Mental health disorders are common conditions that affect approximately one in four people globally, including depression, anxiety, PTSD, bipolar disorder, and schizophrenia, which can be managed with proper treatment and support. The Four Ds framework (Dysfunction, Deviance, Danger, Duration) helps identify when someone may need professional help, and effective support requires empathy, practical assistance, and understanding that mental health conditions are medical issues, not personal failures. Creating supportive environments at home and in the workplace, including accessible counseling services and family therapy, is essential for recovery and preventing relapse.
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| Health n' lifestyle | Mental health and psychosocial supportAdded:
Good morning and thank you for keeping it Citizen Television. We appreciate your time and company. Health and lifestyle begins right now. We are in the month of May and we know that this is the month we usually escalate awareness on mental health that is contributing to a greater percentage of the global disease burden in Kenya and of course globally. And we want to talk about the kind of support that people need when they've already been you know diagnosed to be having either one or two of the mental health disorders and we'll be talking about the stigma around mental health and what you need to do in case you're not part of the statistic but somebody around you is. How do you tell first of all and how do you then become part and parcel of their support system both at home and at the workplace? And we're going to dig deeper and to see how mental health presents in these two different contexts and I have with me an expert in studio to help us break it down. Anthony Muoki is not new to the show. He's a psychologist. It's good to have you again. Thank you so much especially for the citizen and you precisely for making time for us to have this very important conversation on mental health. I'm glad today to have this comprehensive conversation on how our various individuals needs to get supported both by family members and at the workplace.
Exactly.
>> that you're talking about the workplace cuz we rarely talk about mental health at the workplace.
I feel [snorts] like at the workplace is where you're supposed to be at your best, show up in your best side, you're energetic, you're performing, you're showing up but then we forget that people come to work carrying a lot of baggage and a lot of burden and a lot of issues that they go through in life. So how then do we create a positive supportive environment at the workplace to deal with mental health issues. But before then, let's let's let's begin from a very basic point of view. It's mental health awareness month. I don't know what strikes you, you know, in terms of the progress we've made when it comes to mental health awareness. I'm I'm actually very inspired by the fact that in the last decade conversations around mental health have become quite normalized. It's not as it used to be back then. But from where you sit, you you you are you are you are better placed to tell me more about what's been happening in this space. What Do you think we are headed in the right direction? What I would wish to appreciate, Safin, is the fact that people are now more comfortable talking about seeking therapy, for instance.
You've heard in streets people telling each other I I know I know a good therapist, you know. And it's normal. It's it's it's becoming very normal for individuals to even ask for help. Anytime in most cases I'm sharing that I'm I'm a psychologist, I'm getting very positive feedback.
Initially I used to hear terms like, "Oh, you are the guys who read brains or read minds." But now people are asking, "So when I come to you?" You know, when the conversation starts from that, shows that the level of continuous influence that that mental health personnel or media services like like like Citizen is doing and the impacts subsequently that that that we are seeing. But what is even more encouraging is the fact that even in public service I've seen a number of institutions embracing both private and public and and government-related organizations having mental health conversations like I spent significant time yesterday managing a staff and training on mental health awareness. And it's it's a government workplace environment. Privately it's so. And now talk talking about who we are and our relationship with mental health and workplace, you notice besides school where we spend a lot of time, Safin, the other places where we're likely to spend a lot of time is work workplace and and we are going to have conversations around there. But, so definitely yes, there there are fruits on the same and it's very encouraging. And even the individuals taking mental health related courses is encouraging.
Counselors and psychologists board released their gazette and you can see the numbers growing, you know.
And and and there is like somewhere we have a toll-free number where where I've seen people constantly calling, you know, to to seek pieces. Yes. Individuals have come up with apps and other websites and and people are reaching out. So, there is growth and and I want to to to validate and make individuals feel more comfortable seeking for for having these help seeking behaviors.
>> And there's no shame about it.
>> No.
>> Yeah. I was just about to to jump and get into what we really wanted to talk about, talk about support that is needed, but I don't want to assume that everybody is on the same page when it comes to mental health awareness. So, I'll go back a bit to the basics. Uh maybe just to help us understand what is mental health wellness from a very simple layman's, you know, point of view because it's it's a month of awareness.
>> Exactly. There could be somebody who is showing some telltale signs of a mental disorder, but they don't know. They just feel like it's normal. This is something I can I can sail through.
But it we could just help somebody with that information. So, when you talk about mental wellness, what are we talking about exactly? True. I'm going to break it in very simple statements that individuals will from this moment out of this conversation they'll be able to even share what mental health is. And to be able to do that, I'll split in into two sessions. The first one is what is it that we are looking into individuals or else what is it that I need to look into myself to really determine whether I might be distressed or having a mental health related conditions. And I'll summarize it by sharing around four Ds that we can use.
There are Ds. Yes, like four D's.
>> be A's. Okay.
>> Yeah, yeah, yeah. On a lighter note.
Yeah, we we we picking D's for for easier. So, that's the the the the consumer of this message finds it very comprehensive. We talking about this functionalities. For example, when you have symptoms that make it difficult or challenging for an individual to continue with their day-to-day activities, you know, even difficulties waking up and and doing things that you previously found interesting, for example. That could be an indicator. An individual is struggling to be present at job. And those who who are present to actually be productive at work. So, that could be a concern. You know, we also talking situations defiance. You know, there is compliance. Yes, defiance. So, we have compliance where we work, where we live. Our societies have experienced and and they have these principles that govern what is actually expected and what is normal. So, when there is deviation in what we are used or else what is expected of us, then that could be an indicator. And that could be like, you know, screaming in the streets, you know, shouting at people, banking >> For a rebellious child.
>> Yeah, yeah, because you could be talking about conduct disorder, for example, you know. So, that's is the the another element that we we we may use to really determine.
And then now we talking about danger, for example. When an individual is could be having danger or else manifesting and showing like signs of self-harm. We talking about suicidality. We talking about homicidality. We talking about individuals who are having suicidal thoughts, you know, ideations, plans, attempts, and so and so forth. So, those are some of the issue few issues that would help us really pick. But I need to really say that um mental health doesn't mean that you are have all those conditions or that you don't have a mental health disorder. You could be having a mental health disorder and if you are adhering to psychiatric recommendation like medications and psychotherapy assistance, then you can continue with functioning normally in the society. So, someone could be having a mental health disorder like bipolar disorder, no major depressive disorder, schizophrenia and other disorders, but they it's been properly managed by compliance by both the individual who's been managed and the society and the people around them so that that they are able to to now stick to the the disease that that we are talking about. So so so yes, you you realize there are many factors that that will really guide and and support such because human beings have at least five dimensions. The psychological being, the emotional being, you know, which is very important especially when you're talking about depression or clinical depression majorly and we have social we are social human beings. Our interactions with the others. We're talking about our spiritual connectivity with our supreme beings, you know, so those dimensions are the ones that when we put them together, they help us to really determine. So if you find some challenges that are touching on the same on the same, then we could be talking of signs of the same, but I need to really share disclaimer at this moment. Before we say someone has a mental health disorder, mental disorders are so many.
So we need to talk about a specific one.
We need to pick a diagnosis and >> Which exactly is is it?
>> Because you see the specific disorder is part of the disease that we are talking about. It's also the duration because again the duration will even guide the mental health expert to to to have an idea of what condition we are talking about. So if one day I'm just anxious about an interview like this or job interview or an exam, that one is then you know. So we will not just pick one behavior, one symptom and rule in.
>> Let me ask you.
So does it escalate from one level to the other? Because you'd find in situations somebody is just changing as the days go by or or within themselves they feel something is changing. They can't really put a finger to it, but one I feel to something is different about them. So, does it change from one level to the next or how do you how do you even tell when to seek help? So, Safin, what I'm hearing you ask is about the severity levels.
>> Yes. So, mental health have a continuum, you know, and they they have levels of of severity where we start with mild.
We then we go to moderate and now severe.
That would be one dimension. The other dimension that you could be suggesting is can one disorder over time now escalate to evolve to become another disorder. And that there is a possibility and I'll share an example with that. We could be talking about, you know, anxiety for example, excessive fear, worry, you know, fear of either known or unknown, but it's so excessive that it's leading to a dysfunctionality in day-to-day. So, if that is not properly managed, it then now likely to lead even to stress. If that is not managed, now you could be talking about depression because now I'll be even scared, worried, concerned, sad that I was not able to deliver in the previous task.
So, there could be quote and quote evolving, but at the same time we could be having one individual having multiple disorders, what we call comorbidity in this case. So, severity levels are very important to consider even when we intend to identify what treatment modality we are going to use. And that has to be done through proper diagnosis done by experts, you know.
>> that we are at it, Yes. why don't you just run us through the most common types of mental health disorders? Um yeah, the the ones you you you see in the population. These are quite common.
Some even walking with undiagnosed disorders without even knowing.
Interesting, Safin. Um in the space where we are as or I can see if around four individuals including the team supporting us.
Statistics here in Kenya show that one in every four is likely to have a mental health related concern you know at any specific moment in time. That should be concerning to all of us. And what you are saying really makes a lot of sense.
And and some of these conditions that are very common here in Kenya, Africa and globally are like depression you know depression, anxiety.
>> people use use wrongly.
>> Yeah, exactly.
>> Anything you're depressed. Anything you're depressed. You people don't know what really depression is. Yes, exactly.
Depression is so bad because we need to even acknowledge its seriousness because most of suicidality suicidality cases especially suicidality cases we deal with have depression related connection.
You know, and we are saying like for example depression is leading to suicidality to a level of around 700,000 individuals globally. You know, we are losing them thousand globally and we talking about around billion individuals. 8 billion individuals.
>> about annual mark? Yeah, annually. Okay.
But now even coming back home you you realize I was I'm yet to to really verify this.
>> 700 deaths. 700,000 deaths.
>> Depression 700,000 depression related deaths. Yes. Because of suicidality globally. And the reason why we are bringing that aspect of suicidality and depression is because of sense of hopelessness and helplessness. You don't know why you need to live. You don't have a reason. You know, you feel like life have lost meaning which is an existential perspective you know. So we have depression.
>> Depression, we have anxiety, we have stress disorders. Now now we have PTSD post traumatic stress disorder. And I was thinking about including journalists. We find ourselves in a in a in a very sometimes very mentally draining situations. You You filming and taking records of an accident that has happened. You do looking at the remains and no and fire incidents is any dramatic things just like police officers. You are frontline. We are like the frontline workers. It's not like you are like you are actually.
>> are frontline workers. [laughter] So, we are the scene where it happened and how the raw the raw nature of how it happened. We we consume it as is before we come and sieve it for our viewers.
Yes, just just like police officers.
They are the one to collect that. And now we couldn't be talking of post-traumatic stress disorder.
>> [laughter] >> No, now we have other very draining conditions such as bipolar mood disorder, what we call majorly bipolar.
And then schizophrenia is another condition. But now, look at this.
Substance use disorders. Oh, that's also a You know, where we are talking about alcohol use disorders among other related like cannabis use related psychosis and and disorders. So, you will realize like almost in every organization, almost in every extended family, we are talking about this one specific colleague, this uncle who who really battles seriously with substance use. And now, society previously used to normalize that, you know, like in every family you have this uncle, you know, this surprises us and with these moves.
You know, you you never know what they are going through. And we are talking about substance use disorder where someone could be actually self-medicating something that they are struggling to cope with. So, the alcohol could could not >> Could be.
>> It could could not be the issue in some cases, but we really need to acknowledge like addiction as a brain disease at the same time. So, so someone initially was managing or self-medicating a situation only for it to become now a condition by itself. At the same time, it can equally also grow independently. And now, look at what happens.
The reason why I I really appreciate what citizen is doing with this conversation today, you realize that individuals with mental health related concerns, the support in most cases is nowhere to be found. Because of something very interesting, we call it compassionate fatigue. You know, I helped you when you were in distress. We have advised you. We have invested a lot of resources for you to to to even be in school. You know, we we are paying your bills. You know, supported your kids, but look at what you are doing to us. So at the end of the day, individuals get tired and exhausted. We've done everything. Yes, but but also >> As friends, as a community, we've done everything for this person, but it's like they don't want to help themselves.
Yeah, exactly.
>> That's the notion.
>> Yes, so so now those conditions are the ones that I've shared have proven to be, you know, having high prevalence rates both locally and internationally. But now you you you realize again, there is a caveat, the gender issues.
You realize in most cases females, statistics has demonstrated that they are more affected, but there are justifications to that that qualifies that. You realize most of these statistics are gotten from outpatients visits by patients who go to different hospitals seeking support on other things. You know, sometimes these some So so female they're affected by mental health disorders generally.
Statistically, but now further research has demonstrated some justification for the same. Because you realize in most cases is it's women who really seek help. So that's where the data is.
>> Yes, and They look for these people.
They they they want help.
>> Yeah, yes. So if if I'm having back aches that I cannot explain, they are the ones who rush to the hospital first.
And now the clinician will be able to pick this is a psychosomatic disorder now recommend you to really refer you for for this, you know. Then we talking about onset ages, you know, late adolescence uh adolescence and teenage. That that's where most of disorder now flip. Like these individuals good when they were in primary and high school. I don't know what they It's happening just immediately after they have sat for an interview and they are waiting for a job, you know? They change. They change.
So, we put all those factors together and they go back to like what causes all this. Yeah. All right. It's good that you've said all that. And I just want to know very quickly how do you How is the diagnosis done?
Because we live in a society where uh there's there's a lot of negativity and negative connotation that is attached to mental mental health.
>> Yes. When you say you want to go seek help, there's already that that eye that eye that you'll be given like it's like you're losing it. It's like you're not okay. It's like There's a There's a way people would would would would would give you some sort of, you know, the attitude. So, how do you do you know when to get help and how is it diagnosed? And is is mental health something that shows that you're you're losing your brain or you're you're becoming, you know, if you know what I mean. Thank you so much. So, so we we need to to to share with the public a number of few things so that I really put it appropriately for for greater impact.
The first thing, no one chooses really to find themselves in that space where now they they have lost it. Mhm. And generally sometimes it's genuinely they have lost it because they are Some are not even in touch with reality or even with themselves. So, that is basically actually losing it.
So, we need to tell the members of the public that no one chooses to be that space. That is the first one, you know?
Then the second one now we go to these individuals who it it has actually happened.
And that's we are sharing these statistics so that they don't feel alone, Mhm. you know? And that is likely to really encourage them to find it more convenient for them even to share that they have a concern. But at what point then therefore do we need to seek help?
We are seeking help if we are finding the conversation the symptoms that we talked about. You know, I'm feeling more sad. I'm normally and and the sadness is so severe.
Actually, there is even almost like a scale for that. How many hours of the day day that you hours that you are you are actually sent in an average day? For how many days of the week? For how long?
You know, that that that indicates because sometimes you could be talking about a a trigger such as loss and grief, for example, that really leaves people with a lot of scars and and and grieving is such a big process. We talking about that. But, so sadness could be irritability could be an an another one, you know.
You know, lack of sleep, insomnia could be another one. Lack of appetite, personal hygiene, you know, you look at someone and you feel like, "Bro, you need to That's why you're saying these things because today we talk about support system and what the community around you needs to do and observe. And as you say these things, I'm actually relating it to what the community needs to be looking at.
Yes, true. You could be having a friend, a colleague, and you're realizing their hygiene has changed. These days they come to work. It's like they didn't even spend the night at home.
And it's becoming like a trend.
>> Yes, yes. You you realize that somebody is not sleeping well or they are withdrawn, sad. They used to be people who are very Jovial, yes. They used to bring light to the room, but suddenly it's like they withdrawn from Isolated.
Yeah. And And we talking about support, these are the things you're supposed to look at so that you can realize whether somebody could be having a mental health disorder. Thank you for really ending and clarifying that. So, you will go to therapy or seek help when two things either of the two things happen. You can actually feel it. And you can observe actually things are not working. You cannot even understand why is it that you really want to isolate, close yourself, you don't have appetite, no sleep, no no racing thoughts, outburst and all these things. That could be one. The other one would be individuals are observing.
Like you realize when you're talking about substance use disorder, you'll literally take look at someone and life has really you know they are messed up.
But when you talk to them, they don't acknowledge it. They actually need denial. Denial is one of interesting ego defense. Yeah, ego defense mechanism.
So you may need to seek out if actually people are talking about it or you have really observed it.
Yeah, and you know what one of the things that makes individual find it challenging to ask for help. Sometimes they say I get patient who say I don't know even where to start. I don't know what to to tell you. But I'm encouraging us that just walk to to therapy.
You meet an expert, they will be able to help explore. Because part of the way they are experts is they are able to pick up behavior, help you describe it, you know, modify it and make it even more positively predictable. You know, that is the essence. So just walk in and tell them I I don't know how I'm feeling.
They will carry it from there. I need help. I don't know what exactly I You know, they will help you know exactly where to They will help you know where to start.
All right, so let's talk about why let's talk about the support system.
>> Yes, please. Why is it important that we need to focus on support. You know, we always tell people open up, talk, share with someone. It's a safe space.
Don't keep it to yourself.
>> Yes. Let it out. But do we have a society that is ready to have these very difficult conversations? And when somebody comes to you and they open up about some heavy heavy stuff that they are going through, are we really ready to take it in and even to know what next steps to take. I mean I see her to Apple. So let's talk about that a bit.
Allow me pick that conversation with one question. Have you ever asked yourself why is it that when you ask an individual how are you today? The obvious answer is I'm good. Because we have a society. Do [laughter] you really want to go out and do You know then what is it likely to have if I actually gave you details. It's not that they don't want to share but they have assessed and seen maybe you will not understand or you don't have the resources to do that. So back to your very important concern is are we really ready to support our colleagues and family members during this this time and I want to assure you that it is not easy and that's why in most cases we are not ready.
It's not easy because it's draining.
Put a situation whereby an husband has lived well with their spouse and they have gotten a kid and them sorry and their spouse now has what we call uh postpartum depression.
You know >> [laughter] >> something that they were not expecting from the beginning. So it's a situation a condition that has happened. Maybe this is not even your first delivery.
You could be talking about the third or the fourth one and now it's if this situation is happening to to to them.
You know so in most cases these symptoms uh find people by surprise. You know you have this person in the family who was good but but you guys can no longer sleep in that home. They bugging the door. They are throwing stones. They are threatening. They chasing people around.
You know quote and quote shaming the family by how they look. So the society therefore needs to understand few things.
We are not helping because we have resources. We not helping because they are just our kin.
We are supporting them because if it was us in that situation, you know, I like reversing that aspect. If it was us in that Yes, yes, if tables were turned, then what could be the right thing for us? You know, it could be for us to to get support. And some conditions such as what I had mentioned, postpartum depression, it's about presence.
You know, showing up, being there, that extra support.
Take now again alcohol or use this other for example, an addiction related concern. Sometimes family get frustrated and they have good reasons why they really get frustrated and get tired. But you realize a patient has gone to a therapy to for for rehabilitation more than 90 days.
And no family member shows up.
Even if this patient ends up >> There's usually the fear, the stigma of being associated with somebody who has a mental health disorder. So yes, you you really mean them well. You want what is good for them, but you you don't want to be seen with them walking to these institutions. You you don't want to be any associated >> associated with anything that that that that that has to do with mental health.
But then you wish them well.
>> Uh-huh. silently Yes. So I think we should we should actually even talk to the community and the families more cuz this is where the patient draws support and strength and hope from.
>> from exactly >> As experts, you could be dealing with this person when they come to your institutions. You talk to them, you take them through the treatment. But who do who do they go back >> back to? workplace, the family >> I I like how how rightfully you are bringing it.
Let me surprise you. You never know how many patients get admitted and the family vanishes.
It's like they they took these guys and threw them in a treatment psychotic facility and vanished.
dubbed like they were literally dubbed.
And I'm asking myself or rather ourselves this serious question that Now, even if these patients are stabilized, are you sure they will not notice that you ran away? What is that likely to make them feel psychologically and emotionally? You know, rejected.
You know, like they are not worth it. Everyone has vanished when they needed them the most, you know. So, so you realize already that becomes another trigger for for the same conditions. And that's when now you talk about relapse. We keep talking about relapse. Uh you were in this treatment center, you have come again.
You are in this condition psychiatric facility and your condition keeps popping up, popping up, popping up. So, we are advocating now sincerely for deliberate family support. But you realize I need acknowledging I like acknowledging the fact that some of these family members and these significant others don't uh run away by choice. They actually generally, you know, exhausted by the same. And that's why we need to have conversation on family therapy. Uh where they will be taken through psychoeducation first. Yes, first first to understand this individual and how the condition manifests. And also how for them they can offer support, psychosocial support to these individuals. And that's why I'm I'm I'm I'm always very concerned when families does not show up for therapy sessions.
So, so it is during therapy that quote and quote we are going to validate and almost normalize the condition such that now everyone feels it is actually our responsibility and instead of leaving it to the big brother to manage our sibling, we can be alternating even the hospital visits, you know.
Look at this. Some of these conditions make it even difficult for people to help them.
Let me elaborate. That you have a condition, someone has a condition that they don't want to see anyone.
The family members become the enemy. And they are calling them names, >> [laughter] >> labeling them, and saying, "It's you bewitched me." You know, So, the family needs some [laughter] level of grace even in that kind of a circumstance. Grace and resilience, you know, yes, yes, yes. So, when we're talking about support, so what what sort of support does it look like in practical sense? Is it money? Is it Like what is it exactly?
People think just taking them to to the to the to the facility to get help is enough. We we >> What more can families do? We will go to family and I hope later we'll be able to talk about institutions. That would really help. When when you talking about support, the first primary step There is no step that we are talking it light like even for them taking this individual to a facility was a major support. We need to acknowledge every milestone because we have seen how difficult it is. So, taking them to to seek help and supporting them during that is very important. But now, there is day-to-day support. We're talking about a patient who has gone to psychiatric intervention for in psychiatric and they have been prescribed and they don't want the medication. Uh-huh. So, ensuring they take it. For Yeah, definitely that. And we have I've gotten individuals who really have very good support uh supporting system whereby we the brother is the one who they are in good relationships, the one who ensures every morning and every night they are there to to make sure that so-and-so takes the medication.
Talking about if the food is not cooked by mom or my elder sister, they will not eat. And so, so-and-so have failed themselves to ensure that this is done.
>> So, that's the only way.
>> Yeah, because now they have to take to ensure it is porridge they have to take meds with the porridge. This porridge is not just readily available. Someone is there to provide it. And some of these conditions are very like like in demands, very very complicated demands that it must be by cooked by so-and-so within these timeframes by so and so.
So, we looking at all those dynamics.
And what basically we are saying is we want empathy served practically.
You know, emotional support. You know, that presence. You know, that that person who bugs the door bugs the wall when you are sleeping in the room next. What are we telling them?
Uh-huh. You know, some these conditions sometimes can really make someone feel very uncomfortable.
So, when they are it is the peak of maniac. So, what are we telling them?
How are we addressing them?
>> Or are we shouting back and calling them names?
>> Yes. So, so what I need to clarify is that we don't shout I acknowledge it we are human. So, we don't shout back to them because we are one. We are exhausted. But I'm encouraging us that we acknowledge we have this at the back of our mind. It is not your choice.
Rational logic is not working anymore for them at the moment. So, it's not them.
It is the condition.
And and look at how they need our support. Have that mindset that it's not them anymore. It is what is in them.
Yeah, yes, yes, yes. It's not them. It's what is bothering them. And and you I like asking us as because you see no one is immune to these conditions. We we talking about these conditions. It could be me next time. It could be you next time. So, so when we put that it's it's like we are we have sympathy, but I want it to be empathy so that we become practical. So, resource wise, emotion wise, and encouragement and restoring their hope. When you find some someone who is just come come and they don't want you to talk.
You tell to tell them in case you want to talk I'm around. And be around. And actually stay there. Yes, I'm I'm around. You know, we can talk.
You know, and and sometimes let's not pressurize them. Tell them it's okay.
It's going to be okay. Some of the conditions and situations they are managing are are lifelong.
Some conditions don't go anywhere.
So we could be using alternative language that we we going this through we are going through this. I'm on your side. We we will manage. Oh you know you're saying some some things that are really making sense practically because some families are usually a helpless.
They don't know what else to do. They think it's only money and and maybe getting them an expert to look at their situation is enough. But you know when you talk about the little things Yes.
that counts. Even that presence, even just being there, talking to them, spending time with them, even just being patient with when they are they actually at the climax of it or the issues and throwing things around and you keep your cool.
>> Yes. Yes. Yes. That's the level of support that is Yeah. Exactly. But then what do you do when you've also reached your breaking point as a as a support system, as a caregiver? Because sometimes let's face it even even with a sick person sometimes you reach your breaking point and you can't take it anymore.
Every therapist has a therapist for a reason. You know, for example, every therapist and that's why we have we have debrief and clinical supervision every moment. Now caregivers need therapy equally. Because when when all these things are happening, emotionally they are affected. And they are equally [clears throat] sad and devastated looking at their kin in these situations. So so they also need to undergo a lot of psychosocial support, you know, so that now the attention is not only to to the person suffering but also to the caregiver as you are rightfully putting. The helper also needs help.
That would be the punchline.
Very important. And look at how one condition now is making almost everyone around them a patient. Yeah, you even even on holidays, you cannot go anywhere.
>> You cannot go anywhere. You cannot celebrate. Everything revolves around this person.
>> When you have family events, you like don't know who how to handle this this person during that day because and that's why I started off by sharing the the dimension so that like we pulled a psychosocial social dimension and see how very clearly it it really comes in handy to support when someone now has another issues with psychosocial no psychological dimensions, you know? You because all these conditions are interrelated and interdependent. Someone is emotionally drained because of an heartbreak for example, you know? And and now they go to substance, they get addicted, then after addiction everything has now to find money, you know, to support this this fella.
But now allow me emphasize that because these conditions can be financially draining, insurance covers.
So we can subscribe them to a policy and this where I also take this moment to encourage insurance companies to also have very deliberate consideration on mental health related concerns and not only on the inpatient.
Please also let's consider seriously outpatient because these these conditions they have so many sessions. I could be managing, you know, quote and quote basic psychological psychopathology that is taking 16 sessions.
Outpatient sessions and that could be draining. It is actually very draining because therapy is not not very cheap in in the country at the moment. So insurance, so you can subscribe them to whatever insurance company that you feel would would really suitably work out.
But also I'm also this where I am also advocating that insurance company have deliberate package for for for for for All right. All right. It is important that you save even out patient cuz why wait until >> Yes. Cuz the in patient case it's already severe.
>> Yes. Exactly.
>> By the time somebody is in patient >> prevent >> It is severe. So, why wait until that time for for insurance cover to come in?
You can actually help somebody at the at the at the very basic level. Let's talk about workplace courtesy of time, yeah?
Exactly.
>> This is the place apart from school where we spend our our larger percentage of our time at the at the workplace. And and now What about mental health at the workplace? It is very exciting for me because we are not just present at work. It is at work where where our efficiency and our effectiveness is expected at optimum optimumly.
>> Yes. You know? And that's very like you remember the dysfunctionality we are talking. We want functionality at work.
Look at the demand. And that's why what is expected of us is very well written.
You know, you have very clear JDs and you have targets.
>> timeline timelines, you know, guide and so and so forth. So, therefore, our workplace should be very deliberate.
Deliberate consciously to ensure that two things. One, >> [clears throat] >> the environment where the the staff is working is suitable enough to avoid two situations where workplace becomes as a susceptibility or vulnerability state, you know, that makes someone at a vulnerable state like what what what we basically people call toxic work environment. That would only would be a vulnerable and a trigger at the same time. So, so I'm coming to work. I have already and my own issues where I'm coming from. And you come in shouting to me like I'm a child or something, you know? So, so we You [laughter] imagine what what kind of reaction that would would attract.
Exactly. And it's happening.
Interestingly, look Unfortunately on Monday it was something else in the country.
You know, and I and I and you could see some people panic. Like, "Will How will I even go to food?" You know.
You struggle you get Good bosses good bosses reached out that night or else early that morning and assured their staff, "Ladies and gentlemen, we notice what is happening.
>> Safety first.
Please consider you are saved.
Some good bosses actually did that.
Others They called where >> the the they wondered, "Where How come you are not here?" when they themselves are not there. You know, those are the factors that we are we are talking about. So, how comfortable do I feel at work? How do we talk to each other?
You know, there are workplaces environment where respect regardless of how you feel about yourself, you are dressed either juniors with a lot of respect and that brings a lot of harmony and a lot of peace. Someone coming in from a dysfunctional family coming to find order. We are different people are different but they talk to each other nicely. You feel like, "Oh, kumbe there is another world where human beings can actually live better in an harmony way." We talking about that situation where work schedules are reasonable. And and today this morning I was talking to someone who was you know, quoted called bragging about their work shifts at where where they are. And we were talking about traffic and he said there is a group that goes around 7:00. That's be before the serious traffic and they leave around 3:00. Then another team now joins them at 10:00 and leaves way later. You know, and that's a simple tactic that that really works magic and you could see the satisfac- satisfaction. Because when we are defining career if we are miss satisfaction, then we likely to be now including burnout in it. Mhm. And burnout is also another Yes. So, in the flesh.
>> In the in the in the flesh. So, we could be talking about that. But now, most importantly, the government has been very deliberate to have guidelines, workplace mental health guidelines, that profile what needs to be done at workplace to ensure that our staff are mentally proper.
>> What are these things? Very interesting.
Like we need to you remember we used to to have wellness departments, for instance. I'll just use wellness and welfare departments, quote and quote.
That is where mental health should should should should be. And and I'll be sharing an example of one institution which is appropriately, I feel, appropriately doing that. Yeah.
We need to have an We need to have identified staff who support our colleagues when they are in distress.
These individuals could be trained to have basic counseling skills, for example, and basic screening capabilities, and even to understand how they can handle a crisis.
I was talking to a principal and they they saying that they they were in a given school and this parent showed up.
The kid was to be, you know, released to go for therapy and so on.
And the parent was, you know, something else. And they were wondering how to really solve that issue at the moment. And the same happens to work, you know? So so we need a team that supports like the the first line of defense that picks so-and-so today, oh we have observed, let's talk to them. Then after talking, we will be able to one, know where to refer them.
So, they need that basic training to for them even to understand what's the difference between a psychologist, a psychiatrist, and a prison.
>> [laughter] >> You know, we need to have that that that support. And you realize these people also need a budget for them to be convenient to conveniently do that for their staff member. So, the way we are able to handle discipline cases at work because of someone who does not show up, who is absent. We need to have another one now with that seriously sit individuals down, see how best to to support them. Including, you know, I and there is an organization I would mention here because I don't have their consent, that they go an extra mile to involve the the other family members when the situations of these one staff is not very well, you know. They involve the spouse, they talk about it, and so and so forth. And I want to tell you it's it's it's very fulfilling when someone feels I am understood where I spend lots of my time. And and they they are looking at my interest [clears throat] is actually their priority. And this should be very intentional.
Deliberately.
>> Should invest money, the right people.
>> Resources to train. Yeah. To train the very intentional.
Should should should I pick what I've seen it work in in a in a very formal setup.
I work for National Police Service Commission for instance, and we have a counseling unit that deliberately it's there to support police officers and to identify different parts of the country to manage them psychosocially and emotionally when they are undergoing distress. Therefore, to to prevent other psychopathologies manifesting and those who already have conditions to be supported. So, the commission National Police Service Commission has deployed counselors and social workers because of what we are talking about social support. That's why I like mentioning that that aspect of we have social workers who support to reunite these police officers with their family members and find social support from the people who really matter to them. But that was not the only focus. They have a focus whereby they have a counseling center at their HQ.
Where staff members can walk in in therapy at workplace.
You know, I feel that's a model that could be applied in other places.
>> be a standby counselor. A standby counselor and an office, a well-furnished office where staff members can go.
We talking about situation whereby individuals are losing significant others. And individuals are struggling with financial crisis. Someone is struggling with gambling, for example, you know, and you know those companies. People are gambling right, left, and center. Salary gets in now. Before I leave office, I'm asking for fare, you know. Those people should know if I knock to door number of six, I'm going to find an individual there who is waiting. So, that we talk about this situation. That's something that can be applied both in public and private sectors at all levels. We talking at There's there's a problem there because at the workplace people feel you're not supposed to show up in that point of vulnerability. The moment people see you that way, then you might even be bypassed when opportunities come, promotions come.
And plus, there are there there are some people who tell you where she does a nyumbani.
You Men don't cry.
Such kind of phrases. [snorts] Safina, >> [laughter] >> there is interventions for that.
>> the wall? Exactly. There are interventions laid properly for that.
And and that's what serious organizations are doing. Proper psychoeducation and mental health sensitization. That's where we have in those conversations. And look at the aspect where we are now talking about bringing experts on board such that I have confidence that whoever it is that I'm going to see is going to to handle me professionally. Mental health practitioners, just like other medical practitioners, are guided by proper ethics like confidentiality is non-negotiable. One of the reasons why you would be afraid knocking a door and joining in is because you don't know how safe that information is. So, with proper sensi- >> They will share with you how it will work against you.
>> Yes, with proper sensitization is is where we are going to break that barrier because we are reassuring people that once you knock to that door, you are going to find someone who will handle you professionally. Whatever you are going to share there is different from the HR related concerns. I'm I'm the person who is telling you, "Come with your troubles."
You know, I want us we we we make that very clear.
>> Many employers would say that.
That's why the best way we can.
>> [laughter] >> And that's where the conversation is today.
One of the reason why as an employer I'd be reluctant to have that office is because if I'm the stressor.
>> [laughter] >> Let's be serious. You're the toxic I don't want every staff to be saying it's the boss. It's the boss. [laughter] And then my problem is the boss today.
And then tomorrow another one. That would be one issue. Then be a good boss.
Such that that is not not You can even be the first client in that therapy room. You establish this therapy room and you can actually book yourself sessions. Fix me first before they start coming before they start flowing in. So, psychoeducation is very important.
>> also be toxic and you could be the problem and you can actually go for help because I I've realized I'm a bad boy. I need help.
What I've seen happen interestingly, the resistance is actually in the first stages.
This time round you sitting people down and you are telling them, "We are going to talk about mental health." Some frown. But if you do it properly, they start asking questions. Before you know it, by the time you are going out for the other sensitization and I'm borrowing this from the experience where where I had mentioned that this is happening that you go for the first sensitization meeting, you get in 20 participants. The next time the number has grown. The other time the toll-free never stops. The commission has a toll-free number where police officers and their families can comfortably call at any day and a psychologist receives.
So, it's something that can be done in any institution.
>> just ask you something quickly out of curiosity.
>> Yes. How do you support a colleague who was grieved who is back to work?
>> Mhm.
Yes. Yes. You know, we usually say, "Oh, we are with you. Tell us anything in case you need anything." What is your challenge? Mhm.
Uh-huh. Compassionate. Compassionate leave. When they come back, you're not sure how to begin.
So, you move on swiftly. We We talk >> Yet, this person maybe could be dealing with something.
>> In most In most cases, they are actually dealing with something. Not even cooling most cases, they are.
Let Let me tell you, grieving in most cases starts when we we we we put the soil on on that grave. Mhm. Because that is when everyone has closure and they have left.
>> real now. You know, it's now when it hits you the second night after the incident. You You know, Africans and are very device a very good way of supporting members in the society and that's why we have this welfare. They show up every day until the event happens. So, after we do that, that is like the closure. So, when they are left is when they break. And I'm happy that you're bringing the conversation of we read aggression of this individual At at workplace. And look at what we are saying, having that safe room, I've seen it really work, you know, immensely because someone knows from here because we have levels of grieving. There are individuals who it will happen because of how close you are with these individuals and the other factors surrounding that.
Some delay grieving. There is someone who will be strong that day they are laughing, cracking. But immediately after that, they come to break in the office and they are like if someone is very insensitive, you know. So, so we need to individuals to take them through a loss and grieve as as a number of steps and maybe to create awareness in these conversations.
While these steps are not cyclic, they they jump jump each other sometimes, we can just mention them quickly so that someone who could be going through the same, they are able to pick and know where rather than where they I think that that would be very fair for for our listener and whoever is watching today.
We talking about shock.
No, an incident has happened and you are like now Mhm.
It No, yes and and you cannot you know you are you are you you are shocked. You are surprised that it's happening.
Immediately after that you start denying. It cannot be. I was with him yesterday. We talked with her. You know you know she left in the morning. How come that has that has happened? You know the denial. Then we go to bargaining. When you start realizing that actually happened I'm actually mentioning very fast. It's very comprehensive. So bargaining it's like what if we had done this? What if this had done? I'm the doctors actually that doctor was what if we had taken them to a better hospital in a better facility? What if this was done? What if actually I paid what if I gave the call? All those things come in bargaining. Then immediately you realize nothing much could be done. So depression kicks in.
You know the symptoms that you are mentioning kicks in. Then after that there is an acceptance. Acceptance is not a surrender. Acceptance is acknowledgement. Somehow we need to crawl in back to life and life must continue. So for someone to walk through that genuinely So when when somebody comes back as friends you are not experts. You are just colleagues.
So what what do you do? What do you do?
How do you make their their environment bearable? One thing is never >> to remind them of the pain at the same time you don't want to be insensitive as if nothing happened.
Observe the person you are handling because every individual is different.
But one of the things that you should not tell them is that it will be okay.
It is well.
It will be okay. You know that statement comes quite often. It's not okay because this person will not come back.
You know.
But we we can use statements like let me know how I can be I can make you you know fix fix fix fix this. I'm I'm here. You need it. Yes. Let me know how I can help. And and don't let them only say much from their side and not you. Yeah. You know, over over pushing. Then be around them as much as possible. Not to surround them literally. Just But that sense of someone is really cares.
I have seen individuals who now later go visiting. Mhm. They visited during when things were busy busy busy. But later some few friends. In most cases it's not very formalized. You you get them. Sometimes now if you're very close to them you can really inquire how they are coping. You can ask them, "And how are you coping? How is your sleep?" And that already shows concern. Then they tell you, "Ah, these thoughts keep coming. No, I can I cannot bear it. Like I slept at 3:00." Then that you know, those that concern. Please tell me, "Are you eating?" Mhm. You know, sometimes people say very careless statements while in with the intention of inspiring. Regardless of what is happening, eat fast.
You know, eat fast. They say it's not easy. It's not that they are choosing not to eat. So asking those questions could show concern. All right. It shows concern. Anthony, I know with you I can sit here the whole day >> [laughter] >> and we still not, you know, have done this conversation a lot of justice. I know there's a lot that we still need to talk about, but I'm so happy that you took us to a perspective about mental health that is rarely talked about, you know.
>> This is rarely talked about. Now I believe that people are better prepared Mhm.
to to know how to handle these difficult conversations in difficult situations if you have somebody who is part of the statistics Mhm. of people who are dealing with mental health disorders.
Thank you so much. I believe we should create another platform to pick this up from where we've left. We just put a comma. Mhm. That's just a comma we are putting. Thank you for watching. We hope that we've enriched you and empowered you as we mark the mental health awareness month. My name is Safina Chegomah this morning. I've been having a sit down with Anthony Muki. He's a psychologist. Asante sana, daktari.
Karibu. Thank you so much.
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