Thursday, February 20, 2014

Mentally ill deserve equal job opportunities

By Lukoye Atwoli
Sunday Nation 02 February 2014

Last week there were numerous newspaper reports about a mentally ill doctor being nominated and interviewed for a top post in a county government. While most reports were factual and reported events as they actually happened, some were outright sensational and insulting both to the candidate and mentally ill people in general.

One newspaper headlined the story using the term “mad doctor”, while another referred to a previous case in which the doctor was alleged to have killed someone during an episode of illness. Almost all the stories had an incredulous tone, expressing surprise that a mentally ill individual could be nominated for such a post in a county government.

But what are the facts?

Mental illness can only be diagnosed by a qualified professional after taking a detailed history of the patient, and a physical and mental state examination. In many cases, investigations have to be carried out to establish the exact cause of the symptoms and, in some instances, physical causes are identified and treated, eliminating the mental illness totally.

Many people with mental illnesses are unaware of this fact, and continue to suffer from serious symptoms without knowing that they can be assisted to live a happier, healthier life. These “silent sufferers” are to be found at all echelons of society, from the poorest community to the most affluent groups. It follows, therefore, that even at the top levels of our many governments it is possible that some leaders are mentally ill but are unaware of this fact.

Most people think that mental illness is so obvious that it is easy to identify an individual suffering from such an illness. Unfortunately this is not the case. Mental illnesses run the entire gamut of human experience, from mild forms of anxiety disorders through moderately severe depressive episodes to the more obvious psychotic episodes that many identify with the term “madman”. It is, therefore, unfair to target an individual and label them negatively simply because they suffered a severe episode of mental illness and displayed their symptoms in public.

Obviously we need to articulate a policy on employment for people with mental illnesses. Such a policy must be careful to avoid falling short of the constitutional injunction against discrimination on the basis of one’s health status. Such a policy may prescribe, for instance, that a person suffering from mental illness is entitled to equal opportunity when seeking employment based on their ability and experience.

The only caveat that may be employed is that such a person must produce evidence of continued treatment and follow-up by a mental health specialist in order to ensure that their mental illness does not interfere with their work. This would mean that even after employment, should an employee develop a mental illness, they would be entitled to receive treatment and continue working once the treating physician gives the green light. Assuming that one is unable to work by virtue of having a mental illness is abusive, discriminatory and downright inhuman.

Should we decide that people with mental illnesses should not occupy certain posts in government or elsewhere, we must begin by conducting a mental status evaluation of everyone in those positions to ensure that they do not have a mental illness that interferes with the execution of their duties.

Only after doing this would we be justified to lock out any fresh applicants with mental illness. 

Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine.

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