Sunday Times 2
Are we waiting for more tragedies to recognise the importance of mental health?
Many would have been shocked and horrified to hear the chilling details given at the press conference by the prosecutor in Marsilles, France on what had taken place in the last few minutes of the Germanwings Air Bus flight 4U9525 – a regular flight from Barcelona to Dusseldorf before it was allegedly deliberately crashed by the co-pilot on the Alps. It is difficult to comprehend why a 28-year-old co-pilot would lock out the pilot and crash the aircraft, deliberately ending the lives of 150 innocent unsuspecting people.
Immediately and justifiably, experts including aviation psychologists have started talking about the mental state of the co-pilot and about previous occasions where pilots deliberately crashed commercial planes, presumably because of disturbances in their mental states. Such instances are rare and already reference has been made to deliberate crashes of Egyptian, Mozambique and Indonesian pilots. It may be dangerous and premature to find out what went wrong in the Alps crash but I would like to bring up a few issues needing attention and discussion in all segments of society and especially among those responsible for public safety and individual care.
We are familiar with situations where the primary objective of the person in question is harming others and during the process the individual concerned also dies. Suicide bombers, various hold-ups and Hara Kiri by Japanese during the war are well known examples. Such people are known to have their thinking, beliefs, motives and behaviour focused towards the realisation of a particular goal even at the expense of their own lives. Such people are unlikely to be suffering from a recognised mental illness although some of them have could be identified as having what are called personality disorders.
There are others whose primary aim is ending life because of the serious mental distress often associated with mental illness and very serious life difficulties. We are familiar with occasional press reports of parents committing suicide with their children. I will never forget the chilling description of a colleague of mine, a medical specialist in the UK who found his 11-year-old son and the wife, an accountant, dead, having taken an overdose of drugs in their own bedroom while he was away at work.
Most people underestimate the extent of distress in a person suffering from serious depression. Over a million people commit suicide annually in the world. Many of these people could be helped if adequate steps such as early recognition, support and treatment is extended at the correct time.
Another group of people are prone to accidents as a result of impairment in their mental state resulting in difficulties in concentration, short attention span, distorted perception, impaired judgement, slow reflex action and behaviour. If such a person takes control of others’ lives even briefly such as in the case of drivers and pilots, the consequences could be disastrous in the event of a mistake. We often hear of such instances where drunken drivers are responsible for fatal accidents. Some of them are in a deliberately-induced state of mental disturbance as a result of taking prescription drugs such as pychotropics or dependence producing drugs such as alcohol.
I have had a few experiences in which commercial aircraft pilots in Sri Lanka consulted me with problems related to alcohol abuse, mental illness and other anxiety-provoking conditions. These have been extremely difficult situations for me both professionally and personally as I had to respect the confidentiality, privacy and doctor-patient relationships while ensuring public safety.
We as a nation need to openly discuss these issues and try to understand the importance of mental health in individuals, and in communities to prevent such horrific disasters and promote the health of people. The help seeking behaviour of people in Sri Lanka is changing very rapidly. Increasingly in Sri Lanka many people from all levels of the society and from all age groups seek help from mental health professionals. It is unfortunate that the mental health system has not been adequately responsive to emerging mental health issues at professional, service development and regulatory levels.
It is the responsibility of people, all agencies including the government and media to promote an open discussion on the subject of mental health rather than delegating this important area of health as has been done traditionally to Angoda. Mental health problems cause serious distress, disability and death to self and others. Mental health problems also prevent realising the potential of the individual. Early recognition, treatment and care will preserve and improve their lives and those of the community.