So we’ve spent the week going cross country and touring the mental health institutions of Sri Lanka with two other British volunteers and I’ve been left with three key questions.
1) Why is so much tea drank is such a hot country?
2) What were certain members of the royal family thinking with those hats?, and
3) What exactly makes a person “crazy”?
In Sri Lanka, as in Canada, there is a lot of stigma still surrounding mental illness. The difference is that many other issues including the civil war have halted progress in this area of health care. In Sri Lanka the cultural values also tend to be different than in Canada. The collective group ie: the family is valued over the individual. Therefore, “madness” can sometimes be defined as disharmony with the family. In some instances in rural settings family members will commit their sons or daughters into a mental institution because they are in love with someone of which they do not approve.
If a family member does in fact have a mental illness such as depression, it is extremely difficult for a poor family to support him or her. In some cases, this family member may be committed to an institution for life and deserted by the family because they do not know what else to do. Often people lacking education believe a person with a mental illness is possessed by evil spirits and they are fearful of them.
Sri Lankans in general value being calm and collected. They do not believe in sharing their problems with others. They are private and reserved. Therefore, historically talk therapy has not been used or found to be effective. Mental illness is still predominantly treated with drugs and people who seek treatment are often the more severe cases.
In addition, Sri Lanka has one of the highest (third highest I believe) suicide rates in the world. There is much speculation about reasons for this. However, one thing is clear, many people who could use help are not getting adequate support.
On our trip we met many committed professionals who are working hard to change the image of mental health and improve the care. They are setting up more programs, rehab facilities, etc. throughout the country.
In Batticaloa, an area devastated both by the tsunami and the civil war, we met the most amazing group of women who are being trained to be community mental health workers. These women would travel (some hundreds of miles) to receive weekly training from a VSO volunteer. They just receive the equivalent of $1 for their travel expenses and once completed, they will be paid on the lowest pay scale. However, they were so passionate about their work and really committed to making a difference in their communities.
One woman told a story of how she has managed to win the friendship of a woman in her community with OCD. This woman’s illness is so extreme it has caused her to lose her husband and her children. However, now she will allow a mental health worker into her home for tea and to discuss a plan to get better. This is huge considering this same woman wouldn’t let her own children or husband in the house for fear of it getting too dirty.
Some of the conditions we saw were appalling, but meeting people such as this group of women really lifted our spirits. If people like this are willing to work together, a big difference will be made.