The demographic factors which influence mental health behavior
change
The fourth objective of this study was to analyze the demographic factors which
influence mental health behaviour change. Gender, age and socioeconomic status
became evident as the demographic factors which influence mental health
behaviour change.
The data collected indicated the possibility of female students being more
knowledgeable about mental health issues than male students. Similarly, older
students showed more knowledge of mental health than younger students. This
therefore indicates the likelihood of female and older students adopting positive
mental health behavior change than their male and younger counterparts. The first
indicator that female students were more knowledgeable about mental health issues
than male students was their responses to the question about the types of mental
illnesses. Out of the 6 respondents who indicated that depression, dementia, post-
traumatic stress disorder and schizophrenia were mental illnesses, 5 were female
and 1 was male. Of the 6 respondents, 3 were aged 17 and 2 were aged 16. 1 was
aged 15.
The second indicator that female and older respondents were more knowledgeable
about mental health than male and younger students was the responses obtained on
the causes of mental illnesses. Among the 38 students who chose witchcraft as a
cause of mental illnesses, 13 were female. 6 were aged 13, 5 were aged 14, and 2
were aged 15. The remaining 25 respondents who chose witchcraft as a cause of
mental illnesses were male. 13 were aged 14, 7 were aged 15, 3 were aged 16 and 2
were aged 17. Out of the 33 respondents who chose curses as a cause of mental
illnesses, 9 were female and 24 were male. Of the female students who chose
curses as a cause of mental illnesses, 5 were aged 13, 3 were aged 14 and 1 was
aged 15. For the male students, 11 were aged 14, 6 were aged 15, 5 were aged 16
and 2 were aged 17. From these responses, it can be argued that since fewer female
students chose witchcraft and curses as causes of mental illnesses, they have more
knowledge of mental health issues than male students. Equally, older students
appeared to be more knowledgeable than younger students as they did not choose
witchcraft and curses as causes of mental illnesses. Those who chose witchcraft and
curses as causes of mental illnesses are likely to have negative mental health
behavior such as not taking their mentally ill relatives to hospital. Data obtained
from the psychiatrists and psychiatric nurses interviewed corroborated this view.
One psychiatrist observed that:
People who believe that mental illnesses are caused by witchcraft and curses
cannot come to hospital for treatment when they are mentally ill. They cannot
even bring their mentally ill relatives to hospital. Instead they look for a mganga
or offer traditional sacrifices which they think will heal their relatives.
Differences in knowledge levels of mental health were also seen in the responses
regarding confidence to seek information about or treatment for mental illnesses.
Whereas 316 respondents comprising 95% responded positively, 18 respondents
comprising 5% responded negatively. Among the 18 who responded negatively,
only 3 were female students. The rest were male. This further indicates that female
respondents are more knowledgeable about mental health issues and they are more
likely to have positive mental health behavior than their male counterparts.
The psychiatrists and psychiatric nurses interviewed said that more women were
confident to seek information and treatment for mental illnesses than men. One of
the doctors said:
Women are more confident to seek information and treatment early. Men are
mostly brought when their illnesses are chronic. They never come on their
own. It is rare. Most don’t come on their own.
The responses to the question on what respondents will do to a mentally ill relative
or friend also indicated the level of knowledge and the respondent’s mental health
behavior. Out of the 320 respondents who indicated that they will take their
mentally ill relatives or friends to hospital, 97 were female while 223 were male.
All the 14 respondents who indicated that they will take their mentally ill relatives
or friends to a witchdoctor were male. 8 were aged 15, 5 were aged 16 and 1 was
aged 17. Based on these responses, it is still evident that female students have more
knowledge of mental health than male students. It can also be argued that younger
students are more likely to have negative mental health behavior than older ones.
Data collected from the psychiatrists and psychiatric nurses corroborates the
finding that female respondents are more likely to take their mentally ill relatives to
hospital than men. One of the doctors interviewed said:
What I have seen for many years is that more women bring their mentally ill
relatives to hospital than men. I don’t know whether men are too busy or it is
because of culture.
A nurse added:
Women are the ones who frequently bring their mentally ill relatives to
hospital. They bring their children and even husbands. Men do not bring
patients to hospital. If a man’s wife is mentally ill, she will be brought by
other women relatives. Not her husband. Again many men abandon patients at
the hospital. They never even come to visit them. Women will never abandon
them. They visit them until they recover and then take them home.
Out of the 316 respondents who indicated that they will interact with those who have
been mentally ill but have recovered, 93 were female while 223 were male. Among the
18 who indicated that they will not, 4 were female while 14 were male. 7 were
aged 13, 9 were aged 14 and 2 were aged 15. Unwillingness to interact with those
who were mentally ill but have recovered is part of the discrimination against the
mentally ill. It is a manifestation of stigma.
Further, the data obtained on awareness of mental health communication campaigns
could indicate that female and older students have more knowledge of mental
health than male and younger students. This is because out of the 11, or 3% of the
students who indicated that they were aware of communication campaigns for
mental health, 7 were female and 4 male. Out of the 7 female students, 5 were aged
17 and 2 were 17 and above. Among the male students, 1 indicated that he was 16
years old and 3 were 17 years old. Therefore female students are more likely to
have positive mental health behavior than male students. Similarly, older students
are more likely to have positive mental health behavior than younger students.
Additional evidence of a possibility of female and older students being more
knowledgeable about mental health issues than male and younger students can be
seen from the fact that all the 3 students who indicated that they had attended
communication campaigns for mental health were female. One was aged 17 and
two were aged 17 and above. These responses can also be used to argue that female
and older students are more likely to have positive mental health behavior.
The psychiatrists and psychiatric nurses interviewed also indicated that more
women attended mental health communication campaigns than men. One of the
nurses who had attended the communication campaigns for mental health said:
More women always attend the communication campaigns for mental health
that we conduct at Mathari Hospital. I think it is because they are the most
affected. They might be the ones suffering or their children or husbands. So
they always come to get more information.
The reason why female students could be more knowledgeable about mental health
issues than male students is because women tend to be more vulnerable to mental
illnesses than men. Mirowsky and Ross (1989) say that women experience higher
rates of psychological distress, including anxiety, depression, worry and
demoralization. In a national survey undertaken in 2007, of Australians aged over
16 years, 23% of males and 30% of females aged 16 to 24 years had experienced a
mental disorder in the past 12 months (Slade et al., 2009).
Women’s vulnerability to mental illnesses more than men seems not to be limited
to geographical location or economic status. Patel, Araya, de Lima, Ludermir and
Todd (1999) studied four low- and middle-income countries (Zimbabwe, Chile,
Brazil and India) and found that common mental disorders were significantly
associated with the female gender. Similarly, results from studies in the developed
world indicate that women have on average about a two-fold increased risk for
depression and anxiety disorders over men (Belle & Doucet, 2003; Nolen-
Hoeksema & Keita, 2003).
Since studies indicate that common mental disorders are strongly associated with
poverty and its associated variables of adversity, insecurity, rapid social change,
social exclusion, reduced access to social capital and malnutrition (Lund et al.,
2010; Flisher et al., 2007), and that women are more affected by poverty than men
(Patel & Kleinman, 2003), it can be argued that this is the reason why female
secondary school students in Langata District are more knowledgeable about
mental illnesses than the male students.
Furthermore, the World Health Organization (2002) argues that during adolescence,
girls have a much higher prevalence of depression and eating disorders and engage
more in suicidal ideation and suicide attempts than boys. Boys experience more
problems with anger, engage in high-risk behaviours and commit suicide more
frequently than girls. In general, adolescent girls are more prone to symptoms that are
directed inwardly, while adolescent boys are more prone to act out (WHO, 2002).
In this study, out of the 36 respondents comprising 11% of the respondents who
indicated that they were vulnerable to mental illnesses, 29 were female while 7 were
male. This is also an indication of higher knowledge levels among female respondents
than male respondents concerning who is vulnerable to mental illnesses. It indicates
awareness among the female respondents that the high levels of poverty and other
factors such as insecurity and drug abuse which are more widespread in informal
settlements such as Kibera where most of the respondents were drawn from expose
them more to mental illnesses.
Regarding age as a factor that influences mental health behaviour, data collected
from the psychiatrists and psychiatric nurses interviewed indicated that younger
and middle-aged people are more likely to have positive mental health behavior
than older people. One psychiatrist said that:
Most of the people who attend communication campaigns for mental health
and seek treatment when mentally ill are young. The majority are between 20
to 40 years. They are either in some college, unemployed, self-employed or
working. Young people.
A nurse said:
The majority of our patients are younger people. So they are the ones who ask
more questions about mental illnesses than older people. Even when they are
ill, they come for treatment early. Some make a follow-up until they are
completely healed. Older people patients are not many. The few I have seen
are stubborn and some do not want medicine. They give up easily.
Differences were also seen along gender lines regarding some of the sources of
information about mental health. Whereas all the 334 respondents indicated that family
and friends were their source of information, 218 respondents indicated that their
source of information was teachers. Out of these, 95 were female and 123 male.
Among the 211 who indicated that their source was the media, 45 were female and 166
male. Based on these responses, it could be argued that female students rely on family,
friends and teachers for information on mental health more than male students. On the
other hand, male students rely more on the media for information on mental health than
female students. This information could be useful for mental health communication
campaigners in choosing the medium of communication. Regarding socioeconomic
status as a factor that influences mental health behavior change, the psychiatrists
and psychiatric nurses interviewed said that most of the people who brought their
mentally ill to hospital, followed through with treatment and accepted them back
were those from higher socioeconomic status. One doctor said:
Those who are well off do not even bring their patients to Mathari Hospital.
They take them to private mental health clinics. They also support them until
they recover because they know that mental illnesses are like other forms of
illnesses. Also, the treatment of mental illnesses is expensive. Many poor
people cannot afford the money required for medication. Consequently, they
detain the mentally ill at home, take them to witchdoctors or bring them and
abandon them in here.
