11.2.1 Identification of people with mental illness in the community
In order to identify people with mental health problems, you should perform routine enquiries during your practice in the community. You can identify people with mental health problems during your daily work. For instance, when you go to a village for your routine work, talk to important people like the village shimagle, neighbours, kebele or village leaders, teachers, youth leaders, women’s association leaders and shopkeepers. Ask them to tell you about individuals they hear saying they are possessed or bewitched, or who appear to be suffering from a mental health problem. Inform them that these conditions can be helped and that such help is available at the nearest higher-level health facility. Request them to refer such people to you or to the nearest health centre or hospital. Every time you meet them, remind them to do this.
Likewise, when you visit people’s homes, ask tactful questions (without offending any family members) to obtain information about anyone in that family or neighbourhood who may be suffering from mental health problems. When you go to a school to carry out school health activities, ask teachers and students about any children who have fits, or have behavioural or learning problems. Lastly, it is important to be sensitive to possible mental health problems in those who contact you for other health-related problems.
Using this approach, you can identify people who may need help during your routine duties. Make sure that you identify who they are and get their details, so that you can refer them to a doctor who specialises in diagnosing and treating mental health problems (see Section 11.2.3).
Suppose that on one of your village visits the village leader informs you that Mr Abdissa appeared to be drunk frequently in the last few weeks. You decide to pay Mr Abdissa a visit to see how he is doing. Based on what you have so far learned in Study Sessions 10 and 11, what kinds of questions would you ask Mr Abdissa?
As you may recall from what you have learned so far, it is important to show an interest in the people in your village and to be an active listener. Before asking Mr Abdissa sensitive questions about his problems, you would start making friendly conversation, for instance about village events, or how Mr Abdissa’s crops are growing. After having created a friendly atmosphere you would try to get to know more about Mr Abdissa’s possible alcohol problems by asking questions such as: ‘Have you been worried about drinking too much alcohol recently?’ and ‘How much money and time have you been spending on alcohol recently?’
In your work you may encounter individuals who need emergency care. In the next section we will discuss how you can manage these situations.
11.2 Management of people with mental illness