One in four people will suffer a mental illness, but will they all get the care and treatment they need?
Victoria Baux has spent most of her life abroad.
She wonders whether her travels were a way of dealing with a difficult family problem.
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Her mother, Ann, was diagnosed with depression at the age of 39. But she had been unwell for a long time before that and her illness had taken a heavy toll on the entire family.
Victoria also has friends who suffer from some form of mental illness. And she recently discovered that many people she has met have also struggled with it, often without her even noticing.
This motivated her to embark on a journey: she wanted to learn about the best ways to help those suffering from mental illness, as well as their families and friends, who shoulder so much of the burden.
In doing so, she hopes to make peace with her own family history – and her mother.
How I discovered mental health activism
I’ve always been completely aware of my luck. The fact that for years I was unable to fully enjoy it is probably what led me to journalism.
At a young age, I witnessed extreme poverty in the countries where I grew up – Madagascar, Cote d’Ivoire and Gabon – but I had everything I needed, and more.
My father had left France in the late 1960s to work in the development economy sector and spent 30 years abroad, mostly in Cote d’Ivoire. In a country where many people lived on one meal a day, I was driven to school by a chauffeur and spent my weekends at the beach.
I hate to say it, because it has always made me feel guilty, but we had an easy life.
That was, in all regards but one; for our material comfort could do little to ease the invisible pain of my mother’s depression.
It was only when I had my own children, and discovered that I didn’t have the tools I needed to be a good mother, that I realised how much of a toll it had exacted upon me.
My first memories
One of the clearest memories of my childhood is of my mother’s breakfasts in bed. Getting out of bed was simply too hard for her.
I don’t remember her playing games with me. She had to carefully manage her energy.
I could see that she was different to the other expat mums, most of whom seemed to put their children at the centre of their lives, and that bothered me, a lot.
My mother never seemed to be able to get enough attention. Of course, I know now that all she really needed was care.
The way I felt about myself, my own sense of psychological balance, was linked to her and the opinion people had of her – and, let’s be frank, they couldn’t stand her. She had an amazing lifestyle and her neediness was perceived as shocking narcissism at a time when she had a big family to care for.
Her illness worsened when we moved to France, leaving my father behind in Africa. Suddenly, she was alone with two children – aged six and 10. She found it even harder to get up in the morning, to take my younger sister to school, to cook a meal. Luckily, the French do great frozen food and there was Heartbreak High on TV.
Of course, I wasn’t the only one affected by her illness – there was my father, my sister, my three stepsisters and her. A family of seven trapped in a situation they couldn’t control – each of us being slowly eroded by it. My mother’s depression was the elephant in the room: we all dealt with it in our own way and we never talked about it.
My mother and I grew further apart. As a teenager, I resented her for the loneliness I felt and for driving family members away from each other.
Of course, none of this was actually her fault. But, for many years, I believed it was.
And, the worse thing about it all was that as her behaviour chipped away at our lives, none of us had a clue that she had an actual illness. We’d never even heard of the word ‘depression’ before.
She was only diagnosed at the age of 39. It took a while to identify the right cure for her, a combination of psychoanalysis and antidepressants, but she eventually got better. Little by little, we started discovering who she really was behind the veil of depression that had concealed her personality for years – an extremely intelligent woman with a great open mind and a genuine interest others.
In truth, we, her family, didn’t really help in her recovery. She did that alone.
Building rage and making a film
My mother wasn’t the most severe case I knew of.
One of my best friends has a strong form of bipolar disorder. She is a talented artist but her illness always gets in the way of her professional fulfilment. This year, she has already been admitted to hospital twice on her own initiative – she simply felt safer there than in the outside world.
Her life should be completely different. But it isn’t, and she is left to wonder whether she will ever be happy, as we, her friends, question the extent to which we should be monitoring her and maybe even controlling who she sees.
A few months ago, I grew so enraged with my friend’s plight and so tired of asking myself over and over what I could do to break the vicious cycle and improve my relationship with my mother, that I decided to use the medium I’m most familiar with to go in search of answers.
Beyond my own personal story, I wanted to learn about how readily accessible treatment is for those suffering from mental illnesses in different parts of the world. The figures did not look good.
According to Professor Graham Thornicroft, a professor of Community Psychiatry at King’s College, London, in the majority of countries, less than two percent of health funding goes toward mental healthcare.
Worldwide, more than 800,000 people commit suicide every year. That is one suicide almost every 40 seconds.
And the economic cost of mental illness is high – in many Western countries, it is the leading cause of disability and costs some three percent of GDP.
Filming the strong in Paris
My journey started in Paris, with my mother.
Although she was the starting point for this film and crucial to making it, I dreaded asking her and secretly hoped she’d decline when I did. But she immediately said yes.
For the first time, she was being what I’d always expected her to be – stronger than me.
Other people I spoke to for the film made me realise how important it is to talk about mental illness, beginning within the family.
Compared to other industrialised countries, France hasn’t been able to create a very inclusive environment for the mentally ill. Medication is often the only form of treatment offered to those with severe psychological illnesses in France.
But a well-known French psychiatrist, Dr Christian Gay, who specialises in treating bipolar disorders, explained to me that medication could only treat the “biological” component of an illness. Other forms of therapy and having a good social life were vital to a full recovery, he said.
The Club House is an organisation that started in the US. It supports the mentally ill whose professional lives have been disrupted by their disorder, via local community centres where they can gather and participate in a wide range of activities. This kind of initiative isn’t widespread in France but it’s starting to exist. There is now one Clubhouse in Paris, run by people – doctors, academics and professionals from different backgrounds – who I choose to call “mental health activists”.
“People think that if you have a mental illness, you can’t work,” Claire Hatala, one of the founders, told me. She has dedicated her work as a sociologist to improving working conditions for the mentally ill, while also ensuring that companies benefit from those improvements.
“I met people who struck me a lot. They told me about their illness and how it was for them at work. I was very touched by them,” she explained. “The way they saw their work life pushed me to ask how the professional world could become more inclusive …. What can we do so people take these issues seriously, even though they are not ergonomic or technology related? That’s how I joined a charity where big CEOs were discussing special needs at work, and how companies could use this as a strategic lever.”
I spoke to at least three people for this film that had suffered a severe mental illness but still worked. Among them was Florent Babillote, who was diagnosed with schizophrenia when he was 20 years old. His story finally gave me a little bit of hope.
On the day he found out that he had schizophrenia – after violently attacking his father, as he had convinced himself that he had another family in Brazil – he thought his life was over.
But, after years of concealing his illness, he eventually wrote a book about it: winning his battle against the disease and the stigma surrounding it. He had turned schizophrenia into a creative strength.
I left France feeling reassured that, even if there was still a lot to do, especially in rural areas, the country was moving in the right direction; embracing new forms of therapy and treatments, like mindfulness, which Dr Gay now practices in his office.
A slap in the face in Cote d’Ivoire
On the flight to Abidjan, I felt a mixture of stress and excitement. I hadn’t been back since 2008, when the country was still entangled in a 10 year long political crisis. The election of a new president after years of dictatorship had transformed the country for the better.
At the Deux Plateaux district, Abidjan’s little Manhattan, we met Professeur Delafosse, the man in charge of the National Mental Health Programme. He elaborated on the different cultural approaches to mental health in Europe and Africa, and assured us that Cote d’Ivoire was on the right track.
But what we found on the ground wasn’t what he had described.
We drove a few hours inland, to Bouaké. We had arranged to spend the week with Grégoire Ahongbonon, a man from Benin who launched a small NGO, the Association Saint Camille, to help those who had been rejected by their families and society in general. He calls them “the Forgotten” – most of them suffer from the most severe forms of mental disorders, but there are also some with epilepsy.
Grégoire is a devout man who suffered depression after losing his business in the early 1980s. He was, he says, saved by a priest who took him on a pilgrimage to Jerusalem. Religion plays an important role in the Association, which doesn’t get any funding from the Ivorian government or public organisations. It relies on donations and charities. Grégoire’s recruits and helpers are all Christian believers and the small clinic we visited, a few hours’ drive from Bouaké, is run by nuns.
Grégoire has made himself known through parts of Cote d’Ivoire, Benin and Togo for rescuing mentally ill people who’ve been put in chains by their families. He is the only recourse for hundreds of people with mental disabilities.
We followed him on two rescue missions. One woman, Amenan, was sleeping on the dusty ground, her right ankle tied to a tree. When we took her with us, after Grégoire summoned the whole village and explained that her illness could be cured, she expressed no feelings at all. No joy, gratitude or relief. She was with us physically, but not mentally.
The other woman, Loukou, displayed the same emptiness in her eyes when Grégoire freed her. Her brother told us that he hadn’t known what option he had other than tying her to a rock, after she’d become violent and even burned down the house he’d built for her.
Putting a sick person in chains is unforgiveable, but I felt compassion for this poor man all the same.
In Cote d’Ivoire, many people turn to sects to solve their problems – it can be a lucrative business.
Some run prayer camps; places where overwhelmed families send their mentally ill relative to be prayed upon while tied to a tree.
This can go on for weeks, months, years even. I met many people who’d been through one before they were eventually rescued by Grégoire. It seemed to be the norm.
My last striking memory from our stay in Africa was the children of mentally ill women who lived inside the St Camille’s shelter.
The crew and I were the best entertainment they’d had in a long time. They kept asking us to take pictures of them and I felt we were their only window on the world.
They were happy and bubbly but I wonder how they will be dealing with their mothers’ disorder and their own lives as adults.
The beginning of another journey
I met again with my mother in her cosy Parisian apartment. The contrast with Africa was incredible and my guilt star was shining bright and strong right above my head. It was no great revelation that my problems were insignificant compared to the difficulties faced by the people I’d met, but still, when I showed my mother the pictures I took in Bouaké, something clicked in my mind. It had taken a while, but I had finally started to feel empathy for her and shame at myself. It had taken all this time ….
I realise that, for somebody who has never witnessed a parent falling into depression, it must be difficult to understand how I could resent her in the first place – she was sick and just needed help. But my own suffering had blinded me.
And now the story had grown much bigger. It was no longer about me and my mother, but about me and mental illness in general.
After Paris we travelled to London, where we met Graham Thornicroft, a professor of Community Psychiatry at King’s College, London. He confirmed what Grégoire had hinted at – mental health is not given a high enough priority globally and people die unnecessarily because of this.
He called it a “scandal” and stressed that it should be included in the UN’s sustainable development goals, which would, he believes, encourage governments and well-funded international organisations to invest in mental health, as they did with Aids and Tuberculosis in Africa. Since our meeting, the World Health Organisation and the World Bank have announced that they will be co-hosting a meeting on global mental health, which will look, in particular, into depression and anxiety.
This film is just a small contribution to, hopefully, changing attitudes towards mental illness. We found out while making it that one in four people in the world will suffer a mental illness in their lifetime. It is a reality we can no longer ignore, a public health matter that needs to be addressed urgently, worldwide.