University of Nigeria
Research Publications
ANYANWU, Joy I.
Author PG/ M.ED/S/88/6142
A Survey of Traditional Conceptions of Mental Illness
Title among the Educated and Illiterate Citizens of Emekuku- Owerri Imo State
Education Faculty
Guidance and Counselling Department
December, 1989 Date
Signature
ii.
--.-----DEDICATION
This work Is dedicated to my f arnilies: Orientation and Conjugal. iii.
This Gork would not have been possible without the expert advice and supervision of Dr. P .O. Wwaogu my Project Supervisor at the various stages of its production. I am indebted to you.
I also wish to exprecs my sincere gratitude to my husband, Mr. C.U. Anyanwp for his moral and financial support . I am equally indebted to my brothers, Ezeikpe
Ornemgbaji, Chinenye and my sister, Dr. (Mrs .) A.C. uwaegbute who through her motherly assistance made the completion of this programme possible at this time.
Thanks to you all Dr. Ahurnibe, Dr. A.J. Orji,
Mr. Ekwe and my other friends too numerous to mention for your invaluable a~sistence. This Thesis has been appr 1ved for the Department of Education University of NigeriU fl;ukka
------INTERNAL &XAMINER
------EXTERNAL EXAMINER HEAD OF DEPARTMENT TABLE OF CONTENT -PAGE I Approval Page r. .. i I Dedication .. .s ii Aoknowled$eaent r. .. iii I Table of Content .. iv List of Tables v Abstract vi
CHAPTER ONE Intorduction The FToblem Aim of Study -. .,' ' :. :stions .. ky$.Ah@&3 .. Area of Studv- ..- - CHAPTER TWO Review of Literature ..
Researcn Methodology .. Design .. Population for the Study .. Instrument for Data Collection Method of Data Analysis .. CHAPTER FOUR Data Presentation and Analysis CImER FIVE Discussion of Findinga .. Conclusion ec~dSuggestions .. Limitations of the Study ..
APPENDIX - QUESTIONNAIRE 6 . Conception bnaed on (cauees ~duca.tcd/illiterate citizens) 116
Description Table Conception bnee on (Zducated/illitecate citizens) It. 1R
Conception based on Bat method of trcatDlaot
Conception based on aelationship n
Conception based causes (~~d.uleS/Y~~ths) ILB IIC li IID Conception bcsed on Pe:-iiztmency of Cure IIX: IIF Conce2tion hac;ecl. on relationship IIG li IIH IIIL IIIB Conception bmed on Method of trectr.ient I IIC 11 1133 Conception based on Permanency of 11II: cure 1, IIP Conception based on Relctionship IIIU it IIIH The Primary purpose of this study was to investigate
the conception of the educated and illiterate citizens of
Emekuku about mental illness. The study was carried out in Er~ekulcu made up of ten -. villages, There are four hundred eduoated and illiterate
respondents randenly ,:elected from five of the ten villages - 80 people from each village. This number is made up as follows:
10 literate and 10 illiterate adult males
10 literate and 70 illiterate adult females
10 Literate and 10 illiterate young males
10 literate and 'I0 illiterate young females. *, *, To enhance data collection, $ame rebearch questions were used and they incLuder
how do Emekuku people diagnose or identify mental illness What are the bharacterijtics of ~nentalillness
Can mental illne:.s be classified and on what basis What are the clespes of mental illness.
What modes of treatment are adopted for mental illness.
Is mental illnezv curable
How do people relate with ex-mental pntients. (i) There is no significant difference between the conception
of mental illness by the educated and illiterate citizens
of Emekuku.
.- (ii) There is no significant difference in the conception of mental illness by the adults and youths,
(iii) There is no significatodifference between the conception
of the male. and females of mental illness.
The data obtained were analysed using percentage. The
chi-square (x2) statistic was also used to test the level
of significance.
It was found out that mental illness mean:: one thing
to the educated group and another thing to the illiterate
group as shown by the significant difference that exists
in their conception of mental illness based on causes,
treatment, curability, and relationship with ex-mental
patients. The educated group were more enlightened in their k views tlbout mental illness, than the illiterate group.
The female respondents in this study were also less
traditional in their conceptions about mental illness than
the male respondents and the difference was signigicant. The youths were equally less traditional than the adults
as indicated by the significant difference that exist in
their conceptions. mental illness is caused by witchcraft and inheritance among others has shifted to include drug addiction which is :,cl&.L : acclaimed to be the major cause by almost all the respondent- in this study. i The researcher therefore, suggested that
(a) A well packaged and incessant entightenment campaigns,
in vernacular, about the effects of drugs should be
mounted in churches, schools, media houses and asylums to
prevent or reduce incidence of mental illness.
(b) Seminars and workshops should be orgnised to enlighten
the public about mental illness, ways and means of
handling mental a.id ex-mental patients, since relationship ?I
with ex-mental patients is not cherished by normal
people i2reapec'tive of age, sex or education.
(c) Asylums should be provided with adequate facilities for
crafts and other aspects of adult education to make for
self actualization and enhance social integration of
ex-mental patients after discharge. EilAF'TI3H ONE
~11'i'KOiXuCT10Ii
Plental illness according to Roper (1978) i; arrested
or incomplete development of the mind, psychaphathic disorder
or any other disorder or disability of the mind. + From earliest times, mental illness has been defined
primarily by social ceriteriar Those who deviated from
perbcribed, expected or typical social behaviotlrs have been
considered either insane, criminal, eccentric of sick.
Little concern has been zhown for individual criteria such
as people's happiness, feelints, or even effectiveness in
functioning as members of the society as long as: they arc
not public nuisance.
~~CTqn1,'fIC'- - ,d---,,,------..-- OF TXC MENTULY ILL : '$he characteristics of the mentally ill vary greatly.
Some 'ire confused a;; to where they arc, who they are, or who
othors sre, that there cbn be no doubt about the ,,eriousne:,s of their ~bnormality. Others are excu;,:;ively elated or depre.,sed or unresp@,nsfv-.
&bme possess stranbe processes of thinking that makes them LC;.,.
unintelligible. All the; e people are suffering severe mental
illness which the law calls insanity or madne:j.; in the local
*arlance and they are treated in the psychiatric hospitals. 2.
There are yet others whose mental illness is not as
extreme but who still are so handicapped by doubts, fears,
a~mrp~uLrrionb and worries that they become ineffective. They
are aware that they are ill but may not realire that they
&. suffer from psychoneurosis. They are notfound in mental
hospitals.
Another group is no unresponsive to the demands of
society that they are in constant trouble with the law and
of course, many of these are in correctional or approved
institutions.
In effect, there are various forms of mental illness tha-t
a concise definition cannot be proffered. (&&&IFICATIOW----- Or' H61vTAL ILLNE.J;L: Mental illness from all indications can be cla~sified
based on the characteristics of mental disorder.
:ubst-quently, the diagonistic and htastistical Manual of
Menttl Disorder 11 - DLM II published by the American psychiatric Association classified mental disorder into: 1. Mental Keturdation: This is subnormal intellectual
functioning with jJr.~airment in learning, social hdju: and maturation. ii. Organic Brain byndrome: This is a physical condition whose symptoms are caused by damagesi;ho brain tissues and leads to psychoses and non psychotic disorders. 3. iii. Psychoses not attributable to physical , .. u... conditions (such as organic brain damage). They include: (a) Schizophrenia - Impairment of integrated emotion, though! and behaviour; withdrawal from human contact and reality. (b) Major effective Disorders:- severe disturbances of mood and feeling. (c) Paranoid ~tates:- Delusions of persecution or ;,?~:..;ia- grspdiosity . IV. Neurosis:- Ltrong anxiety, conscious or uncon:;cious, no jiross distortion of reality or severe personality didorganisation. They include: (a) anxiety neurosis, (b) hxatericak neurosis; (c) phobic neurosis (d) depressive neurosis (e) neurasthemic neurosis (f) depersonalization neurosis (g) hypochondrical neurosis. V. Personality Disorders: Deeply ingrained maladaptive patterns of behaviour that are different from the psychoses and neurosis. ~omeof these categories reflect personality styles that re.;emble specific psychotic or neurotic divordzrs but which do not show the more 4. acute and disabling symptoms. Other categories refer to more specific forms of socfial deviance namely: pqrqnoid personality cyclothymic personality - mood swings from euphoria to sadness; hysterical peqonality antisocial personality; sexual deviation; alcoholism drug dependence Psychophysiological (psychosomatic) disorders: Physical symptsms such as high blood p:ressure or stomach ulcers produced in part by psychological factors. Special symptoms: - : peech di,turbance; specific learning disturbances, Tics; disorders of sleep (d) enurebis f~edingdisturbances. Transient situational disturbances. Hippocrates as quoted in Zilberg and Henry (1941) cla;siiiad mental illness into (a) phobias (b) epilepsy (c) mania (d) melancholia and (c) paranoia. ------ChUaEy OEiYEIu--.------TAL ILLIvLS Many studies have demonstrated relationships between socio-economic status and prevalence of psychiatric disorders. It is recognised for example that schizophrenia .- (a type of mental illness), is mo$t common in areas of poverty and dense population ($role et a1 1962). This is because, low status is associated not only with low income but also low levels of education, Occupation and general prestige. Therefore according to social conditions, view point in Srole et a1 (1962) such cou~munitiesengender schizopKenia through the fru;;trations, culture conflicts, group tensions and social disorganisation which occurs under these condition:; In addition to the socio-economic status as a causative akent of mental illness, abube of hard drugs like heroin and cocaine among others may contribute to mental illness. Inheri-Lance is not absolved in the causation of mental illness while some people may believe that it is a punishment from the god8 for sins committed either by the patient or his relations. Martin (1977) reports that Greeks and iioman physicians and philoiophers held points of views that were esrentially modern in their denial of supernatural explanations for both physical and mental di:;orders. 6. The Greek physician Hippocrates (460 - 377 B.C.) for instance, was one of the fir:;t to advocate naturalistic *xplanation for disturbed behaviours. In speaking about epilepsy, referred to as sacred disease because of the belief . % that it reflected posse:;sion by a e;od, he say:; "This appears to be in no way more divine nor more sacred than other diseases but has a natural cause from which it ori,inates like other infectionsn. And again "If you cut open the head, you will find the br in humid full of sweat and smel'ling badly and in this way, you rney:see that it ib not God which injures the body but diseaseH. some others like :,zasz (1970) do not believe that there is anything like mental illness. To him, "mental illness" is a term used by people to de~cribethe problem of living. ------.------D1AChO.,Ib OF MElvTAL ILLNE;:; The diagnosis of mental illness can be done throubh I. Psychological te;:t~which are highly $ti niardized procedures for obtaining a sample of behaviour from vhich inferences can be made about a paruon's general functionin,. They are usual$ constructed so that a person's re;,ponses chn ba qualified and compared with norms obtained in a large sample of other individual:;. They seek to reduce come of the uncontrolled influences that operate in other means of dia~nosisLike the interview aad provide mora standariized information. 7. Psycholo~icaltests include: Projective test: e.g. the T.A.T. (Thermatic Apperception Tests) ~hichcontain pictures of vhrying detress of ambikuity that a person is asked to make up stories about. Persotiality, inventaries e.g. the MFPI (Minnesota Multiphasic Personality ~nventory)developed by Hathaway and Mqkinly in 1943. It consists of 550 items of various topics ranging from health, attitute;, moods to iocial interests. Observation: This is concerned with what people do. some observational information can be got throubh interviews and one notes the person's appearance, drejsing, b~haviouralcharacteri::tics, like nervousness, speakink fast or slow, avoiding eye contact, utc. Truditionally, mental illness is initially diagnosed through observation. From this observation, some people may go to native doctors or prayer hou::es to find out the cau>e . Tabubwr 0)' MEhl'AL ILLNE,L In Europe, from the history of medical psychology, durirl~ the tine of demonology which lajted f'rom AD 200 to the 18th century, the mentally ill were treated with cruelty e.g. flo,ging so as to drive away the offending demon or keep it calm. 8. In France, Phillippe Pine1 chained the mentally ill until 1793 when he decided to unchain them as a result of change in the belief as to the etjntogy of mental illne s. (jtafford - Cleru. 1963). . ,. Incarceration and killing of the mentally ill was equally practised as a way of getting rid of the possessing uemons because they believed that the mentally ill were either witches or devilish. In effect, there was no particular method of treatment not even medical intervention. It is however gratifying to note that there has been a change in the treatment of the "lentally ill which is basically as a result of changes in the soci~ty,advances in L-iences and more especially, different ways of defining health. This chanke has brought about thc existence of psychiatriz services with trained personnel in the psychiatric hospitals, D~:pitethe existence of these medical facilities, people still cling to their traditional method of treatment by native doctors while others consult spiritual churches and their prophets dependink on what they believe are the causes of mental illness. ATTlTUVE TO MFjNTAL - -- - .------. .- -.. ,-- ILL[~GLC -- - - People'; belief about mental illness equally affect their attitude towards the mentally ill. For instance, in a study condu&xI by Ogbonna (1976), he reported that people shy away from contacting marriage relationships with any family with the stigma of cases of mental illness. ,, In studying the effect of stigmatization on ex-mental patients, Cumming and Cumming (1975) found out that8 (a) There wils outright expre.:sion of shame or inferiority becauie of hospitalization. (b) fin expectation of discrimina.[ion or inferior treatment from others. Ostracism is the most common attitude towards the mentully ill in most communities in iiigeria. Familie, often lcsve their mentally ill members to roam about the street: irrespective of what peopla might say. Even tho.,e who have been treated either medicully or traditionally, suffer the same fate. They are not, tbken serious in any discussion. And comments like "do not mind that mad man or womanN i$ vrry common. They are so enstraged from people that they may become extra-ordinarily ,. aggre,sive and violent since they believe that no behaviour of theirs will be ac%epted.as 'tnormal". On thc other hand this enjtrangcment may lead to the exmental patient withdrawing conpletuly from people thereby cresting another opportunity for another bout of madness. 10. ------.----~TATEMEI~T OF PHObLEM From literature on mental illness and personal observation, it seems that the mentally ill are today the targets of public disagust and rejection. They have taken the erstwhile societal position of the lepers. tIence, we can see them wondering alorik our streets naked or half naked. Exoept for the fact that mad people have been rejectsd or defilnsivdy forgotten by their friends, relations and even .the bO~crnment, how else can one explain their continued presence alonb the streets invpite of the nation': wsalth and the progress made in tha field of mental health. As of now, govcrnn~entha:: not yet phoce"menta1 illnljss in t,hc list of social problems to be included in the nationel welfare despite the fact that the government is capable of takink adequate care of all mental caaea by training the r equired persmnnel, rehabilitating and even campaigning for the prevention of mental illness. >econdly and of primary concern is the fact that some of the -bandon& mad persons are related to educated people who are well placed in the society as to effect the needed better social conditions for thc mentally ill. Thirdly, the incidence of pzople ueing the mentally ill, who are sometimes chained and in a line to collect money and food items in cities and towns like &~aekukuis a that coulu have invoked public sympathy and 11. immediate action from the elite group i.nd public health officials who either see them or read about them in the news- papers. As there are not many documented evidence to accour~t ., for the non challance which both the general public and the .government show the mentally ill, the researcher has con:iidered it worthwhile to make a study in this area. --..------ALM OF -TUDY This study aims at finding out whether the educated people reully believe that the nentally ill should be left to their fate or whether they have a more sympathetic and po:+itive attitude toward then1 than the illiterate group but behave differently towards them due to other reasons. Some other variables would equally be examined to det~rminatheir influence on people's beliaf. The include; (a) H~J: The difference in age amon, people often affect their outlook and attitude to life and think, around thorn . . Thi$ .is Dacauoei some behaviour.;.,are. out@own w while some others art: acquired a5 people grow. (b) ;.ex: Normally, men and women do not see many things in the same perspective due to the highly emotional disposition of the women. This study will eitlicr prove or disprove. the statement. --RESEARCH QUESTIONS -? To sharpen the focus of this study and the questionnaire, the following research questions have been adopted. 1. How do Emekuku people diagnose or identify mental illness. 2. What are the characterivtics of mental illness. 3. Can mental illness be classified and on what basis 4. What are the ckasses of mental illness 5. What modes of treatment are adopted for mental illness. 6. 1:s mental illness ourable. 7. Mow do people relate with exmental patients. me----HYPOTHEdE& -. To facilitate the analysis of the study, the folloring hypotheses have b~enput forward. 1. There is no significant difference in tho conception of mental illness by the educated and illitarute oitizcns of Emekuku. 2. There is no significant difference h the conception of mental illness by the age groups (adults arid youths). 3. There is no significant difference between the conception:: i of the males and females 06 mental illness. - -. - - 14. -. -. -----AREA OF sTUDY: EMZKUKU COMMUNITY E;mekuku, dhich is the setting for this research, spans between seven and seventeen kilometers Eust of Owerri. It is made up of 10 villages namely; Ezeogba, West' of Emekuku is nearest to Owerri, followed immediately by Ezedibia, < kkulovo, Umuakuru, Umuocham, ~zaraowaila, Okwu Errieke, UboegblSLu, Ubou~'ll_Ln;: nd Aznraeyb~1.uthe furtherest from Ow trri which is Seventeen kilometers away . Thb largest in population is hzaraegbslu followtd by Ezeoiba; The estimated population of the whole Emekuku is &bout 20,000. Emekuku was where the Cztholic Missionzrias settled in thc old Owerri District and therefore wes the craddle of kmowledge &ad development for them. They built a hospital, Cathedral and schools which are all very popular even today. All the villages in Emekuku are of the same ancestor. Their traditions are basically the same including their belief system. An Emekuku site air, K.A. hjoku surmised their oneness thus: The lcnd of Emekaku ~hsabode of Peace and love The old Catholic town Many a neighbouring town I! Through you, have seen the light. -----CHAF'TER TWO ------fiEVlhW OF LlTERATUHE------BELIEF ABQUTMEMT~ILLNFSS ALL OVER THE WORLD Studies carried out by several investigators hove shown L that beliefs about mental illness bxist all over the world frog: thz primitive cave dweller to the fnodern sophisticated man with his high level of technological advancement. In some areas, it is even believed that such n high technological tidvancement is one of the causes of mental illness. i However, beliefs of the early man were much more super-i I 1. stitious than those of the modern man. For instance, Coleman (1976) reports that the early chinese, Egyptians, Hebrews and I I ~ Greeks had their peculiar views and methods df treatment of I I mental illness. They attributed mental disorders to demons that had taken possession of the individual. This belief ahwl gained a strongfoothold among since, like many communities of h today, some natural phenomena were attributed to the influence of spirits. The symptoms of the disorder helped them in deciding the type of spirit or demon that possessed the patient, For example, people who exhibited religious f anoticism were thought to be possessed by good and acceptable spirits, while the much excited and over-sctive individuals were said to be possessed by evil spirits.' Such possessions among the Ilebrews, were said to result from wrath and punishment from God, shewing , ..~ 16. r: .-- that they believud that punishment from God can also ctiu~€rr: .- mental illness. Beliefs and attitudes towards mental illness are however, chnnging gradually, Treatment of mental illness is equally no longer as crude as it was in the early part of last century. ennnly (1970) carried out an investigation in the United States to find out public views and nttitudeslbowards the !nontally ill, He and his associates performed a series of studies to determine to what extent the mentally ill are hdd in low esteem; whether the public holds different kinds of views and attitudes towards mental illness, ,and whether uttitudes towards the mentally ill correlate with demographic char~cteristicssuch as education, uge and other factors. lhey found that generally, the ment~llyill are regarded with fzcr, distrust, and dislike by the general public. Comparing nttitutdes towards the n~entallyill with public attitudes towards normal' people yfic mentjll ill nre roprdcd as relatively worthlesfi, dirty, dangerous, c~dunpredictab f c and so on. They a130 found that the more cducsted pople are, the less they held derogatory attitudes towards the mentally ill. They therefore suggested that if people had face to fece contact with the mentally ill, and with those who have recovtred from ne~italillness, much of the stigma associated with msntal illness would be removed. For thin reason, they have proposed thht the general public . . ( be encouraged to visit mental hospitals and meet tho patf~<€Y^'- at first hand. Their belief therefore, iz that most ok the strained relutionships with the mentally ill is that either the k~nernl public is misinformed or uninformed. They are either ,, misinformed because the average man holds nurnberous misconcep- tions about mentcil illness, or uliiformed because hi: has little inforii~ationabout many of the problerns of tho mentally ill p.iopla. Hnlpert (1970) reported a survey carried out insever-lP ..reds of United Ltates of Ainerica by iiarnsey and Seipp in 1946.. The first was in Trenton, dew Jersey uhore the survey was designed to obtain data on conceptions cnu i~iformationregading 0;usative factors associatad wi.th mental diseases. Uatq were [email protected].<,. according to:: age, sex, religious affilintions, aduontional l&el and o~&~ationalclass. The survey revealed thut the higher the educational cnd occupationnl level, tho more enlightened the opinions about mental illness. The higher educated group more often cited cmotioncl end physicbl aifficultics as being the c~usn+,ive factors in .>ton-talillncus, while the lower educated group cited cnvironnental and bohfivioural cauals such as alcoholism, ovor e&ting and overwork. hore of the women ascribed mental illness to emotional problems while more men mentioned cnvironmental and behavioural. factors. In their opinion about treatment, the majority of the re: pondents fel& that troatrnent would be of help to a mentally ill person. Most of them did not associate sin with insanity, although mLny were undecided on whother insanity is inherited or not. Halpert, liamsey and Yeipp reported that the hikher the educational and occupationcrl level, the more optimistic the respoildent was about the likelihood of recovmy, the greater his Ocndbnefib~ akicommend professional treatment rather than home care, the more fraquently he qualified his response &bout the possibility of hereditary factors being involved in s~entalillness, the less often he assoicibted sin with insanity :.D? the less he cited poor living conditions as a ci.~uceof mentel illness. They also found out that people in the older hge groups associated poor living conditions with mentcl illness more often than did tho younger groups. Iiepert also reported another more recent ;jtudy done by Lemkau and Cracetti in 1962 in BclLtimore. This was to investigate popular opinions and the general publics knowlodge about mental illness. lhcy used the interview and u stcgndnrd questionnaire meh-hod to secure data on opinions and beliefs of a slrilplt: population of the public about mental illncss. Tho papuLc,tiOn sampled w-r from a relatively low socio- ..* . iaonoillic group involving 231 subjects whose medien ages were in the low 30's. Forty percent of tho respondents wvse Nugroe:. From the ztudy, the inve!:tigators found no evidence L of rejection of the mentally ill. A majority of them had the belief that mental illness oan be cured. Half of the respondents showed willingness to fall in love with a former mental patient and the next half were also willing to livs in the same room ,with him. On the question of working together, 81% showed uillingness to work with a former mental patient, 62% disagreed that almost all mentally ill persons are dangerous, 85% agreed that certain kinds of mental illness can be cured at home, &nd 60% agread that former mental patients do not coamit more crime:: tha* Inoral people!. Only about 15s o@uld be clnssified as rojoctiny or wanting to isola&e the mental patient. The result o.f their findings butMessed the hope of the researchers concerning the changing attitudes towards mentel illness. Optimistically, they therefore consluded that: If people are viewing the mcntally ill cs sick rather tha)ltrangressors, if they are beginning to distinguish bctWcen soci~ldeviation and mental illness, then perhaps, they will . look increasingly to the physioion for cuoa on how to react to the mentdly ill. , / 20. To confirm that cttitude and beliefs cro not restricted to one aountry alone., Townsend (1975) carried out ti compitri;tiv;: sbudl in which he tompared the views of Amaricai~scnd Garmans on the aonception of mental illness. His investigc;'tion '.'.I. . ,~ . was mainly to test the fbllowing hypothosesr That intorcultural differences in popular and pr~fessionnl conceptions of mental illness cxceod intracultural differences, that is to say that professionals and laymen in e~chcduntry should. r.e+mblc each other morein th~ir aonceptions of mental disorders tban-they resemble their -- . .. .- . . ~. s.t;tus equivalents in the other country. ". . That regarding intrgcultural differences. the GeCncn and ihoric~nprofession groups should, us a result of professior::..l_ socihlizntion, rosetable each other more than the Gorunn and American laymen re&mbls each other. that the conceptions of aontal disorder held by Germail arid Puericin mental patients resemble thc conceptions of their -. * io naf- nKlzsrOf% s i".fi-ir-+~.ymen_npyethkn they resemble ~cch -. . -- ? -._...... ,. -...... -..- othor. - .- ._ ._ . Townsend matched samples of German hnd Ancricnn high schoal students and mental h~spitalstcff Bho complc.Led L 6.0 - item questionnaire on conceptions of mental illness. .-.- The coaccptio;?;; of these groups *,wed gfeatir differences botween countries thcn batwen popular and professionel view within aach country. 22. TO them, ouch a distrubunce is reactive in nature snd can be merely transitory and is subject to .therapeutic influcncc. The next is the onu they ctll 'Quistcskrankheitf (mental illnuss: insanity) which they boliovo is inhiritcd and is therefore a result of a fphysicul' dis,~c~soprocess'. This i- they believe, runs a fixed course, und is not. subject to therapeutic influoncc. Jackcl and Wicsor, tho roport continued, pointed out that this popular dichotoinous taxonomy of tho Germans directly parallo Ls the dichotomous taxonomy of the German psychiatry. This showa that cvon the German psychiatric astablishmonts tend to propound this t~xonomy. Tho Bnorican prof c: sionals, according to Town. end, olio i show cinilur uncorthinty and lack of concensus, but despite thi:., both the Amuricun lcymcn anJ prsfessionals tend to emphasize or~vironmentalfactors and will power compared to thuir Gcruan I counterparts. I ! On the conceptions of tho Germunc, and American patients about mental illness, Townsend intcrvipwsd them on the cnrv.bili';;, ho asked them questions like "Is mental illness ourable or not? ' On both question:j, the Gurrnun patients considcrcd montal illness less curable than did their American c3unterpr:r ts. On stereotypes of insanity, the Americans differed significantly from the Germans in response to quz::tions like "how can y3u recognize a mentally ill persons*? Americans tended to cite stereotyped bizzare beimviours and apperance as diagnostic criteria, that is, they tended to cite disturbances of montal functions, cognitions, and judgement as characterising mental illness. It can be seem from the above' patient study, that the German and Bmcrican patient. tond to have tha same views with their raspuctive professionals in their respective countries. For instance, tho Gernisn patient' g~nerallyagrt;e that mental illness is a virtually incurable and public gcnerclly agree that mental illness residos in anvironmcntally induced b~haviourdeviations. In the ~mericansvicw also, such a deviation can be eliminated with the right combination of motivation, skill and will power on tho part of thz patiant and physician. Another study of tho public's beliefs an3 attitudes tow,.rC- mental illness was done by Rabkin (1972). He used Nunnalylo questionnaire system to learn whet people think and what they know about mental illness. Over 3,000 opinion statements relati:); to bauaes,'.sy.mptoms, prognosis, inaid.ence nod so0ialsignificancci .T..mental h~althproblems were collected from diverse public and professional sources. By removing apparent duplicatds cn3 redundancies, Habkin reduced the numbar of itrnes in the ,> yuastionnaire to 240 with a 7 - point likert f.,rmut. He g&ve these forms to 350 subjects and factor-cnalysod their rcsponsas to identify underlying dimensions d~scribingtho content of public information cnd thinking about mental illness. 24 From this study, he found out that beliefs held by thc public concern the poculiur physical apperance of thc mentally ill, thiir lack of will power, tho grouter susceptibility of women and the aged, and the role of msrbid thoughts in precipitating mental illness. Such beliefs hnvo lcd to tho gcnercl acceptance of the storuotyped stigma attached to mental illness which exists even among professionals working in :. psychiatric hospitals. On tha effect of such stigma, Rabkin observed that within a psy,o.hiatric,~. hospital, where many patients are sent against ' < their,will, inmates soldom share the rights, liberties and ,&isfactions that civilians enjoy. On their return home, according to Rabkin, they often 'find that being an ex-mentcl patient is more of a liability than being an excriminal in the yursaence of housing, jobs and friends. BG'LIEFS IN AFRICA -i3 -i3 -.--, -- Positive or negative attitudes towards mental illness ad mental patients are ndt: restricted to the Western countries alona- Africa and her neighbours also have their own views. For inc-tence, Dragus (1973) rep~rtedthat in 1966, he found that in Isreal, ilnmigrents from the archaic end traditional countries of the Middle East did not differ from settlers who hed come from the more economically advanced regions of Europe in their 25, acceptance of mental health fncilitiss r-nd personnel, This report Wils the sequel of the studies by Adis C2:;tro and Waisanz:. "9 cs reported by Drhgus (1973) in which people be1.ievt.d that montal disorders tended to bc associated more with economic i' development and modernization. . Such c h)rOne notion made many , , people to restrict the aa6p.e of psychopathology more narrowly outside the technologicelly advanced countries of the West only to believe in the prevalence of authori%rian nttitudcs toward:; . . the mentally ill incountries rulsd in a dictatorinl end ;' '. A,..,.. totaliterinn manner. In tho recent pest, however, researchers have extended their studies on beliefs and attitudes towards mental illness to different part, of Africa. Such studies indicate thet traditional beliefs and attitudes towards montal illne$g throughout African heve strikink similarities. In his paper titled "Mental Halth*, Professor George CarstgErs (1974) observed that in traditional societies, mental illness and epilepsy, with its sudden interruption of the subject's n~rmal consciousness, have been regarded as being caused by t spiritual agencies, either'dcmonic or divine. Treatment in such areas was left to the priests, exhorcists and spiritutl hsalers. i'If the patient failed to recov!:rti, he continucj, ;! the angry. spirit was believed to br; too strong t~ resist". 26. Such societies too often blame the.victim.of mdntal illness for having transgressed in some way, so that he or she wzs thoukht to deserve his/hcr affliction. Carstairs ob~ervod that in many doveloping countries, families will travel lone disthnces in search of help for a mentally ill relative, but if the illness persists, a time comes when they will stop tryin: any further to cure him tnd either keep him at home confine3 and bound if his behaviour is very disturbed, or lot him wander about the village. H6 reported thst an Indian psychiatrist oncW-told him that in cvery Indian town, one can find homeless chronic schizophrenics wandering through the streets like stra; cattle relying on charity or on stealing food ta keep alive. Dr. Giel (2978) reported his obs-rvation on beliefs and attitudes towards mental illness amone the people of New Guinec -nd Ethiopia. His article was based on his experience as a practising psychiatrist in those two countries. Because of the africanfs traditional beliefs about mental illness, Giel re!n-rcd I'i.ven a native African who took his psychiatric training abros,! find8 it necessary to make some adjustments when he tries to practice in kfricau. ii leech in the throat, as found out by ~i~l,wo., the Ethiopianfs way of describing the mezital illnri!.:~ called 'hysteria aphoniu'. Dr. Giel states thct the chango in life style frequently has a profaund effect on they way people with mental problems are treated. In describing how rural areas deal with mental illness, he observed that mentally ill people with serious or mild psychoses are usually kept around the family circle where they often get treatment from Lfrican healers. The more violent ones become dhtdasts, also may end up in prisons or I vmder about aimlessly. An extremely violent patient may be killed by the community, According to him, people in rural areas who have neurobes or person~litydisorders are usu~llynot regarded as sick. ~uchpeople often go to native heelers fan treatment, On thu part spirits play in cases of mental illness, Giel pointed nut that in rum1 areas, as soon as a troublesome situation is expluincd in terms of the porson's being possessed by n ;pir.it of some kind, it become? more tolerable. These patients often remain outside the realm of psychiatry. Dabrunner (1961) observed that in Ghana, generally, witchcraft is often at the bottom of mental illness. By this is meant that Ghanaians generally bldieve that mental illness can be caused by witchcraft. Ln his study on the belief in de$tructive witches snd their cffects on Bkran tribe, Debrunner observed that in the forcit zone, especially in Ashanti, the lunctic is more feared ib then respected because of his potentiality for evil. 28. Mental illness is regarded by the people as a disaster which is lmpelite tn mention except In vague and circunlocutory tens. An afflicted person is lded uprn either as a victim of juju .s 8 witoh, Because bf this, it is custanary to subject hh to fetish tests to determine whether he is the victim@ the aggressor, He found out that suspected witches are ostracised and isolated by .h cmrmunity, and such witches are usually mad. He reparted that Dr. Tooth met a wanen of about fifty fran the Akin district whose sister explained that the wanan was a witch and consequently became mad. Debrunner therefore, concluded that the social ostracim and suspiciana nf people arcund the nanan seem to have driven her mad, He also found eut that in Afrioan traditional courts, judges always tried- to exchde the mggestien that witches might be menMUy defective pqrsonj: rind mt c.nscious agents of evil spirLts. This means that judges differ sane what in their views that witchcraft can cause mental illness sin08 a witch aan feign mental disorder in order to avert the crude treatment meted .a witches. In anmtber study also in Ghana, Jahoda (197k) attempted to under stand mperically how supernatural or superst;itious beliefs affect the attitudes of people towards certain objects, Fmn the study, he fomd out that there is ample evidence, including psychiatric observations and other relevant studfhs, that variations in one's fortunes in general, and misfortunes in particular, are apt to be attributed to outside agencies. Ons would therefore expect people in such societies to feel 29 * themselves less masters of their own fate than thoir counter- parts in Western industrialized countries and the extent to which this iv the case should be related to tho prevalencs of supornaturel beliefs . I Such supernatural beliefs can lead to thu ettribution of certain maladies to evil spirits, witchcrsft or ancestrnl punishment as can be observed in most rural areas. BELIEF hBOUT MENTAL ILLNUS IN IGBOLAND The Igbo's seem to have .traditional beliefs which creetc ur~favourableattitude toward mental illness for instance, the abandonement of mad people to roam the streets. This attituJ~ is e repult of their anirniitic beliefs about the csuses of mt-iitd illness or madness which is the English interpretstion of "lrc.', tha generic Igbo name for all forms of mental illne-s or cbnormal behaviour . This view is supported by Ogbonna (1976) in his study on the ettitude to mental illness of Igbo undergraduate student: The respondent: in his study were flaked to ~irittup what their people believe about mental illness covering its cl&ssific~tiz~, causes and treatment. lie concluded that (a) Moatal illness is first of all believed to be inheritec or ccused by demoniacd possession. It could also be induced by charms. 30- I (b) Mental illness is benerally believed to be incurublc. (c) No one wbnts to contract murriage rd~tionshipwith 1 any fcmily with tho stigma of cases of mental illnes;. I Hence, people do not admit thc,t their rclntion is mdnttrlly I I ill. I Usurilly, treatment is qdmini;;lsred secretly by the aid I (d) 1 of the relr;tions of the pr~tientund most times, it i:j iI done somewhere far from home. Failure to respond to treatment, which would jeopardize I the name of the family, leads to total abandonment of the yz.tiint. In a similar study on the attitude and belief of Nkpa people, especially those within the age range of 50 - 70, believe that mental illness is caused solely by external factors such as witchcraft. Actually, the belief in demoniacal cau::ation of human illnzss among the Igbos applied to other forms of diseases other than roanti1 illness. However, the problem today is., that most of other diseases like leprosy, have been liberated from these beliefs and subsequently, attitude towards them ! have changed. Today, for instance, people openly scrid their ! . relations to leper colonies and receive them back whan thcy have been declared cured. Such attitude would have bcun I impossible forty years ago. But beliefs and attitudas tow~rd 1 -mental illness seem to have remained the same all the time. ------EFFBCT OF GD,CI~TIOI\~0i1 ~.RILUI'I'IO,~,~LC O~UCEPTION~ 2 ------..BOUT MhiqT'i& iLLi%s Euucation zccordin~to Websti.r 1 :: .. 0th Ccntury ,:iction:.r.;y, is El process of training and developing the knowledyo, ,;kill: mind and chiractur e.speci&lly by f orma1 :;chooling, tet~chilnt :*nd training. Okafor (1984) dcCinad education us a process of acculturatiori throu[$ which the individual i:; holpod to ~ttnintho devclopment of his potuntialitics (uhich ore both physicd end nientd us well as spiritu~l):nd their max.imum activation when nece: :s.ry, accor.lini. to ri;;ht rces:)il and to schiuve thereby, :his parf,ct solf fulfilment. . . Co:~s&,,uently, c:uc::tion should be concerned with the :~evelopentof the whole pzr.:on in terris of nffectivo behcviourul and psychomotor aspacts of the individual. PracticalLy in all countries of the world, there arc basicnlly two socizl ngencies of ducat ion nmcly; the family which is bcsically sn impurfict society since its educ~tioni:i based prinurily on the b:;sics of livint: in the family cad to some extent, thu soci~t:~. ~t has lirnitiid fncilitits and its educc.tion is unerganiz~d and inf ormcl . (b) The ;t te which is a civil and perfect society wi.th ell tho futilities for a formal and orpFnized uducntiol: of its citizens for effective end useful living in the society. 32. From these uefinitions, one ccn infur that a forrnelly I educated person should be e.ble to reason and act f~rbeyon' i the level of one with only informal education or an illitcr,.;. I Thi, is bdcausc both his affective and intelluctual facultis; uhich shape et-titude and belief ha:: been developed. ituferink: to Adam's (1964) position that mentd illnes, results from (a) 1nadt;qu;te opportunity for lec,rning necessary social ~lrillsand (b) The appearance of difficult or problematic social situctions for which the individual lack:; ei'foctive solutions, skills or previously lonrned techniques,,' It mcans thct learning which is basically cducstiori, ~houldequi,; one to prevsnt mental illnes since he .auld hnvi. lcxrnt the neccssery social skill? for interpersonal relctionships both tn tho family and th~ wider scope of the :,chool. It a1:ro influencd one's attitude and beliefs about mental illnws duo to intertiction with othsrs. L study in Benin City i.n D!ic..ric negotx; this view. The study revualed that o madman is consid?r'ed by tlic 91 froch University ~raducte:,from vcrious 9niver;ities and ,',tatus in Nigorir, to be very dengorous, unpredictable, dirty, bad and worthless. (dwaritefe and hbir;, 1975). In thk same vein, Freeman and irii:;sob~um (1960) did not discover any evidonce to !;hob' L that attitudas about ment:tl illness are rel;.ted to educatio!~:~' level. This study wn- done in the state of Washington with a samplc of over /,00 adult:;. Thcry concluded that thos;e chcr[:ed with health ducation pro1,ranmua must ba cnutisu:: in thinking that more fact:; would necessarily altcr people's opinion. Down here at Msulck~, Ogbonna (1976) ,5tuciyinp7 the attitude of I{;,bo undcr gradu~testowsrJs mental illndss reported that hizher u 2ucntional attainment is no cnarant;L, to chcnge of a-tti-tude towards rniln-La1 illnezs. There are many ather studiur: that have facts that contradict those stubed cbovu. ;iollin&shertd and dudlich (1958) four~ildistinct differeilcc?~in nttituds.; and knowltdga about mental illni..:,. c.nd the mcntclly ill as a function of social cl~;:,:, (which i.; ino.,tly attained i:lrough educatior.) arid education. The authors infered from their results thtt the upper class nlembers h;ve more favourr;ble a-ttituJe:: towards ;~:.ychia.tri:;i;:. and more accepting of mentnl patients then rr.erl,bers of the !, lower cli;r;.:es. idthoueh report:; on the influonci of education on conceptions of mental illness has not been completely cl~~rI I cut, it is hoped that this research will yield results -th.?-i 1 will be fsvourable to e;ucatioc. For, it is expected : .: normally that those whose affect criZ intellect hua bacn a=veloped throut:h education c.nd who, in one way or the other know the causi's of mental illncz:: would hove more modern concept of mental illness. ~,~FL3siuChOF ,,~&-~IQ dTTITUD2h ~hilCUgXZ''.IOG ------d3UT PIEL L3 Torrl: (1975) in his study with 36 male and 76 female unJergrsduates of r Canadinn Uilivsriti ty found that women were more unf~ivouri:blethan men in their attitude. Be made u:;e of case histories of ols:;ei-;:;ivu ani; compulsi~o patients. Thc result of this ;tudy revrdecl 1hu.t males ratu :;uch patients s:, less ill perceive less difficulty in ;:ett:iiii, dont; with them than the females. 35. Farina et a1 (1974) have done more exten:;ive work in the area of mental illness and sex differences. In nn earlier study, they found that people in interaction with an ex-mentul patient me in conflict. ' They find the ex- patients objecthable and disturbin& but yet feel the need to support and help them. 3ut in a later study, they discovered thct in contrast to their previous studies which found no sex differences, women were more acceptin, and tenerous than Inen toward the mentally ill (Farina, 1975). Results of studies in this area, h&ve not actually been convincing. It could be argued either way in thilt nien may be rnorc ;,ccayting just for the more fact thaL a man would not feiir being atlucked by r, mcd man; he will be i!qud to 21 fibht. Women on the other hand, may not 55 able to fzce such a .situation. Wonierl are naturally more :;yrnp~.thetic and woulu pity the mentally ill arid so be more accepting and generous to them then men. 36. EYFECT: OF BELIEF Oh HELATION attitudes towards the object &bout which we hold the belief. Morgan cnd King (1971) in their study on the interwoven nature of beliefs and attitudes remark that attitude:j and beliefs though distinguishable, go hand in hand. Beliefs shapt attitudes which determine what we will and will not believe. For instance, a per:ron who believes th::t lightening can kill, msy develop a ne~etiveattitude towards thunder 2nd. may a1w::ys: tremble whenever he hears thunder claps, In like manner, people's stereotyped beliefs about mental illnes, may albo affect their ral:.tionship with exmental yetied ;n a utudy to determine the influence of perceived mental illn~;. on inter2ersonal rslationi-,hips amon:: pcoplc, Farinn and Hing (1965) quoted Nunnaly as reportine; th.i.t in dmericu, tit least, there is a keneralized hichly unf aviourable attitude can undoubtedly colour the perception of a iJersol1 believed to be mentally ill ev.;n when his behnviour is, by all staudcrds, norol!. It may also resist change bceuse a person holding the ne&ative attitude may Cefuse to communicate with the class of peoplo unf avow ably evaluated. Wunnaly s study which involved 60 male undergraduate psycholo~yshudents zt the University of ~onnect;cut yielded valuable information in the way people perceive 2. former mental patient. 37. It was found th~tthe i.dea of belie~in~,an individual to be mentally ill redres:, the perceiver's willingness to work with him. For instance, when a co-worker is viewed as mentally ill, .;ubjr:cts prefer to work alone rather than work w:ith him on a tzsk, end they also blame him for inadequacies in performance. These findinhs point to the fsct that believinl another to ijt mentally ill, i:; a casual fcctor of the ,,enera1 negative interpersonal relationship :: which exist between people 2nd ex- niantd patients. Atigmatization also ha:; b;:en found to be a major . .!>-.il,. contribution factor in thz stainod relationship between the public and the mentally ill. Nunnaly (1970) reports thht the sti~maattached to mental illness in U.;.-. is very general both across social groups and across attitude indicators. He asserted that there is a ;tronfj "ne&,at-ivehole" associated with the mentally ill. i.ccorilin~ to him, the mentally ill are cor~jideredunselectively as being all things bad, his research also suc,gests that one of the cornerstarie of public attitudes towards mental illnessis the feelinL that the mentally ill are hi,hly un;,redictable. They are thoug.ht to be people who do not go by the rule:; and who, because of -thsir uehaviours, may suddenly ernbarass or endan~erothers. He concluded that the ymblic feel:, that close con-tcct with 'the mentally ill is like sitting next to a ternperrrmental explosiv* which may detonate without warning. 38. Because of this f eelink, many people become very uncomf ortnble in the prezence ,f some one who is, or is purpol-ted to be mentally ill; In a study on traditional beliefs of Mkpa people about mental illness, Oluhuezi (1979) found out that the people see asshcfiation with the mentally ill es more or less, detrimental to the life of the "normal people". The2equally dread mental illness. -B&LIEVE& IN THE iV3iY-EXLCLxE2JCE OF MJGdTLL ILLNE;.:; While several studies hcva shown that mental illnes;; exist; ih all. parts of the world, ;$oine people still do not bi,lieve that t,here is anything like mental illness. In his article !I the myth oE mental illnesstt :Iza:,z (1970) ar,ued .that there is no such think like "mental illness" in any si,iiificantly meanir., ful sense. In medioine, the term illnes:; i;;used in literal, nor figurative way to denote an undesireble nltera-Lion or chang.e L'.!,,-* from optimal levels of organic bodily functioning. But the term "mental illness, is applied to various patterns of hehavioua considered ~nalad~ptiveor inappropriate by implicit psycholog'.lCS. .. and social standard:;. He maii,t;in:: that :,ince mental illness is not a literal tnirig or physical object which can exist, it ther~~ fore "exi:jts" in the same sort of way in which other theroritic~'. concepts exist. ..A 39. !la observed that throuyhout history, certain conceptions ;uch as deities, witches, and micro-ortanisms h.ve been seen L; rieople as cuusing a ~i:stnumber of thints, end that mental illness his been regsrded in a similar way 2s cau;intL manJ7 diffcront happenings. He referred to the proponents of the vi,.. of mental illness as people whoce main aim i:: to createthe i3d in the popular minds tha-t mental illnest: is some :;art of d;:;a.r ,, . . ,:+., or entity like an infection or malignancy. ile rejected t;ucli vie..'. on the $,roundu that if it vere -true then, people could catch or get a "mental illness", one might have or harbor it, one might transmit it to others and finally, one could get rid of i., !Ie ma:intains that there iono evidence to support the idea rat". all evidence suilpor t;; Lhe view that what lpeoplo now call merit-:' illTle:j.ses are for the most p;:r-t, communtcation~ expres ing un- acc$tible ideas, oftcn frnmcu, moreover in an unu:;ual idioms. Futnerroore, he asserted that belief in mental illncs:;, ju,. like withcraft, i:j widely used to act as ;-,>cia1tranquiliser. Thus enciruraiint tht hope that ma:;tt;ry of certain specific pro- blems may be achieved by mean:, of substitutive (symbolic - muii cal) operations. It serves to discure the fact that life far most people is a continuouj stru(;gle not ft~rbiological sur- vival but for "a place in the sun", peace of mind and or some other human value. 40 Szasz maintains that the phenomenon now called mental illness should be looked at :qfrc.sh and more simply, that it be removed from the categor%$ of illness and be regarded as the expression of man's stru[:,glc with the problem of how ho \ should live. I* similar view to thct of Szgsz wa: expres.;ed by Ldams (1964) in his article "mental illness or in-ttjrpersonal .. behaviourM? In his opinion also, there is nothing like mental illness in any metningful sense. He believes that th- concept of functional mental illness is a vc&al analagy and wonders why the term "illness" should be arbitrarily applicd. to defineu patterms of behaviour particularly when there is no evidence of any physiological disorder or mal-functionin?:. To him, mental illnes3 is a phenomenon involving inter- personal behaviour and not a hcalth or medical problurn. Fai:Lure to clarify these distinctions, he asserted, has had unfortuncte consaquences. Efforts toward understanding and effactive alleviation has been hampered by the Semantic Confusion which results when the word "illness", is used denote both physical disease e:~titiesand maldaptive pat of interpersonal behaviour . ..dams maintains that "men-tal illnesst1 results from two types of conditions namely: (a) Inadequate op20rt~unitii.sfor the leernini: of necessary social ski1:Ls. 41 - (b) The appearance of difficult or problematic social situations for which the individual lacks effective solutions, skil1.s or previously learned techniques. His suggestions -therefore are that to alleviate or prevent mental illness, a syst~;rnnticunderstanding of interpersonal conduct must be maintained amonc yooyle. ------CHILPTXI( TKBEE ---jlz:; EdC------H y7"'tLlrlJbClT,3 ?I Lsign: This is a survey into the conceptions about mental illness by both the educated and illitcrate citizcnn of Emekuku. Y?YU,Li.TIUIU -F'Oit TIIZ I\T,UDY- The populetion for the study are 1. The educated citizens of 3mekulcu:- Tneso are people who had ilttained t;t lea5:t the West African Lchool Certificate and pos:;ibly, other hi;her 2. The illiterete citizens. These are people with no forms1 elucation up tc those with First !,chool Lecvini, Certificate. 5ample: This is made up of 400 people randomly selectcd from 5 of the ten villcgcr in Emoku.?ci:. Each village had 80 people. This number is subdivided into (a) 10 litcreta adult males ;nd 10 il1.itorate adult male:; (Ldult - agc range - 40 yeers and cbove). (b) 10 literate youn; mates and 10 illiterate young malos (Youth - cee rage - 18 - 39 ye:-rs). (c) 10 literate adult females and 10 illiterate adult fcmcl,i. (d) 10 literate young fcmal~sad 10 illiterate younk females. 43. -AINC'THU?4i'ldT------FOK DiiTa COLLECTION The likert type of questionnaire with a three point scale containing 24 -i.tems will be used in conjunction \ with oral interview of the aged and some illiterate respondents. bince the study is on both the educated and illiterate citLzens, the English and 1;bo versions of the questionnaire wi3.1 be used. The questionnaire is divided into two sections. 5 ~ctio~: ,. i,s designed to elicit information on (a) Causes of Mental illness (b) Best Nethod of Treatrlient (c) Permanency of Cure (d) Kelctionship with or attitude towards ex-mental pctimt.. Zection B elicits informstion on traditional diagnosis, bchavioural characteristic:: and cla~sificationof mental illness. There will be a pilot study to generate questions for the questionnaire on tho various aspects of mental illness mong the citizens of Emekuku. ------DATA C OLL LC TIOM : The questionnaire will be distributed personally is all. the villages chosen. 44. Assistants however, will help in the collection of' the questionnaire from those who may not complete immediately. Besponse on the oral interview will be directly obtained from the interviewaes. narc$\ ILNALY,1j : The data collected will be arran,ed in Thbles in the followin& nreus: (a) C~uses (b) Be.t metnod of 1lror;tment (c) Fermanency of Cure (d) fielationship with ex-rnentd patients bc.sed on age, sax and education. The purc~.nta[,eof re:;pondents in each of the itens is used in annlysing the data. To Test further the statist-icd significance of the 2 responclents, the Chi square (X ) :;tatistics is applied. Its usage is !>wed on the fact that the data collected is at the nor.~ind scale. --C i2liPT8;i FOVB naa PiiE; ENT2T IOtJ I& D ALLYqIs The main jbjective of this study was to ascertain the traditional conceptions of the educated end illiterate citizens of Emekuku iibotc mental illne:;~. in conceptualizing mental illness, v:irjous aspects e.~;. . , causes, best method of treatment, permanency of ours and relationship with ox-mentally ill were all considered. There were the* hypotheses tested for and the dato col.lccted were prosanted in tcbular form. Percentcccs and chi. square - observed and expected frequency tt,bles are used to test tha hypotheses. ,' three point ccnle quosti&ire W,u: ~bd't).agree, .tiisagree .,ma neutral. , ...... --.--1iY P OT HE;&:T&I There is no si~nificantdifference in the conception of mental illness by the educated and illiterate citizens of 2mekuku. Causes: Traditionally, witchcraft, punishment from the gods end ance..tor:;, drug abuse, Ogba.nje, inheritcrnc- end poverty are all iden.Lifiocl a:; causative fc-ctor:; of rnent::.l ill.nes:j. (These ware identified through the pretest conducted on mental illness). In ordsr to ascertain the conceptions based on Cr,uses, the respondent:: were asked to agree, disagrca or exprer;a neutrality on any of' the i-dentified causes. P. from Gods 33.(10.5) P from irncestors 21 .(10.5) ~. poverty 93(46r%) AS can be ~wenfrom TnLle I;. above, from the illiterate citizens, witchcraft cau:;c:, inantal illness according to 31.57; of the re ,pondent~., 417; :.i:,- md 27.5$ ware neutral. On punishment from the ;;odt;, 21% of the re. jrondents agrcad to it:; wcro neutral. Punishmt.;nt from tha tncestorc cen c;Lse mental illness cs expres>ed by 7 .yp re-pondents. Zi2hty one gcrcent disagreed ur~d 12.5% were neutrc~l. I Hard dru,. is a major cause a6 ider: respondents. Twenty two percent disagreed whila 2.5% had no opinion. Ogbanje was agreed to by 21.5% of the respondents os a contributin~factor in mental illness, 43.5% disu~reed and 32% were neutral. On inheritance, 45% airead, 34.5% disagreed and 17.5% were neutral. Poverty attracted 34.5% agreements, 49% di:;a,reed arid 16.5% were neutral. From the abovc result, Hard drug, usaje is the major causc of menthl illness ciclcd directly by inheritance. On hard druk, 61.5% of educated citizens reed, 32.5% disagreed and 9% were neutral. Ogbanje had 19.5$ a&reem,nt:, 45% dlsa~reementsand 38.5% neutral respondents. Inheritance was itreedto by 55%, 371% disa~reedwhile 10.5% were neutrel. Poverty had 46.5% ~greements, 42.Th dis~~grementsand 11% neutral respondents. The educztcd citizens equally had hard drug usage as a major cause of mental illness aided by inheritance. There is however, a difference in the number responding to thwxe two among thc educatad and illiterate citizens. To test for a statistical significance of the difference in 2 the respondents' conceptions, the Chi :.quare (X ) statistic was applied. . x2 calculated = 16.78 2 X critical value at 0.05 level of significance df I = j.84 2 The X calculated is more than the X' critique and it shows -- that difference between the two groups of respondents, is . .. - ., . ~i~nificant...... I, .. . . . The treatment of men-tul illness by Native doctors, orthoL~;. ~ i doctors, Torture, Prayer houso, dru~rei:triction and no treatment at all w,-re rks,londec! to by both the cducatod and illi-berate citizens. To ascertain wnicn is the best me-tbod 01' trcatment, ~qutivedoctors had 37.5; of the cducated citizcn:: atreeing us can bc seen from Table 1<, 42% dizagreed and 20.5,: were neutral. Orthodox :lectors : The prayer hou-es commended 31 .5$ agreement:;, 54.5% I disagreement l4$ were neutral. 50. Forty five percent of the respondents felt that drug restriction is the be:;t method of treatment, 42% di:;cLrccd and l3$ were neutral. In effect, drut; re:.triction is accleimed the best method of treatment by %he educated citizen:.;. Netive doctor;.; also can offi:r an ec;ually gooci trc~tmnt. Six psrccnt of the ,. respondents will prefer no treatment at all while 578, dissgrcud ~1.13. 37% were neutral. Amon$ tne illiterute :,i.ow~r, ;d&tivi, doctors had 4% :,~reem~nts,365 disatrc.;e~,;entsand 228 neutral positions. bee Tau18 IC. Orthodox olbthoci had 27F z;reamet!tu, 59.5% dis~greements and 13.5% wsre neutral. ?our ;-loin% five percant of the re::pondent:; felt .that f'ortu.- i:, the be:,-t ~11~thodof trwatmcat,, 70% di:,atreed ~nd20.5; Were neu tr a1. Dru& re,triction at.t,ractcu ,;b$. u,:r~:.eihe:lt::,u I 5 i::5. t;ild 20.5% neutrzl po::iiion:;. Y~Lprayer houses were prei'srrcd ?. 61.5% of the ~.e~ljonde~~t:,30;! Jioti~recd while 8.5); were neutral :ix perc,.rit will not tre~tthe mcntoliy ill, 70,.: di:~&~,r::edto this while 24% wcre nwtr6.l. ]In effect, tho illiter te citizens conceive t'ke 2rn;cr houses a:, ofisrin:, the bd:.,t inethod of -trent~nent. Dru~r.e:tric..i, according to them c;n b2 Bii equally good treatment. I For statistical ,:,ii;iiificznce, ;ti: Tsble 10, . -- x2 calculated 7.56 2 The x2 ctlculatcil is more thun the X critical Wluc. There it; tnarefors si,nificant dif f erencc between the responses of the two .roup:: on the berjt method of treatmcn~t ,---. In addition to the already identified methods, the following were added in this section. Cutting pact with the spirits traditionally, looking nemtal patients up and the view that any modman that visits or strays into the market square has no cure. In respondink, 275 of the educated citizens agreed that native uoctors cure mental illness permanently as can be seen in Table IE, 555 disagreed arid 18% were neutral. * 53. Thirty threi. percent of the respondents agreed to the role of orthodox doctors in achievink a permanent cure for mental illness, 50% disagreed while 17; were neutral. Flop,~ingat..:actcd ntreements, 80x. disagrements and 173 neutral postions. The Prayer houses offer a permanent cure as express~d 25,5j~, 38b clisagreed and 36.5,d were neutral. For pact cuttint, 36; akread to its permanency of cure, 35.5i: disagreed while 28.5,: were netural. Lookin6 up mental paitintc has 18.52 agreement!:, 74$ disa,reements and 85 neutral positions. Hard drug restriction attracted 40.5; agrsements, 48.51: disagreements and 1 I$' neutral responses. Thirteen percvnt of the respondants felt that mental illness has no cure, 69.5% nisagreed while 16.59 wore neutral. A madman who has gono to thc msrkct square aun ncver bs cured was the opinion of 2477 of the educated citizens, 65% ilisagread and IT/ w~roneutral. Thc educatod group, from all indications feel that mental Illneab can be curcd permanently by hard drug restriction. P8ct cuttin, with the spirits can also cure mrntal illness psrrnandntl~. From the illitoratl: group, purmanency of cure by native doctors had 31.5/: agreements, 48.5:; ~isa~riementsand 20% qeutral responses. I ! I 54. I I I Orthodox method attracted 24% agreements, 50.5% disagreemcn+. and 25.5% neutral respondnets. Flogging was agreed to by 1% of the respondents, 56% disagr,ed while iYb were neubal. Prayer houses were preferred by 42% while 34.56s disaeretd and 23.5;b ware neutfal. Pact cutting enjoyed 22.5$ agreements, 60g disagreements and 171: neutral responaents. Locking up was favoured by 118, 64.5%. disagreed while 24cL were neutral. Hard drug restriction ~oitbrsa permanent curs as responded to by 46.5%. Forty percent disagreed while 13.5 were neutral. Eighteen percent of the respondents felt that mental illncss has no cure, 40.9$ disagreed and 42: wwo neutral. However, 26$ of tho resyondonts felt that madman who hiis gone to the maPket sequare cannot be cured. Fifty five percent disagreed and 1% wore neutral. For statisticul analysis, sea Table IF 2 x2 c lculatud is more than the X critical value, there is ti rcfore a significant difference is the responses of th two groups rukarding permanency of cure of mental I I illnur s . d. H8luti 3nshig with ex-muntal Patientso -----TliBE IG Conception based on Eelartionship With Ex-mcntal Pnticni: EDUC -&TED ZLLITGLTE --. ,- TOT& A& D' N A D r ------C-.-.------Relates 39(18.5) 3O(l5) 131 (65.5) 25(12,5) 125(62.5) 50(25) 400 wo Hdat- ionship 24(12) 5~(25) 126(63) 30(15) 30(15) SO(@) 400 Frol3 the educat~dres2oncionts, 18.5j aLreed that regctioilship exists between people znd ox-mantd pzticnts, 15: dissgrced and 65,5,., could not make ug th~irminds. Lee Table IGo 13n thz qubstion of no relationship, 12;: of th~Lducated citi~,~.~ exists, 62.5,L :.isa,redcl md 15,. set on the fence. Twenty five ;)erc,>nt of the illit~ratzrespanacnts agrec3 to no relationship, 456 di~3~rr;c.dwhile 4O$ could not m:zki; up their minds. ILL ITEE-ATE 1% D i\I T Oi -&I :io relat ionship .24(31.5) 50(40) 126(128.5) 30(27.8) 3O(l07.5) 80(65) 4c:j x2 critical value ct df 5 = 11 -07 57 .. The x2 calculated is lesn ..than the critiquo, there is I therefore, no significant difference bktween the two groups' ! conception of relationship between people and ex-mentsl patients. I I In all but ana aspect of mental illness, there exist I ! I I, ,ignificant dif furences in the conception of the educ~tedand I i illiterate citi~ens. I I The differcncc in their conception about relating with I I I exmental patients, though not significsnt, helps to refute tho I I 1 hypothesis that theru is no significant difference in the I I conception of mentrl illness by the educated and illiterate ! I I citizens of Hmukuku. HYPOTHESIU --- I I is There no significant difference in the conception of mental i 'I illness by thc vcrious age groups. 58. 31 th adult respondents, 21:; sgreed that witchcraft is a c.:a.;u sf men-tal ilinesq 70,' Jisatrced and 91; wor~neutral. phis i:, ::novr. .'-it ::ablz IIii, 59. agr~vrnknts, 487 disogrccmcnts and 5.8 neutral respondents. Fifteen percent blames tbe azcestors, 52% disagreed and 33p were neutral. Drug as a major cause was agreed to by 64.5$ 12.5; disagrei and 33%) neutral. Ogbanje plcys a part - 27% agreed, 47s ilicogroo3, 26,; were neutral. Mkntal illness runs in families - 67.5% of the youths agreed, 14s disagreed, 18.5$ werc undecided. Stitistical different --TdEJJia -.- IIB ------CONCEPT1 ----- W Craft Gods kctadstor Drugs Ogbanje Inheri- tanca ------Povbrty TOTd -we-- 6 0. 2 X calculated - 15.1 2 X critical value ct Sf I - 3.84 2 2 X calculated is m.jrc that tho critical value of X There is therelore a significant difference in tho conception of the adults and youths in the cases of mental ill -5s. I YOUTH:, TO'I2.L ------.----- +---- +---- 14. Doctors Orthodox Torture On b~stmethod of treating mentcl illnoss, 46% of thc cdult; felt thnt Nntivc Joctors offer the be:>t rnothod, 25.55 disagreed while 28.5;; were neutral as is shown in Table IIC. Orthodox 2octorn bnjoycd 47;, ;gr ccmonts, 24% gisagrebments and 29s neutral respondents. Mintnl il.ines,; is best troatsd thr:,ugh torturu was the vi~w of 6% of the ahl-t respondents, 76% diragrac9 while 182 were noukr.. 61. Poverty cen make one go mental, was the view of 58.5,; of the youths, 31.5% disugreed, 8.?,, neutral. For the youths, the major cause of mental il1nes:j is inheritance although drugs end poverty contributes to manta1 illness. While the prayer houses had 33t of the adults agreeing to their offering the best method of treatment, 24% disagreed, 43;i 1 I neutral, ;rug restriction attracted 50.52 ofirctments, 37.6; I I disiikri oinants and 13.53 neutral respondents. i ~ineperc~nt of the adult r~~l~oncicntsfelt tnct th~ri:is n.3 I trtatmwnt for mental illnosr;, 50% ::iscgriod and 41% wori: neutrcl. ! Far the wiult respon.lents, it ccn them be said that they tip Jru& restriction as the best mothod or troatntnt while not ! neglecting orthoGox mcthod and Nativc doctors. Thc responses of the youth:, inJicote thoL 33% agrocd thct native ductors offer thti best mothod of traatmant, 47; Jisagr~od, 1 while 20% sat on the fence. I Orthodox method is tho bsst in 37.53 asreed, 39.5s disatrcu:! and 27h were aeutral. I I On torturinl; the ~icntallyill 8s the best mcthod of traatc;:at, I 1 10.5% of the youths atroed, 54% 9isagrccJ 35.5% neutral. I The r2entally ill should be taken to the prayer housus for I best results - 51% agreed, 262 disagreci, 23% wi-re neutral. 1 I I 62. Drug restriction is the bast method. as axpressed by 58.5; of the youths, 16.5-ji howav~r, disagreed and 23.5$ were neutral. Forty two percent of the responAonts folt thet mental illness has no trectmint, 26.52 hisagreed nnd 52.5% sat on thc: fence. For tha youths thun, Drug r~~trictionis the best method o tr,:ntrnent without ncglezting the prayer houses and orthodox doctors, in that ordm. Statistical difference ------T13LE I1 D (BE,>T METHOD OF TKE,.TP~EPJT) W. Doctors 94(63.8 Orthodox 92(63 48 Tor tur 6 Drug i:ust. 140 Trcit. 2 X Calculated - 12.45 2 X Criticcl valu~at df I - 3.84 2 2 The X calculcted is nard than the X critique. I I I Thcre is therefore, a signific~ntcliffcrcnce in tha I concdption of mzntal illness by the ~dultsand I I youths bcsed on best method of trcatmen't. I I i I C. Permenbncy of Cure . 63. Tablo II E shown i?coplc's response to the permanency of cure. i Th6 native J3ctors offer a permanent cure was ogroccl to by 25.5% of tht adults, 471: di~a~r~c.1while 28.5% we.ca neutral. Twenty four !j purccnt of th~rcsponddnts favoured orthodox m~dicino,46% iisagr~~' 11 Flobiing had @? agrcenonts, 76i: Jisagruements while 18% wort r neutral. 64. Twenty four 2drcent of thc respondents preferred the prayer nousus, 32% discgrued and 42.5s were ncutral. While 216 of tho respon'cnts preferred cut tin^ pact with the zpirits, 45% disagreed, 345, ncutral. Lecking the mental patients ", ul; zttrtc-td 6% tigracments, 60s disngreernents an: 34% nwtral ruspondants. Drug, restriction nnd 37.5% of the ajults aprccing, 49% ::isqr~ed and 13.58 were neutral. Mine yorcent of tho resyondontl; felt thet nlental illness hzs Y,O cure, 50; iisayre-d, 41$, neutrcl. A m::dman thct wsnJcrs into thc msrket jquarc cannot be curui was thk conception 3f 2c. 5,2 resgon~ont~,40;:, discg,re*d while 37.5;: maintain~dneutrslit~. ,'I Pricycr houses offer n ,,errnant.nt cure as cxpresstxl by 51$ of thd youlid respontlcnts, 27.5;. visajraed whilc 2YJ: were ncutrel. Thirty three piroLnt profarrccl cutting pact with the spirits, 60h discf5rucJ with this cnJ 7.2 were neutral. The mantally ilL shoulj. be - that is the oxpre: sion of 1j.5J of the raspondents whilc 62.s Jisapoed with that and 24% neutral ruipondents. If herd 3ruG usage i,,restricted, mental illness will be cur~d t perrncnently ou adrced bgj tnJ 58.y$, 18% ~isagroe~~while 23.5% wero nuutral. Drug iLestriction ranked hi.&hsst far the ysuths. i Mental illno.,s has rio cure - as cxprcsced by 21% of the young , ,./_ ,* .. ? ~-~espondent~,26.5% disagreed end 52. y$ neutrel respon3onis. ! If a madmsii-strays into tho market :,quare, his madness cannot bu cared as bexpresaed by 22.5% of the respondents, 34x disazrced l and 27/, were neutral. 'Y 8 'L YOUTH -- - .-- I x2 calculated = 8.32 ' 2 X critical value ~t df 3 = 7.815 2 2 The X c;:lcul:tiJ is marc than the X crit~que. There is therefore a significant Jifference between I I the edult and young citizens conception ?.bout the ! pdrmanancy of cure of mental illness. ! ~ d Relationship with kx-me.,tal patients 66. --- ... . - ---. . . Five porccnt uf the i~dultsagreed to people(sre1etionship with . , ox-mental patients, 685 disu~rceciand 27% hid no views (sea Tablo IIG). Seventy percent agr wed thot no relationship exist between puo,.l . . . ,:nd ex-muntal prtients, 2% ilsagreed with this stanl while, lo/; .2 . .. .&;* were luutrd. -.I ( .-.I ;.evente~>nperccnt of tho youth however, cgread to relctionship, I i j .. , . 752 disrrgreoLl and 85 were neutral, I. . I .. ;?v~nty one pkrcent of the ysuth however agreo~lto nnc relation- . .-:$.* 1 . 16. j$ snip 12.5b disagread while wcre noutral. Frsm the responses, the youths are m.ore tolerating of LX-mental patients. ,...... 3:, The s-tid%stical i ignificincd i:; shown in Tabbe I1 H. I \ x2 criticd value at df 5 = 11 -07 I 2 , , The X calculattd is less then the X" critique, there is 1 4b therefore, no significhnt difi'erencc in thc conception of relationshiI1 - with ex-mental ydients by thc adult 2nd young citiz~n:;. The adults end Y:rui.?l iri<,nificantly in terms of cause be::t mothod of treatment end permanency i ours sf mental illness. To have an association with ex-mental g~tiants,they differ, thouth not significantly in their views. The hypothasis that stzitas thct age has no significance in thu conception f mental illnessby E~nckuku citizens, it; hereby, not accei~ted, ~~~QTHE;,I,, IiI There is no si~nificantdiffdrenco butween the concuption of ; the malea anJ. fmaleo on mental illness, Table I11 ir above shows the resyooses of males and females to tho identifiud cauaea of mental illness. 1 Of the mule resgondei-its, 34.5z. egreuj. that witchcraft can causu ! mental illncss, 23.5; Jis:;greeS while 425 were on the fence. I Tho gods can make one mcntnl cs n punishment was agreed to by 26.55 mzles, 38.8Z :?isalrced, 2nd 57.1% were meutral. The ance~tor:;should be hold responsible for making onc m:.d cs I i pun:ishment. 20% agreed, 38.82 ,iisagreed while 57.1% were neutral. 1 ~ Hard irug usa~ocsn make one mental. 44,s agried, 38.G Jisai;reed an3 2$, undecilcd . Oebanje is the major csu-e of muntal illness as expr~sscdby I I a,. Inheritance should be blamed for mental illness - 83; .greed, 51, di~a~reedcnd 120ere neutral. linety ono ;)ercant said poverty is the ceuse of mental illnes:,, '..y;i. iisa~rodwhile 6:; were neutral. ,o, for the males, ~overtyis the major cause of mcntal il1nus.i elthough Jruk usage an3 inhurit~.ncoalso plays ci part. From thi: female rtspond~nts,46% agr;.ed that witchcraft can Ca~~;c3rnentnl illness, 415 dis~t;rebdwhile 732 wert neutral. The gods can make ono mcd was the view or 3O.X of the resp3ndunts, 57.52 lisugroed, 32; neutral. Twenty eibht percent agree? that theanccstors can make one md, 56,",, disstrceil and 165 were neutral. Hard drug usaga is e c~usativeagent in mcntal illness. 872: ag~ec9,8i', Jisagrec.1 nand 5$, neutral. Fifty five percent of tho res;ioiidentr; blamed Ogbanje for casor: of mental illness, 34;: LisfigrecJ while 11% wero noutal. Mcntcl illnessis an inherited disease sags 86s of the resgondents, 8% Jiskgreed and 6% wore neutral. saventy percent conceivcs mental illnes:. ase result of poverty, 12 disakrced cnd 18; were neutral. Thc female respondents ranke3 drug first as thz major cause of ment,al illness. Inheritmcc and poverty also ploys a pt~rt. ! For the statistical significance, see Tahlc; III D I ! 2 X = ! criticc.1 velue df I 3.841 I 2 2 The X calcul~.todis more thcn the X critical value, thcrc is therefor* c &nific;n-t difference in the I I cancuption of tho melss cn3 famulo,? about causcs ~f mental I I Forty two percect of the male respondents agreed that the native doctors give the best treatmect as can be seen from Table I11 C, 45% disagreed while 13% were on the fence. The orthodox method is the best says 38% of the male respondents, 5V7 disagreed and 12% were neutral. If a mad person is tortured, he is cured. This was the view of It% of the respondents, 82.5% disagreed and 13.5% wcre neutral. Forty eight percent agreed that the prayer houses have the best method of - treatinent, 2G% disagreed while 32% wcre neutral.. Mental illness has no best method of treatment was the view of 89; of the male respondents, 62% disagreed and 15% neutral. Hard drug restriction is the best method according to 6@ of the males, 25% disagreed while 15% were neutral, For the male respondents therefore, drug restriction is the best methoil I while the prsyer homes and native doctors can equally do a good job on I i \. mental patients. I Sixty percent or the female respondents on the other had, agreed that I I the native doctors have the best method of treatment, I@disagreed and 24% sat on the fence. i I Whilo 46% of the respondents acreed to the orthodox method, j(% 1 disagreed and 211% were neutra. 1 I Torturing was favourcd by 6% of the females, 8@ disagreed and 14%, I neutral. The praycr houses offer thc best method as expressed by 8@, 14% disagreed and 6% were neutral, Eight percent of the fernales felt that there is no. best method of treating the mentally ill, 5% disagreed, 42% were neutral. Restricting hard drug usage is ti;e best method was the view of 7'1% of !i I the femalcs, 136 disagreed, 11% were neutral. For the female respondents, it can be deduced that they prefer the praycr house;; for the best method in treating mental illncss while drug restriction and native doctors also play a less major wle in the treatment. \ I L I For the statistical diffcrence, see Table I11 DC I I I 2 X Calculated = 11.96 2 x critical value df 1: = 3.8111 2 2 , The Y, calculated is more than X critique at 0.05 he1of significmcc, There is tht-rcfore, a significant difference between tho males and fenales QF conception of best method treating mental illness. f' 75. While 16% of the male respondents agreed that mentnl illness ha no permanent cure, 64% disagrecd, 2@ wcrc neutral. Forty two percent however fclt that if a madman strays into the market square, he cannot be cured again, 4C% disagreed and 18%, neutral. Locking thc mental pi-icnts up offsrs a permanent cure, - 1% agreed, 75:X disagreed, 15% were neutral. Drug restriction offers a pcrmanent cure, 58% agreed, 25% disagreed and 17% werc neutral. For the male respondents therefore drug restriction offers a permanent cure. Some of the female respondents - 42% mgreed that the native doctors offer a perm,anent curc, 45% disagreed, 17) neutrjl. Thirty six percent endorsed the orthodox method, 5C$L disagreed I+$ neutral.. Flogging thc mentally ill offers a pcrmanent cure - I@: agreed, 600j disagreed, and 3% were neutral. Forty two percent of the fcmalc respondents endorsed the prayer hourse as a source of permanent cure for mental illness, 55% disagreed while 3% were neutral. TABLE I11 E ..- * N. Doctor Orthodox Flogging 7. HOWC. ?act Cut. No Cure Karlwt No Cure Loc!dng -----Drug Rcst ---TOTAL Thirty eight percent of the male rcspondcnts con wive the native doctors as o:i'fcring a permanent curc nr; can be 6ocn fror? 'i'able IIl E, 35% disagreed while 27% were neutral, Orthodox method offers a permanent cure says 3@3, 4576 disagreed, 11%, neutral. Flogging was agreed to by 872 of thc respondents, disagreed, 41%. ncutral. Fifty pcrccnt endorsed the przyer llow~os36 offwing n pcrinancnt curc, 5% difiagrced and 2G76 were neutral. Cutting P::ct with the spirits of:fer a permanent cure - 3474 agrqd., 3% disagreed uld 3176, neutrcal., Wental illness has no permanent cure - that is the view of 24$ of the female respondents, 61% disapeod, 15%.were neutal. If n mad person wanders into tho markct square, his madness will no more be cured - 46% of the females agreed to this view, 5% disagreed and 4% were neutral. Locking up the mentally ill results to a permanent cure - 14% agreed, 63% disagreed whilc 24% sat on the fence. Drug restriction offers a permanent cure says 7C$ of the female respond 20h disnpreed, I@were neutral. The statistical difference in shown in Table I11 Y TABLE JII F MMCY OF' Em N Doctors Orthodox Flogging P, Howc Pact Cut No Cure Market N. , 1,oclcing Drug Rcst 2 X critical value of df 3 = 9.348 x2 calculated is more than x2 critique. Thcro i:, thero- fore a signifcmt difference in the csncc2ti~nof the males and femalcs on permanency of cure ~f mental illnes., --.--.----RELAATIOML HIP Twenty four pcrcunt sf the male respondents ckr~edto relationship butween people an2 ex-mental patients, 55.2, ;!isagreed, 211 were ncutral. Sixty percjnt agreed that there is no relati3nshiy with ex-mental patients, 20% :Listitreed while 12% were neutral. From tho Female rasyondcnts, 34; aired to the existtnce of relationship b~tween,~eoylo an,! mcntal patients, 622: .lisrgr~d and 4u weru neutral. Fifty i~ercentai;rauJ that no re1:itionshi;) cxist between people anJ ex-mental patients, 302. 2isa~rse.i L;n; 20$, were neutral: . 78. ill these are shown in Table I11 G and also the fcct 4-bi the E'emules relate more with ex-mental patients. The Jato was statistically tested for significant uiffsrence as shown in Table H. --.------TiLYLZ I11 H 2 X calcul~ted= 2.24 X 2 critical value = 11.07 2 2 X ca1culate.l i:, les,, than X critique There is therefore no sl~nificuntdifference in the male nn.1 female Conception of relr tionshi~with ex-mental pntienti. The third hypothesis which states thdt there is no sitnificcnt difference betwaen the conceptions sf thd males bnd fimales is hereby rcfuteJ since significant difference txi' in their vicws about causes, best methoJ of trectment and .3" ptrmanency of cure, I --. - - LU+r-iS'CU' ------IOIU OF FIMDINC The research set out t> determine what Emekuku people concuivu to be mental illness. Threc hypoth*ses were 2ut forwarJ namely: There is no signific:.nt difference in the conception of lncatal illno:;., by the ELucated an5 i1litsrc.t~citizons of Pmekuku. Therd is no si~nificctntJiffarenc~ in tha conccpt mental illness by the various age groups (Aults & Youths) There is no si&nifici.nt difference between the conception.. of the rnulcs 2nd ftmales or mental illncss. some re::eerch que:tions wera also used anJ they inclu3et How do Emekuku people .:iegnsse or iu~ntitymental illness. What are the charactwristics of mental illness. Can mental illnoss b~ classified ~n3on what basis. What are the classes of mentel illness What mode of tre,.tment is adopted f sr mental illness. Is mental illness cur3ble. How do people r~lotewith ex-muntal patients. In or!:@ to test these hypotheses and answer the resccrcll questions, a likevt typc of questionnaire with a three point scule - r.&rei;#dis:.#,ree and neutral, - was used .to elicit responses on (a) Cau::cs of mental illness .* . 80. () Best method of treatment (c) Permandncy of cure (d) Helationship with ex-mental patients. There was equally F. frea response section ta elicit responses on diai;nosis, characteristics of mental patiLnts, classifications, ba. Ls for classification and definition of mental illness. The result. obtained arc: discussed in this section. To thi: majority of Elnekuku citizens, mental illnesr; is taken as somethine that makes one lose one's senses ani becomes unable to articulcte j~ropcrlyin bth orul discussion c.nd other activities. Some take mental illness as Javiation from normal b~haviour, thus echoeint tho social criteria1 hcfinition of mental, illness as Jeviction from prescribed, expected or typical behcviours in the siety. Yet others take mental illness as the illness that affects the mind. Thus support in^ Rsgers (1978) in his definition of mental illnasd as arrested or incomylet~dev~lopment sf the inins:, psychop&thic disorler or any other .[isability or disor,er of thi; mind, 81. The mentally ill is disagnosed by the people through observations and some of the chcracteristics to bk nstioed include: (a) Feedint on refuse (b) Withdrawal fro111 pegple. (c) LgGrcssion (d) Soliloquising (e) Indecent exposure of their bodies (f) Laughing out af orier 3f"~loin~peculiar things for in-tcncb, dancing, run2inir newspapzrs always, or removint; somethink from the body. Emekuku citizdns cre nst alone in the usage of . ,... > stereotyped bizzarc behaviours and appearance as diagnostia criteria for mental illness. Iimcricans, as reported by Wiescr (1970) Uso such criteria also. Germans in the sams study, cited internal critzria such as ;isturbances of mental fullctions, cognitions and judgment all of which lead to bizzare buhaviours and a2pearance as characterising mental illc. nabkin (1972) reyortcd thn-t beliefs held by the public about mental illness, concern peculiar physical appe2.ranca of th* muntdly ill 2nd their lack of will power. Mental illness is classified by the respon.lents in this study b-sd on its stagLs cad other yaramenters like age and c au :; e . 8;?. 62. (a) Early st~~ge:The mad ;~~r?onis just showin; signs of I abnormalcy. It, is taken that hc can bc curd at this stc,,-1 ' (b) Lat-r at~kc: The patient is more or lcss out of control L~Jset in his mcd weys. Ha may have strayed into the mrilkut square c.nd cacnot bo cured cvur aeain as ia gunerelly believ~din Igbo land. 1: The a& at which one becomzs mad counts in the classification. coma rcsponJant;; felt. that if a young person (bclow cte 30) starts misbehavink, thd chcnces of cureink him $6 mora than when zn e13cr purs~n(above 30 years) stcrts .howin, sikns of madness. From the discussions the researcher hud with sone of the responicnts, thd older 011,;s aro more prone to madne:3s b,cnu,,~ of thcir numerous 'trials and tribulations' in tho c3urs3 f thcir livss cn,! cre less likely to bc come c~mi>lut~lynormal later. T~Lyoung one: on the oLher hand, 'havc not ucw~snything'so, thay can ~asilybc: broui,ht beck to norma with proper ozro. Thcy however i:oun:led n note of w~.rnin~th~t it d~i:jcndi, on Lhe ci~u~osand thesc include. (a) Inhbritance ie mantrl illness running in certain fcmilics. (b) Inlucud madnass by witchcraft, on~micsor ~~ro~ress,drug, povwrty or har~shipz:nJ lack of rect which results to brain fag (e;poc:ially for academics). Clasrifici.tion of mental illness is equally based en cruic:,~ Thus, there arL four classes of madness namcly; (a) Madness as a result of punishment from thc gods rnLl a ancestors. (b) M~dncssinduced by witchcraft an3 enemies (c) Drug induced madness (d) Inherite? ma7;ioss. Some of the oiucntc:i citizens classified mental illnes- in to (a) mania (b) !;chizophrenia (0) organic ;,sychosos (3) Ncrosis (c) Psychopaths. Amongst the Germans, according to Wiescr (1970), laymen (I~eopl~outsi~le tho psychictric or medical field) tend to I ~ifferentiatetwo sop::r::tc ar,?ers of mcntal illness onc of which they call "Gemutakrankheitil (cmotioncl disturbance ,,~lancholia)which they view as ~sychologicolcli.;turb:~nco csuscd by external evcnt. 1. To them, zuch a Ji:t,urb:ncc is rc:?ctive in nature and can be merely transitory. It is equally subject to thera2cutic influenct. 2. The other they refer to an *Geistuskrankhcitn (mental illness1 insanity") which they believe is inherite5 an': is thcrcforc, a re:.ult of a llphysicrl disease proci!sC:". This they believe, runs a fixd course and is not subject to therqcutic influence. 8 4. 3. On moJe of trestment, Jrug restriction, thi Native Jectors end srthadox medicine were iJeentified. In aJ3ition to thoao, the prayor houses equally serve cs tr aatmcnt centres. Curability of mental illnoss is a sensitive issue an3 Lanerally elicited sczpticism from the respsnJents. This result :orrisaondc with Ocbonna (1977) reporting th~tmental illnc,js is b~1icvu.l in Igbo lend to b~ incurable. This belief in thc incurability of nental illness inadvcrtuntly af'f scts rolationshi;~with us tho cc.si: with rusyonlents in this study. Helnti.onship with cx-mcntal jetienls is not highly chori;hcJ by "normal pcopler This rcsult is suppcrtcd by Olubuozi (1979) in his rqort thct peoplo ir, Nkpa su~associction with the ment:*l ill as more or 13ss detrimental to the lifz of "n3rmal ,,co;,le" . Farina and Ring (1965) quoted Nunnaly as roportin~that in America, at least, there is a generalbze~lun fovourabL attitude boward the mentally ill even when his behaviour is, by all :;tandcrrJs, normal. 85. To further elucidate tho results obtained in this stu:iy, c3ucational stawlard, age and sex were considers,: as variable:: in ,>coplo's conception of montc.l illness bi-.sed on causes, treatment, cur ability and relntionship with ex-mcntal patients. ------EDUC...T ION.-L :;TihD ...RD On causes, 7'.5$ end 61.52 of th,? i.llitcr;..tcs nnrl c,lucctc.3 citi.zens ros;>cctivuly, atree thzt hard drug usage is a cnu.ativ agent of mental illness. Thc response of thu illiterate: coulJ bc litcr::lly trrnslatcd in\! sunmo:rized a:: I1t,hcre things chil,lren teke thcse days make thcrfl mel; it wns n3t like this bcforcn. ("those things" refcrro.! t.2 in thc statement are ?ruts). Thcy went further td Bay thnt the numbor of ol3cr but mad peaplc along the strouts hcvc roluccd considerably but 3nc :;e%:: these smull boys and girls with thcir leaders everyday. Although drug wi:s acclaimed as a major cause, there is n strong belief thc.t mcntcl illnos:: runs in fnmilics (551:) e:uc~.tcJgroup and L5f. illiti;rntis). I?qr instance, soma of tb interviuwe9 resi~onL..nt:; cite.! a pcrticular family thet hod 4 men runnin,, mc,J successively at certr.in cgcs in their live:;. Of th~4 men, one w, s adduceJ incurable since he has p:.s.;eJ. .t21rough the stegeo of tret;tment given to others an2 yet, mad in all aspects, Lub:;equtntly, the report continued, thct one is now wanderin& along the streets in Oworri town: While morc of the educated .roup than the illiterate group blnmod povLrty with its attunJant problems as n ccuse (42.5; c.nJ 34.5$ -esp~ctively),m3re of the illitrratc citizen:: than thc eiv.cl;tuJ citizen:; felt thet witchcraft cm mnkc one rnc8.l (31.32. .nd 14.g rec;pcctivcly), Thus, there is a ~i~nificantdifference in the two iroups' cor~c~ptionof the causes sf montcl illnts%. Luch a sitnificarit difference is supported by 11zlpet (197L I who in his rcport of a study by Hamhey et a1 in 1984, revealed that the higher ths educational anJ occupational 1~vil the more enlightend the opinion$ about mental illness. The hibher uducLtoJ ~rdupmoft ofton cited omotiancl cnd physic;l Jifficulti~sas being caus~~tiv~foctors of mental illness while tilo lower duceted group citeJ environmcntnl cnJ s~haviouralcauses such cs alcoholism and overwork. He also reported thtlt tho hither the cduc~tionclan3 occupatiannl levels, the more i'roqu~ntlyis the rasijonse :.bout the possibility af hereditary factors being, involveJ in ment:,l illness and the less often is mental i1lne;s asu~ci?.tedwith sin. 87 . In rcspmlinc to tiit: best mothod of treatment, the illiterat~sacclaimed the ;,rayer husks which, according to thsm, also offer a garmanont cure. The u~lucztci:group on th~ other hcnd, pr~forreddrug restriction which to .them, ~lss off~rsa permanent cure. This result is suk)yorts.l by Halpert (1970) who rcport~i thut the hiyhsr the e~~ucitioncllevel, the greator the tendtncy to recommend profcs:,ioncl treatment rather than home cars. Tha illiter~ti:trougsf response may stem from the fact th;t they :.re eithd uniformd about asylums - th~tis, they 2-r~not aware of b:)th thcir existence 2nd treatment &iven ij than = or misinforrnL,;l in terms of h~vint;a wron~notion sf wh:t t is happunin,, in asylums which mdi. then pref~rthe prayer hou:;.. for a sicknesi, which thcy bc1ieve.i wvii cause4 by hard Aruy ... usu;;g,;. Dcsi~itothu f iLct th:.t the rcsporlJent Lrougs believe thnt mwntal illnes: is cur 61u, thoir relationship with ex-mental patients is not vury much cherished. This is uvi2uncc2 by th~fcct that only 13.5J of the c.;!uccto.rl re..,,oniznts a,riu,J to a relationship with ex-mental patients, 127i Jisa~.rcad. Ti].. illit,r L I. :,lily 12.52 ajroeinl, to n relationship with ,x-mental patients, while 1% said there shoulJ. be no relationship. The Jifference betwoen the two Kroups is not sl~nificant. Therefore, any obscrve3 diffsrence is duo to chance. This trend corresponds with the study by Ywhritofe (1975) in Benin City with 91 fresh Univeristy graduates whcre he found out that mental yutients ere? ro~ar3e.las vcry :I,,n~ordu unprodicetzble, dirty, br:? and w2rthless and so, puo~ledo not heve any rel~tionshipwith them. Ogbocna (1975) in his study with Itbo under~raduetes also reportaJ that hit.htr e,lucational attainment is no ~u:~rnnteeto chanLe or" attitude towi:r:is menttl ill;no~siTQis ... implies that the hii,her ~JucationclfitCninmtnt not withstaniii? i relati3nship with ox-mental gatients, when cornpi;ri;d with thrt of 'normalt people, is at it- lowest ebb en3 may be due to tho bcnerol view of ;n ex-mentill patient as one of unprejictabilitg &nJ worthlessness. In quite e contrast note, lIolling@ed (1958) found distinct diffwencau in attitudes md knowledge about menttl illness and the m.;nt;.lly ill cs a fuaction of social class cn~: ;..ucction. The nuthor infdrrd from his results that the ujri1t.r class members have more favourable attitudes towirds 1- psychiatrists snd acce;>t mrntel patients more thcn members of the lower claosus. 8'9. yhu ~li~htdif f eruncu that exi:sted in the rel~t-ion:,hipwith ex-mental patient; batw~enthe illit~rt~teznZ educatd ~roui~; in -this study thoui;h not st~tisticellysijnii'icant, lands crdence to the f~ctthct eJucction crn have an imp::ct on the trc-itionzl conc~~~tionsf peoplz :bout mentcl i1lne:;s. dother virii:b:Le csnsi3crd w's a:o to det,rmine tha extent of it:; influence on ,iusplc'~-trc2itional concoiitions. .Lults (45;..) iJontifiaJ drub:; as c. major ccuse ,~fmontol illness. Onz3 of the rLcd r~spon3entujtated "These thin,;^ they smoke m~kcthem mnLll'. The Youthj (64r5.z) c'roej. to thi:; statement but blamed. inheritance mcru (67.5J) cc the major ccust. of mental illnass. Only 37.5s of thi: i:.lults howtvor, agrood ti?c.t inhoritanco pleys a ;)zt in mental illness c,us;tion. The yount reslionden-t:; in this research are supported b:~ Otbonlia (19'76) who in his stuJy in the i?ttitula of Iso unJert..r;:uates (wh:, m..y bo ruc;arJed 2:; youths) to lnental illness, reportoJ that 11ienta1illne5s is bi1icvt.J by C,hc responJents to b~.inherite: 3r causoJ by Jumoniacal possessisn The dults' rasponses Jeviateil from tha balikf:; helJ by Mkya people ~spociallythoje within tho age ran-,c of 50 - '70. Olubuezi (1979) reportcJ in his stu,:y thet thi:; jroup in xkpa believe3 that mental illness is caujud solcly by ext~rnal factor such as witchcraft. 90. Halpert (1970) in his own re,)ort atatsd that pcoi3le in the alJer nt;e :,raupa associated poor livin, conJitions with mental illness morc-: often than did the younter ~roups. Ths.,u two finlinks differ somswhat from the findints of this study. 211,is trenJ can be explained by thc fact thnt and 3ru& aJJ:iction with it:- ctten3znt cbses of mental i1lne:js is mclre in focus now thun it has ever been. ,om? of thz c.gd re;;;>gn;urlU,., interviewed i~ointd2ut thct Grugs zire the mcjor causes of m~.~Ln~.i snJ thu yount,er 'eneration are mQre susceptible to mndncss since they ere thc major con:jumcrs uf th~..,e.:ruts. IIatha (1950) supports thcse atd rcs9onLcnts in his report on the Nati3na.l Concord of 7th .;uytember, 1990, thtt i-t wa:; reveals,: in n recent psycholoty week, thct fifteen million iriig~rians are mentally .icran,sd 2nd an unknown percciltage are 2.1~~ bulievod to experience serious emotional an:d environmental strees with the teennturs an3 mi3Jle aged people ns the direct victim8 of this con3ition. The report further quoted the inturnt.tiona1 Pre:,iJent of the Calvary risyital (~r. Ernd5t Uko) as say in^ thet theso groups of Nigerians, who are becornink more prone &~,lruitctkin~ as a panacea to social problems, would Jovclo2 oven mure tlarinL symptoms of mental in:;tability as they tr.lcu charge of government, Commercc 2nd other sec :s ;f the economy. 9 1 I11 ~ Belief in witchcroft however, still sexists as whown I i I by the respsndents (%I$ adults ,inJ 33$ youthu). On be::t i method of treatment, both the adults 2nd youths ;~rufurra; drub restriction most, 50'.5'$ cnd 58.5$ respectively which they I equally believe off-rs c permnnont cure. hhilc the Youths (51;:); will ao to the Srnyer h,>use if ;rug restriction did not work, the adults (47$) wi:ll rather be taken to Native doctors. It B)&y be pertini-nt ts point out here that .:rul: rcstrictisn is hr.n.lld in asylum* .- hospit?.ls for the rncntally ill where tho tr supposed1.y or-ered. liiiijorts in the D:::ily Chrpion Nowspaper of June, 1990, indicatdd thatidmates of the Ka,luna ;tate Lumtic Lsylum h2.v~trowin, access to irugs which had the effect of cp,gravating the c9ndition of health of tho immates most uf whom, the rcpor't continued, are .chronic Jrug gctiont:;. One then wor1~c.r~on thdef'ficacy of JruL rectrictien c.s pructiseJ i.n the.,c asylums. This rul~ortmag equ'lly dccount for hhe alternative methods inJicated by both the uJults cnJ youth:;; Nutivc doctors c.nJ pr:iyer houses raspcctively . iielationshiy with ex-mentd pstiunts".hile 17% of the . youths atreed to reiationship with cx-mental patients, with 71% ilisdgreeini;, anly 55 of the adults cjrezd to : a relationship onJ 705 Jisat:r.ed. 92. These sh.3~that both grou,,s allrue to no relationship with ex-rnentrl patients. But the youths seom to accept the ox-mentclly ill moro. HOWLVC~,Halp~rt (197.0) in his report of 3 study by Crocotti in Baltimore, involvini e ~,rou~whose meiisn sr,~s were in the low 30's~Found nu eviJence of rejection of the mentally ill. In the said rzport, majority of the responJents had tho bulicf that mental illnoas cin be cured. Half of the respon~Lent showed willinbness to fall in love with a f~rmermental patient jnl the next half wero also willini to live in the same room with the formcr mental pctient. Eighty one pert-nt of the respondunts, thz report continueJ, shwoed willinLnesz to w~rk with a former mental pirtient and 62% Sisagreed that almost all mentally ill persons are danierous. in iiuite a contrasting note, Olubuezi (1979) in his :.tudy at Nkpa, reporteLi that cr:;s>ciation with the mentally ill ia more or less ..etrimental to the life of !normal peoplev. Mentally ill iJersons e~redreaJeJ. This may account for the fact that majority of bath adult mi1 youn;; respondents (702 and 71$ respu~tively)Yisai;reeJ to n rel;.tionship with ex-mental ~atients. The soxes of the respondents were tho next variable considered. The result showed that while the female rsspondcnt:~, (87.66) endoreed drug as the major cause of mental illness, the mslrd (91%) felt that poverty is tho @@atestcause. Drub was rnnked next t3 govelty by the males (89%) anJ inheritance next to drub by the fcmeles (86%). The males' response may be attributed to the fact that the men are responsible for the welfare of thc family iind any situation that jeopardize$ that ;losition, exposes them to ::trees which may, in some causes, result ts madness even if not in the mediccl sense. This was echoed by some of the interviewed resyonJents who went further to say that peoijle in ~uchr situation may start being agbressive to others especin, when anythinL touches on their ability to fulfil their manly resi~onsibilities. They may start looking unkempt and show other mad behtviours without anythini: beint organically wrong with them. Some may be seen on the road, tho responlents continued, an3 one start, askinL whether they are normal. krhat can b,: deducoJ from those statements is that men ere more prone to maJness than women.--Tho fuct that one cbn b~ mad due to the morbid and illoglca thou,hts as a redult of one's poor isyosition which may not evtn be peculiar to one anJ subseqiemtly appeibr: ill, unkmpt cind displace one 1s I 94. I1 I ai;greesin at will, can squally be deduced. I i ! Rabkin (1972) in his study found out that morbid thou6hts I ! play some r~lesin precidyitntin~mental illness. i Dezpite the fact that the females attributed ment~l ! illness to drug usale, they believe that the yrcyer house is th~I best place to treat the mentnlly ill. They equally believe that drug restrict'on offers a permcnent cure. i critical look at this response may su$gdst thot the females greater tendency than makts to to to Church - acy Church at all - and their I zuggertive noture, mcde them rec~mmendprayer houses f3r the treatment of mcntal patients. It may dso be thct the prayer houses and their grophets are more ca2able of restricting hug u age by the patients. These sutbestions tend to make one believe thc,t the femalic are either uninfirme2 about mental hosliitals end their services or misinformed especially by these who spread the infsrmation that the mental hospitals use only seJatives to keep their patients iitirpetually aslrep, ;om& people even say thct the vein.. of vury violent onos ore yulle: or reduce;l to woakcn them. yet others say that patients arc chaineJ and flokLe'l rc~ulcrly to ,rive away thcir mahesu. Thcre is also the possibility that such re,)srts as those of the Daily Champion on thz acce3sibility of drugs by mental 95. patients biased the minds of some of the female respondents and rnc3.e them prefer the prayer houses. The males on the other h?,n:l, believe thct drug restriction is tho best metho3 of treatment which can also offer a germanent cure. The males 1 endorscmant of drug restriction as the best method of treatment for mental illness which, accorJing to them, is caused by poverty tend to suygest that I the mallus b~lievcthat poverty leadsig 4rud ad3iction and subsequent mental illness. Tho moles' &re $u$upportod in this suZi;estion by the intern~~ionalpresident of the Calvary hosiJital who said that fliterians in the teenage and midale ag:e brackets me becomin., more ;>rone to drug taking as a panacea a social problems (which is what is whot poverty basically is). L He equally pre3icted that these group c~f Nii.erians would ilevelo? more glaring symptoms of mantel instability when burdened with the responsibility of taking charcc of g,overnmont, Commerce cnJ other sectors of tho ?conomy. It could also bc th~tiru,, r;.!Jiction 1caJs to poverty sincu a lot of money is expm~ledto maintain that exponsivc habit To them thercforo, restricting drug usage will restore the muntally ill to noralcy permanently. I 96 a I 1 On relationship, the females (34b) relate more with ! ex-mental patients than the mnles (24'5). i The females' respnsos ccn be summarized by ishat some mothers and female rolctions of the ex-mental patients said. I he mothers exyresseJ the view that they gave birth to them and nothinG, even their ;)resent condition can make thom change toward:: ! their children. One p~rt-icularwonzn who is so emaciutod ~nd ! alwzys talking to herself (one of thc churacteristics of I nentul illness) hed this to say l1John is my son end I cure@ I the Jevil or cny enemies who though they can soparatc me from I my son throueh thisu. Shc has be~nwith tho boy in tho praycr I house for tho l~ast3 yuors. ;,skoA why she ?houlJ be thure Jespite the fact that there seem not t3 be such improvement I (from my own observntion), .he said that they have tried the I nativo Lactors without success and the prayer house has enabled I 1 the son shed his mad bahuviours. For instance, he can now talk like any other n:~rnaiyerson, cat what others are eating I ,nd sleep which he was not loing when he was comglctely mad. I She can now -iscuss with her son reasonably most of tho time althou~hthere &re some relapses occa:;ionully. !*They will .vcntually arrest th;t relai~sebecause his son is ulriL.ht now1! w:,.::: her conclusion. 97. Her comment about psychiatric hospital is that they flo~ geople, pull their veins to redw them powerless and at the end, tho patient is so docile that one starts woncl~erint,whether he is still a human being. She Jo~snltwant that for her son. This responLentts view &bout thu psychiatric hosl~italis echoed by the United Lssociction of Tri litional Doctors who cleim that Conventional psychiatric hospitals only suppress rather than cure maJness. The male respon~,onts, cspccially the eldcrly ones intorvidwr expkcsscd the view that the ex-mental patients cannot contribut~ meaningfully t3 any discus~ionin the family not to talk cbout makint, decisions. "we only tell them whnt was said - if we carc. - and that is all, what will anyone want to gs to them fort1. i Some of the males even felt that there is really no curi: for madnuas. This they said can be inferreJ from the way they talk, sometimes, they make sense and at other times, cspeci:illy towards tho time they first became mad, they are incohorent. The ex-mental patiants accorJing to tho males, cannot link up wii past events end their agpecranw Jiffers from that of normal pcoplc. The attitude of the males tgwiirds ex-mental patients ccn be attributed to the stigma on mental patients. Habkin (1972) reporteil thit the ;~ublicbeliove thft the 1 mentally ill have no will power and h:tve marbid thouLhts which make them bchava irrntionnlly :nd iggrossively towurJs people. This belief has lal Lo thu g~neralacddptanco of the ~tereotypr?~ Stibma bttachad to nontal illhess which evcn exisksamong profvssional workin6 in psychiatric hospitnls. On the effect of :uch stigma, Rabkin furthsr observed that within a psychiatric hospital, where many patisnts are sent egkinst their wills, inmates seldom share thi; rights, liberties, ;nd ~.~tisf:tctionthat "normalfl yieoplc enjoy. (This ~lso corr~syon~swith the ex-mental ;~atientn'mother's iJa of tredtmant in the >sychii:tric hos;~itnl), On return home, accordnt to Habkin, the ex-msntcl patient is more of a liatilit) than bcint,, an ex-crimincl in the pursunnce >f hou: ink, jobs and frienJs. This may clso account foe tho mad appearctnco the mdes cited as a reason for not relqtint with ox-mental patients, Onc~a stigma is 2lacv:J on somcono, it effects his and people araund. St'x, from the ongoin6 Jiscussion, plays a sitnificant roli: in the conception of mantcl illness by peoplc us;~eciallyin terms of rolotionshiy. Whilc the ftmales in this study relate morc with ex-mental pztionts. This trend is supportad by by Farina (1973) who h.nve Aone more extensive w3rk in the area of mzntnl illness and sux Jifferenccs. - 99. In an earlier study, ,Farina ruportd that people in intoraction with ex-mental patients were in conflict becnusc, although, they found the ex-manta1 patients objectionable, there wzs still that feeling of a n~adto support and help them (which is cxcctly what is hapgcning with the respondents in this study. As much as,mothcrs and. relations know th~itrelapnos are sornotime: cxpcrienc,e.?. by the ex-mental patients, they still relate with them). ,,i 11 In a lltcr study however, Farinc at a1 (1975) liscovered : that in conirast to their provious stuJies which found no sex j diff3rcn~es;~women w~remora cccepting an3 &onerous than men toward the rnbntc?lly ill which mily be as a result of thc < syrngathctio hature of women. This again is the ccbe with thc women in thkc stuJy. They are more sympathetic and so, suportt and felateds with ex-mental patients. .! , The research set out to find out whether educ~tionc~l backkrouncl, sex and i:ge have any effect on the traditional be beliefs of Emekuku ycoylu about mental illnass. It wis found out that recently, the traditional belief thct mntal illness is cauad mainly by witchcraft, inheritance, poverty and punishment by tho g,o;ls and encostor- for. sins committed, has shi tcd to incluJu drug addition which is ucclaimed t~ bl: tho najor cause of mental illness mainly by the educated ;Toup, the adults and fumoles. This has affectd the treatment a.ioptzJ thoup,h not outrit:h~ nlthoukh dru~restriction is ccloimud by the sducttoi group, adults cad youths to bu the bost method of treatment and effor~ a permanent cure, the prayer housa got equal altentidn especicrll: from the illiterate group cind the females. Mentul illness is believe: to be curable by majority of tkic respondents in every group althouc;h there is still a stronk belief that a mcJ ;Ierson who stays into the market :;quc~ecannot be cured again. lielc,tionship with ex-mental patients is still at its lowe:;% ebb for the fact that people still holJ the view tht~ta man person, though supposc-lly cured, is still unprddictablc. It cun also be said that the stigma of mrdness contributes more t:, pzoplels unwillingness to re1;te uith ex-mental patients. , 101. Some fnvourablc attituie towar& ex-mental y ntients however exrst among some of the respondents especielly the oducated the youths and females . In all, educational background, sex and age play very important roles in the trditional conceptlon of Emekuku citizens about mental. illness. In view of the fact thut Jru~h.rs been ncc1;imed as tint m,j..~ I' and incessan-t enli~htenonehtcampai(;ns in vernaculhr about tho effects of drut in cilurch~s, schools, media houses an1 esgocially in the asylums shou1.i be msuntei to mcke users, addicts, parents tLnd relati3ns know the dangers of drugs to hum:;: 'ealth. 2. Information .abou-t asylums, unJ psychiatric hospitals, their ercices and locations should i~ub.llybc mr.de availcble to the public so as to enable gcrents and relations to sent their menti. ill eurly enough for dequate and rpmpt trestmant. This will reduce the incidence of mental pakients roamin& the streets. 3. Craft workshops and other. fecilities for adult cLucation should be provided in the esylums to hasten tho process of treatment snil self octurlization for the disch-rged patients baczuse, it will enhcnco their integration in the society c,fter dischar~e. 102. 4. In addition, the number of ~sylums.should be increase3 to at least two in each state of the Fcilerntion to accommodate all the menttlly ill p er sons. 5. &s much as conventionel asylums ere needed, people still believe in thc efficacy of traditional treatment, so, the United Association of Traditional Doctors (UATD) request that tho government shauld provide asyiums for traditional treatment, be needed to. Although this request is already achiuvin$ results in ,Cdokoto, othar states and governments hsou1.i follow suit. VccorJin~to the UI~TD, ..uch centres should have ftcilities far fnrdn, ,:r,;i cr~.ftdevelopment which should be a;.;~l.ic;!to , augument running costs. Dru~s,for the pro,rnnmes should be provitled by the 13cd Lovernment while staff trainitin anJ dovelopmcnt ::hould be the responsibility of the State ,,ovarnment. 6. The social welfare depi'rtment should bc rounding up the lunatics for rehaliilitation and subsequint treatment when they are seen roamin& the streets. 7. Semimure and warkshopa should be organized to encourage ,JMO;J~~research morc on mentnl illness an3 enlighten the public on the ways end means of hnnclling mental and ex-mental patient:;. preventive mental health care which involves early rucognitioil of p~ycholo~icalproblems that may loe.3 to mxlness, support durin" strees amon6 others, should also be a part of this pro@-ii 103. 8. Families of inmates of both the conventional and traditional asylums (when they are established), should be tracked down and encouragod to visit regulrrly in order to facilitate re-union and re-zocializntion of ox-mcntal 2atients. For us to hang on to the claim of living in a civilized ." society, it will remain a tellin(: of triumph of mJrai and social responsibility if we resuscitate the miid ones amongst us and possibly convert them to genuirpes. fis such, these I! suggei$ions will serve the useful purpose of diffusidg the ., t. traditional belief that ex-mental putients are less human bcini:; ii new era of lood relationship with ex-mental patients maySr. even'b.,e ushere& in. , . Lmrbi~~~sOF THE LTUDY , r Mental illness in Igboland is a vsry delicate issue not willingly discussed by people. This is based on the fcct thot majority of the igbo'~drcad mental illness and do riot associate with mental patients, even though the individual hos supposedly been declared awed . True to this bdlieve, many of the.rcspond$nts wore not wil'lint, to rcspond. The reaction:; got ranged from "wc are not a mad familyn to "I don't have time to t~lkabout madness". t With a lot of persua~ion, some responses were &t ulthouih neutral responses abound in the areas of pmmanency of cure and re1,tionship will ex-mental patients. In planink this research, there was an awareness of the I flaws in using people's conception to discuss mental illness I especially in terms of personal bias end prejudic. I Tht: use of geoplels conception was made inevitable by thcfcct tht' 1' ' that families-wiqh mental case are few and will not be representative of the entire community. Besiiies there is limii~; time for the study. I It is therefore sugtestcJ for furth~rresearch, 11 1. the conceptio- of mcdical personnel nhout mental illness r I 2. TraJition~lmedicine and mdnttl illness. These will complement 10 5. 1 BIBLIOGRAOHY aclama, H.B. (1964) Mental illness or intergtjrmnal beh~~p~~ nmerican Paychol. 19, 149 - 197 iiwaritafe, A. & Ebie, J.C. (1975) Cgy,tmgotarJ' --Attitude jg mental illness in N -e&a. African Joural o Peychiatry 1, 37 - k. Coleman, J.C. (1976) ~i~~g~2~~ch.c,Io~,~ a& moclernA&f! ,. 5th ad. Glonview, Scott, Forusman & Co. P&. 26. Cumming, J. & Cummin(; EL (1975) On stip;mcCuf m,entitl i1 nsgp, in Pars~ectivesin abnormal behaviour ed. & Morris R.J. New York. Pergamon Press Inc. Pl;. 487. Durha, W.H. (1965) Gommunit~_Schisophrunia. An epidemological i~ncily~is.Detroit Wayne State University Press. Ewer%, J. (1960) ~ta_f~erviews;In Guiin GiJ. VBTof f-& -3, .; field. Americans View their mental health. New York Basic Books. Farinn st a1 (1974) =CJPL=~D raactiog to Former mental uatL~~i mavin, tu thzir neip,hbournud. J- -t hmm.psv. VO~.2, IOB-112 Farina & Rine (1965) The influence of perceived rnent+il..&&X.s& ---on ir,te~ersonal helations, J. of abnormcl Psychslogy, 47 - 51. Farian B & H. D. kla&elauer (1975) Sex md mental illness ---The genercsit~of------femals. J. of Consulting and clinical Psychology 43 (I) Pg. 122. Freeman, H.E. & Ka~~ebaum(1960), Helationshiv of Educations ------and knowledhe to epinim about mental illness. Mental Hygit~nce. 1 I Halport, H. P. (1970) Opinions and attitudes about ------raental Health. In :iocial Psycholuiy or mental health edited by Weschicr H. et 81. Hollingshed, A. B. et, ~11 (1958) social Class and mental ilGss_;. New York, Wiley. I Holtzbwb, J.D. et a1 (1965): The sociil1 jntsraction of Co11ei.s Students and qhronicala------menBal ~utients.---- I imer J. of or the psychiatry 35, 47 - 492. ! Jehodu, G. (1974) Su.$ernbturaL beliafs and Chan in Co pitivg xt~tur----e amon3E~inmn 3iiTZif 75-'-%ii%dur e BE Cognitions. Readings in cross-cultural psychology ZD. Berry JiWb et al, PC. 141 - 187. Krech, D. at a1 (1962) 1n;ivi-iuul in Societ~,Berkely, Univeristy of California, Pg. 349. 1 l a reI.. (1975) Gender and .A~~-a=filctor------in attitude ---toward ----thiise---- stiastized ------as mental12--- ill. I J. of Consulting & Clinicel Psychology 43 (1) 1 97 - 98. i Mmadu, S .O. (1976). AtZ;Ltg;l& is mental illness of I6:bo under{:raduate students (UnyublisheL: ~hesis) University of Nig,erin, Wsukka. Morgan, C.T. ct a1 (1971) Introduction to Ps~holo 4th EJ. Tokyo R;~~zEZTZTKI hunnally, J .C. (1970) .g&&ic Bttgtudes Tewards the penta&ix --ill. In Eocinl. psychology and mental health ed. by Weschier et al. New Yorlr Holt, Rine Wart & Ginston Inc, Pg. 531. Olubuezi, F .A, (1~79)~a~~.&~~n~~~iefs~~boq~g~~~_l~llnos s alnon!: the people o? Nkpa (UnyubIisrh;~LA.. : :T'---' University of Nigeria, Nsukka. Rabkin (7972) O~inions+buut rnytaL illness. k Heview of Litera ure, Psychological bdletin 77, 153 - 1'71. Ho~er.. 1%. (1978) Churchill livinp, stoqe pocket' MoJical Di6ti011~_r; Longman kroup Ltd. role et a1 ( 1962' ML'~&~~-~~~~~&~&Q~~~Eb The d~dtown~ahnttan Study, Vol. I, N .Y McCraU Hill Ltd. ,stafford, Clark D. (1963) ScNiatry Tod:~, penguin Rouks Siasz, T..S. i;:960j, ?I.c' My,+,'- :______.I---L1_3f Montal illness The iimerlcan Psychologist 15, Pg. 113 - 118. < I Tounsand, S .N . (197 5) Cultural ConcC4i?t_s, rnct&&-Qj&~~c~ znd .Social Roles: A Compiirism of Germany, & America Bmericnn Sociological R~view40, Pg. 239 - 752. 108. QUEST 1-9N.gAIRF-,I)N. C.O.N,CEPT'IPNS_-"---, ABOUT MENTAL,-----,--., iLLNES5-- This Questionnaire is bein(; used to find out ~hatthe educated and illiterate citizens of Xmekuku conceives to be mental illness. It is strictly for research purposes. A. This ques-tionnairo has 5 spaces depict~ni;your views about mental illness bas& on Causes, treatment, curaSility an3 relationship with ex-montol petionts. Pleasa tick (-/) in any of the spaces that besk represents your views. Name of village ...... sux ...... dge '18 - 20, 20 - 30, 31, 40, 43 - 50 Educational qualification: WI;C,. TC.11, NCE, W.ED. M.ED, O,H.U., H.N.D. c"4zGi_Es-~F-MEExkL-LLLN_Es.S 3l.lnn.i- farms of men-to1 illness can be caused b? ri. :Zcr;.:f .. ,, , . . 71 3.l.lnets 2s :: nunishmcnt from the gods i L ! -: g>i,' -h- ?r..k frou the ancestors liar? drugs (cocain, goof) c;n c~usc::IIG~A~L~.L .illness Ogbonjc is responsible for mental illness It is inherite2 and runs in families Poverty can cause mental illness. FTF.T,~~E$HOD..... ,~...... OF------TREATMENT It can be treated effectively by native docta Orthodox medicine is the best answer It can be treated only through torture Mdq+,91 ill-ness is treated effectively ...... , , , ..... 3, Restrictions on hard drug wage is the answer There is no treat. . for mental illness Permenency of Cure It can be cured permmently by native doctor~ Orthodox medicine offers a permanent cure Flogging the mentally ill cures them permenently The Prayer houses offer a permanent cure It can be cured qermenently by cutting the pack between the patient and the spirits in the spirit world Mentz.1 illnem has.no permanent cure If a madman goes to the market squre, his madness cmct be cured. Locking a mental patient up results in per~enentcure Removal of and restrictions cin hard drug usage offers a permanent cure. RELATIONSLHIP WITH EX-MENTAL PATENTS People don't visit or relate with them because they have lost their senses. Mental patients are dangerous both to their relatiom and others even after treatment. People do not Gassociate with them so as not to incurc the wrath of the gods We do not relate with them since they are always directed by the spirits t\nyone who msociatcs with them is branded mcntdly ill. Thoy have been cured and so :ire accepted. . 110. This section etch to elicit information generally on definition identification, characteristics and classification of mental illness. Please fill in the necessary reponses. How...... do you identify a mentally ill person? ...... \ant...... are the characteristics to watch out for? ...... a*...... L...... Can mental illness be classified? Yes, No. On...... what basis is the clamification done? ...... List...... the classes of mentd illness (in Igbo/English if you know) ...... What is mental illness. AJUJU N'IIIE GBASARA iiRA OGBUGBA Ajuju ndia bu ijs meo nchoputa echiche di gnra ,?kwukwo na nid na-agnghi akwukwo di nn Fmekuku noebe ihe ab,marn ma. ogbugbn cli. Ajuju ndin nwere ohere ise i @;a-ekwu echichc go ntihe na-ebuta ma ogbugba, the eji agwo ma obu hiara ogbugba, na mkpnkorita mmadu na onye ara gbma. ~ikobye ( nlohere ebe i chere nkwekorita gi di. Aha Obodo gi ...... Nwolce Kn obu Nw'myi ...... Ogo hkwukwo gi Ag~bimahukwo, TSLC (~lem.or St'mdard 6) ~fogi, 18 - 20, 21 - 30, 31 - 40, 41 - 80. The na-akpata u5' ?ra di ichc iche nwere ike ibu ~mwu Ira ogbugba bu nLarmahuhu si n'chi 0 bu nteretnahuhu 8i na nnn me ,myi ha Ahihia ike di iche iche di ka (cocaine wii-wii) nn-ebute ma ogbugbn Ogbanje nn-ebute arn Ogbugbn 0 bu ihe si n' UZO KACHA MUI JI GWOO ARA OGBUGBA A na-agwo ma nke oma site ntuzo ndi dibia igbo Ndi dibia bokce knclia agwo 'ma A na-agwo arn site n'ita ha Auhu Ikwusi ha ahihia ike di iche iche ii na-agwo ara ogbugba nke om n'ulo ekperc I3 nwe~hiihe eji ngwo an ogbugba IGWO ARB OGBUGBA KF'P24 KPAM Ndi dibia igbo na-aewo arn kpm kpam Ndi dibia bekee kacha ipyo nra kpm kpm Ipia ha <.he na-&msi arc kpm Ispan Ulo ekpere na-<&wusi ma ogbugba kpm kpm n na-&mi ara site na-ikpa oke ma o bu gbubie eriri jikoro onee ara na ndi mmuo ojoo na-enye yn nsogbu. kirn ogbugba maghi akwusi Gkwwi Ara puru &in enweghi op;wugwo ozo Ikpochi onye ma azo na-enye ya ezi o,mwo Iwepuru ha ahihia ike di iche iche na-enya ha ezigbo opmgwo Ndi mmadu annghi uchoga ma o bu kworo ha okwu n'ihi uma ha fur-, efu Ndi ara.nra na-emesi ndi mmadu.na ndi nwe ha ike o bula mcba a gwochara ha. Ndi mmadoann-atu egwu mekpte ha n'ihi ihe ji ha agnfereha. NCi mmadu maghi eji ike ikwuso ha okwu n'ihi mmuo ojoo na-edu ha. A na-aguko, ha na ndi nn-eso haka ndi ma A pooh ha a nebatn ha. Nkeji nke a choro ima iha nilc gbsorn ihe bu ma, otu e si ma am, akparomagwa ndi ~vana udi mn di iche iche. Biko deputa eziza ajuju ndi a T' T' ...... Y?U uzo e si mata ndi ma? ...... Kedu akpmmagwa onyi kwesiri ichoputa? a...... , b...... C...... d...... E nwere ike ikeputa ndi ma di iche iche? Olee ;be e nn-elekwesi anyn eke udi ara ndia? a...... b...... C...... do ...... Deputa...... udi nrn di iche iche (n3igbo/n'bekee oburu na i ma) ......