It’s no surprise that Botswana’s government did not sign on the commitment to mental health, as done by 95 UN member states. For many developing countries, it seems mental health care is not a priority and does not receive sufficient funding. Plagued with treating communicable diseases and managing a spike in non-communicable diseases, developing countries such as Botswana have significant challenges in integrating mental health within existing systems. Success Capital acknowledges this complex and ambiguous environment. It also positions mental health as a multi-sector issue that should have systems in learning, religious, private and traditional sectors – not just within specific health departments or units. More work is needed to better understand and shape a comprehensive mental health policy and enabling legislative framework. One that is less punitive, accommodating of vulnerable groups and strengthening community engagement.
‘Gongwe wena o botoka’ is a common phrase of frustration many Batswana youth relay to each other. A culture that often absolves supporters of survivors from doing care work, into rather centering on their own problems. Invalidating others challenges, leaving challenges to God or a higher power and not being aware of underlying mental conditions. PTSD, Depression, anxiety and bipolar disorders are considered ‘white people’s diseases’. Even more abstract is psychological treatment, counselling and support group seeking behaviour.
One of Bakang’s early experiences, dealing and reckoning with depression by age 15 – there was a lack of support. His guardians responded that he is ‘too soft’ and that he needs to be hardened by working at the cattle post. Exposure to struggle and hard work are centered around masculinity and growth. This is reflected in many homes across Botswana. Thus, when an opportunity to support and affirm the importance of mental health – Botswana remains behind for its people. Whether it would have been the inability to connect virtually, consult constituents widely or simply affirm its human rights commitments; Botswana failed to vote for its citizens.
Ending stigma around mental health and well-being should not just be commodified for the elite, educated and well heeled. It should be central to bringing dignity to service delivery, upholding the rule of law and shaping an inclusive and progressive society. This needs the following:
1. Understanding the links between mental and physical health towards an integrated, multi-faceted primary health care package and system that continuously learns, adapts and improves for its residents.
2. Curating a culture of believing in survivors, patients and young people, including those who do not hold power in society, homes and public spaces.
3. Encouraging counselling and therapy beyond just instances of loss, grief, disease, stress of struggle.
4. Building a peer social support structure that moves beyond the guidance and counselling model in schools
5. Incorporating community wellness systems that can leverage vulnerable group experiences, customary court systems, law enforcement and other governance systems for more holistic and dignified solutions building