without better methods of delivery.    Even providing counseling for many mental health problems is largely impractical for lare segments of the possiblity.   The lack of strong solutions makes the promised cures offered by charismatic practitioners all the more appealing.

Along with the need for more healthcare practitioners,  the people of Chad also require education to correct some of the prevailing beliefs about the true nature of mental disease and misconceptions surrounding psychiatry.   With suspected witches and possessed being actively persecuted in many communities,  men, women, and even children can be driven out of their villages and forced to become refugees.  The same applies for chronic mental patients with no real option except to survive by begging. 

And the problem goes on.

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