Monday, 28 October 2013

Mental health training in Somaliland - Day 32

Tuesday 22nd October

The first day of teaching sixty-eight fifth year medical students! We meet early to prepare the room and get ready for the students. This is an exciting, though slightly daunting, day. We are all aware just how many medical students we will have to manage during the next two weeks and though we have been planning for a long time, we hope things go smoothly. Today is about introducing the students  to psychiatry and mental illness, and setting the scene for the next two weeks. We ask the students to all write down a case of mental illness they have seen. Most of them recall cases of psychosis, which is the usual pattern and perhaps unsurprising as many of them have witnessed people with acute psychosis on the streets at some point. 

It is fascinating to hear the beliefs surrounding mental illness that the students voice. Many are scared of people they feel are ‘mad,’ others say that as children they felt that all people with psychosis were ‘killers’ and some admit that as children they would throw stones at people who were mentally unwell. They agree that many people with psychotic symptoms are thought to harbor ‘djinn’ or ‘evil eye’ and as such are ostracized from their communities, as are their families. We suggest that they keep in mind these beliefs as the two weeks progresses, and to think about whether these have changed or not during the time of teaching, and meeting people with mental illness. We take time today to talk about professionalism- as this is an important part of the teaching we offer. We also teach on communication skills, in preparation for students meeting patients and also trying to do psychiatry OSCE’s. The class is large, though we are impressed with their interaction and participation.