I have a friend with a mental illness. Where do you take a mental health conversation once I’ve opened with, “How are you feeling?”
It really depends on what answer you are given by your friend.
The answers might range from ‘Why do you want to know how I am,’ to ‘I feel depressed and suicidal and I am on my way to see my psychiatrist who, for the past 10 years has enabled me to navigate the bipolar mood disorder that I have suffered from since late adolescence’.
Other possible answers might be ‘Thank you for asking and how are you doing yourself’.
Your friend with a mental illness might himself have noticed that in the last few days, you have taken a too keen an interest in his mental state and might have concluded that he is not the one with “problems” but rather you are the disturbed one.
You simply cannot predict where this conversation could head to.
Over the past 10 years or so, Kenya has witnessed a rapid change in mental health literacy and among young people, the stigma of discussing mental health is rapidly declining.
Many factors have led to this positive trend, and in my experience, the young are mostly miles ahead of their parents.
About a year ago, just as the Covid-19 crisis was coming to an end, we saw a 17-year-old boy who asked us to evaluate him for Attention Deficit Hyperactivity Disorder (ADHD).
Asked what made him think he might have the condition; he explained the events that had led to his self-referral to us.
He told us that he knew he was a clever boy in part because of his stellar performance in primary school but also because he came top of his class in those subjects like math which did not require much reading and found history and literature most boring because one had to read and concentrate for long periods of time, and so he did badly in those subjects.
His ability to concentrate was a major problem as his mind kept wandering off.
During the pandemic, he had spent much of his time googling the various conditions that might explain this type of class performance and ADHD kept coming up as a possibility.
At first, he discussed it with his mother who told him that mental conditions of that type belonged to non-believers, and she promised to pray for his healing.
His father was even more direct telling him that he was a lazy boy who only needed to pay more attention to his class work, play less and respect adults more.
He also told the young man that he used to be the same and had taken “charge of his life by being a man.”
His class teacher had saved the day. She had noticed that on some days our patient could concentrate and do well in some subjects and in others his work was rushed, untidy and full of silly mistakes.
After several weeks of back and forth between the school, parents and the affected boy, was adequately treated.
After receiving the answer to the question “How are you”, you should be ready to proceed with the consequences of your concerns about the mental welfare of your friend.
I will presume that in asking the question you had specific reasons for the concern expressed and you should be ready to respond accordingly.
The good news in Kenya is that our mental health agenda is on track and if you mean well for your friend, it should not be too difficult for you to express genuine concern about their mental wellbeing.
