In countries experiencing the frontline effects of climate change, the COVID-19 pandemic has contributed to ever-increasing needs for mental health support, exacerbating the impacts of financial and food insecurity. The national provision of these services in Benin, however, is inadequate to treat the population, yet stigmatisation remains a barrier to rethinking current practices.
At a time when the mental health impacts of both COVID-19 and climate change are becoming increasingly recognised worldwide, it is striking to observe a lack of conversation on the issue in Benin, West Africa – a country impacted by national pandemic mitigation measures and a transforming natural environment. The United Nations High Commissioner for Refugees (UNHCR) has criticised the lack of psychiatric centres in the country given mental health support needs, despite the government and organisations, such as Elle-Fille-Femmes, offering opportunities to discuss mental health provisions. It is estimated that there are no more than 13 psychiatrists and six highly trained psychologists in the country, supplied by a significant number of traditional practitioners and religious leaders for nearly 12 million people.
Pressure to address mental health services in Benin has been forthcoming from psychiatrists, mental health practitioners themselves and non-governmental organisations, with or without direct religious affiliations. Stigmatisation of mental health issues is perceived by practioners as preventing the issue from receiving more general and specialised attention.
For many years, the CNHU (Centre National Hospitalier Universitaire) was the country’s primary institutionalised mental health service provider. Today, three public centres provide mental health services to the population: two in Cotonou (South: CNHU-Hubert K. Maga and CNHU-Psychiatrique of Cotonou) and one in Parakou (North Benin: Centre Hospitalier Universitaire Départemental du Borgou CHUD/B). These institutions are supported by various private providers such as religious institutions, NGOs and traditional practitioners and are more present in urban areas.
The impact of COVID-19 in Benin
Isolation, the economic burdens of lockdown and other mitigation strategies to address COVID-19 in Benin have had serious mental health impacts. Despite divergent effects across spaces, the socioeconomic impacts have been direct and indirect and, sometimes, paradoxical. Pandemic containment measures decreased local market activities and cross-border movements, including trade with other West African countries, and turnover in micro, small and medium enterprises/industries fell an average of 53%. Additionally, a report by the UNDP demonstrated that COVID-19 caused a loss of earnings for many families, increasing difficulties to meet their needs (rent, food, education and bills). While some institutions have congratulated Benin for its economic prowess compared to other African countries, many Beninese have asked for more action to improve social life beyond the numbers.
Climate change, armywarms and food security
In June 2021, staple food prices surged and armyworm moths ravaged many farms. The government blamed the lack of rain. In contrast, Professor Michel Boko focused the debate on better food planning, arguing that a lack of rainfall in early 2021 could not justify increased prices by June. He stated that the creation of food banks like the Office National de Sécurité Alimentaire (ONASA) or the National Office for Food Security would help manage similar situations as it had done in the past. But the ONASA was dismantled in 2016 by Patrice Talon’s government, possibly for mismanagement issues. The population complained about the price surge and asked for authorisation to protest – as is the process – which the government denied.
Farmers in the country were already impacted by changes in weather patterns, confronted with irregular rainy seasons with drought ‘pockets’ and short, abundant rainfalls. The combination of these factors fails to provide farmers sufficient water when needed, or otherwise an excess for short periods. The challenges associated with changes in weather patterns, along with deficient food planning, have created perfect conditions for despair, stress and anxiety among many Beninese.
Talking about mental health
Despite debates over the significance of COVID-19 and seasonal climate changes, as well as socioeconomic damages and the price of essential goods, a conversation about mental, psychological and psychiatric effects is barely heard in the country. Implicitly, social networks, family, friends, religious leaders and to some extent mental health specialists are playing an important role in supporting mental health, but the scale of the challenges means these efforts do not go far enough.
There is a need to refocus how Benin thinks about this aspect of public health, incorporating its provision into primary healthcare and encouraging conversations that lead to support, especially for those who might not show outward signs of need and feel unable to reach out to their surrounding social structure. Indeed, many people remain suspicious of approaching mental health specialists. The system should be rethought to go beyond putting homeless and mentally disabled people in psychiatric centres. Crucially, mental health support, access and resources should be expanded and destigmatisation processes should be supported, with quick and accessible training provided to local populations who can apply methods to their network directly. With the effects of the pandemic ongoing, and the climate emergency receiving more attention, a strategy for dealing with mental health could be within reach.
Photo by Joseph Keyser on Unsplash, taken in Benin.