Beloved, I wish above all things that thou mayest prosper and be in health, even as thy soul prospereth 3 John 2

Health care workers are obliged to use the best medical science to relieve suffering and pain, treat illness, and address risks to health. The institutional corruption of health care consists of deviations from these principles. —Donald Light, 2013

Prosper Kudzanai Mushauri

Counselling Psychologist and Mental Health Policy Consultant

The issue of non pharmacological care in Zimbabwe follows ardent best medical science, reason and Constitutional aspirations that are enshrined in the 2013 Constitution of Zimbabwe. Whilst and not withstanding comparisons of mental health with physical health which often have supported and promoted metaphors that likens mental health conditions with physical health to ensure that mental health receive attention mainly in funding as has been done in issues of physical health. It is trite to us that psychological conditions with the nomenclature such as schizophrenia, depression, ADHD, anxiety amongst others are without a known pathophysiological basis and even drugs which seek to address these conditions are also working without a known mechanism of action. Hence being guided with such understanding we stand guided within the context of Zimbabwe not to confine the practice of mental health only to biological essentialism which to this day has on its own failed to give plausible aetiology and treatment of psychological distress. Following the scientific arguments of Szasz in the Myth of Mental illness we agree that psychological challenges are diseases of Macbeth and non medical approaches such as psychological approaches should be sought so that the patient might “therefore minister to himself” in a way that comports to the ethical mores of psychological praxis.

As health workers in Zimbabwe, we are obliged to make use of the best medical science to relieve suffering and pain (Light, 2013).  The science from longitudinal studies from studies by Martin Harrow show a compelling story, that over a period of two years or more non-medicated persons living with psychosis have better outcomes than medicated persons living with psychosis. It is from such sound studies and others such as the outcomes from the Open Dialogue in Finland and the Soteria House formerly by Loren Mosher and now in states like California that we have followed the science in non-pharmaceutical care and with this science we are compelled to follow as we comport to the ethical mores of client beneficence in mental health Issues.

Following detailed science as found in the various accounts of prominent researchers such as Professor Joanna Moncrieff, that the psychiatric drugs work from a drug model approach rather than a disease model approach. Following Dr Peter Breggin’s detailed scientific accounts on the effects of drugs including in matters which he on his capacity acted as a expert witness in American jurisdiction. And taking note of the admission of the DSM 5 chair in 2013 that the classification manual which is the basis of pharmacological care, lacked both validity and reliability in diagnosis we are bound therefore to seek alternative care which is professional and does not result in Iatrogenic injury. We also take note that DSM 5 has included in its publication a section of neurological damages which can result as from use of psychiatric medication, hence in this approach which is non pharmacological we wish to avoid irreversible injuries such as tardive dyskinesia as we help persons living with psychosis in Zimbabwe. 

In line with our Constitution in Zimbabwe which came into effect in 2013, we follow non pharmacological care as a way to expand choices of mental health services from just pharmacological care and increase accessibility of mental health care to persons defined in our constitution as persons with mental disabilities Section 22(1) to treat them with respect and dignity 22(2) to minimize damages suffered by them. We therefore find non pharmaceutical care as in tandem with this section as it is non coercive in its treatment and more so it also comports to the Universal Declaration of rights of persons living with psychological difficulties.

For more information kindly email me on pkvamushauri@gmail.com