AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN

YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

1.0 Background and Introduction.

Substance-induced psychosis (SIP) is a growing concern among young people worldwide,

including Zimbabwe. SIP refers to a condition where an individual experiences psychotic
symptoms, such as hallucinations and delusions, as a result of using substances like cannabis,
methamphetamine, and cocaine. The condition can have severe consequences on an individual's
mental health, social relationships, and overall well-being.

In Zimbabwe, the prevalence of substance abuse among young people is alarming. According to
a report by the Zimbabwe National Statistics Agency (ZIMSTAT), in 2019, 23.4% of young
people aged 15-24 years reported using cannabis, while 12.6% reported using other illicit
substances. The report also noted that substance abuse was more prevalent among young people
in rural areas, where access to healthcare services is limited.

Sally Mugabe Primary School, located in the Agricultural Production area, is one such rural
setting where young people may be vulnerable to substance abuse and SIP. The school's
proximity to agricultural production areas may expose young people to substances like cannabis,
which is often grown in these areas.

Despite the growing concern about SIP among young people, there is limited research on how
national health services respond to this condition in Zimbabwe. The few studies that exist have
highlighted the need for improved mental health services, including early intervention and
treatment programs for SIP.

This study aims to analyze the national health services' response to SIP in young people aged 16
to 25 at Sally Mugabe Primary School. The study will explore the following research questions:

- What are the experiences of young people with SIP at Sally Mugabe Primary School?

- How do national health services respond to SIP in young people at Sally Mugabe Primary
School?
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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

- What are the challenges and opportunities for improving national health services' response to
SIP in young people at Sally Mugabe Primary School?

By exploring these research questions, this study aims to contribute to the development of
effective interventions and policies that address SIP among young people in Zimbabwe.

Substance-Induced Psychosis (also known as drug-induced psychosis) causes a variety of

symptoms that are common in mental disorders; it is psychosis that is linked to substance use
(NDARC 2019). Ganti et al. (2016) define psychosis as impaired perception of reality
accompanied by delusions, perceptual disturbances (illusions or hallucinations), and/or
disorganized thinking/behavior. The psychotic features are thought to be a direct physiological
effect of a drug of abuse, medication, or toxin exposure, and can occur during intoxication,
exposure, or withdrawal.

Substance use disorders are widespread and appear to be more prevalent now than in the past,
owing to increased availability. According to the DSM-V, 7 to 25% of patients who present with
mental illness have SIPD as a result of substance or medication misuse (American Psychiatric
Association, 2020). Globally, alcohol and illicit drug use cause 39 deaths per 100,000 people,
with alcohol causing 35 deaths and illicit drug use causing four. Illicit drug and alcohol use
accounts for 13 disability-ad nojusted life years (DALYs) lost per 1000 population worldwide
(WHO 2019); the disorder is more common in men, younger people, and those with low income.
SIPD affects two to three men for every woman, depending on age of onset. Other individuals
prone to alcoholism are those with mood and anxiety disorders those, those with antisocial
personality disorder, those with a gambling disorder and those who use tobacco. In Zambia
alcohol and illicit drug misuse has been on an increase according to WHO 2010 the 12-month
prevalence, percentage estimates in 2004 for alcohol use disorders for females aged 15 years and
above was 0.16% while that for males was 1.47% and Prevalence estimates for drug use
disorders for females (15+ years) was 0.17% while that for males was 0.53%. The prevalence of
cannabis use among the age group between 15 and 64 years was 17.7% for the year 2003 (WHO
2010). SIPD affects two to three men for every woman, and the onset age ranges from 16 to 3
years. Although medical complications progress more quickly in women, men appear to have an

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

earlier onset. Certain occupations, such as bartenders, construction workers, and writers, make
people more prone to alcohol use disorders.

1.1 Problem statement.

Despite the growing concern about substance-induced psychosis (SIP) among young people in
Zimbabwe, the national health services' response to this condition remains inadequate,
particularly in rural areas such as Agricultural Production. The lack of effective interventions and
policies to address SIP among young people aged 16 to 25 at Sally Mugabe Primary School
poses a significant threat to their mental health, social relationships, and overall well-being.
Therefore, this study seeks to investigate the national health services' response to SIP in young
people aged 16 to 25 at Sally Mugabe Primary School, with a view to identifying the challenges
and opportunities for improving the response to this condition."

1.2 Purpose of the study

The continued rise in drug and alcohol abuse among Zimbabwean youths poses a challenge,
raising concerns about the type of preventive measures put in place to combat the vice.
According to some field observations, drug and alcohol abuse in Sally Mugabe is becoming an
epidemic, owing to a lack of attention (Masiye & Ndhlovu 2016). There is little available
information regarding SIPD and substance abuse prevention policies used in Sally Mugabe's
communities, so this research study is being conducted to fill this knowledge gap. It is hoped that
the findings of the research study will provide the necessary information to youths, parents, and
the nation at large. . Furthermore, the study aims to provide useful information that will assist
health care providers as well as serve as a reference point for other researchers. It will assist
policymakers in developing and implementing policies or laws relating to psychotropic
substance misuse among youths not only in Mbare, but throughout Zimbabwe, with the goal of
reducing arbitrary drug and alcohol use to its lowest levels. The study's findings will also assist
the GRZ and other critical partners (for example, NGOs) in developing more effective
rehabilitation programs and more mental facilities for substance abusers and mental patients,

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

respectively. Furthermore, very few research studies on substance-induced psychosis have been
conducted in Zimbabwe; thus, this study will be a valuable contributing to the body of
knowledge on the increase in prevalence of substance induced psychosis in our communities.

1.3 significance of the study

This study is significant because it will contribute to the development of effective interventions
and policies that address substance-induced psychosis (SIP) among young people in Zimbabwe
(WHO, 2018). The findings of this study will inform the development of targeted interventions
and programs that address the unique needs of young people with SIP in rural areas, where
access to healthcare services is limited (Mugweni et al., 2017). Furthermore, this study will
provide insights into the challenges and opportunities for improving the national health services'
response to SIP in young people, which is essential for promoting mental health and well-being
among this population (Kabiru et al., 2018). By addressing the research gap on SIP among young
people in Zimbabwe, this study will contribute to the existing body of knowledge on this topic
and inform policy decisions and advocacy efforts aimed at promoting mental health and well-
being among young people (UNICEF, 2020).

1.4 Research Objective

General objective.

The aim of this research study was to determine the prevalence of substance induced
psychosis at Sally Mugabe among youths aged between 16yrs to 25yrs admitted at the
school between January 2015 to December 2020 in order to fill the gap and establish why
there is an increase in the number of substance induced psychosis admission in the area
compared to the other districts in the province.

Specific objectives.

 To identity which age group is mostly affected with substance induced psychosis?
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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

 To identify which year had the highest prevalence of substance-induced

psychosis and it's effect on agriculture
 To identify the occupations of patients mostly affected.
 To determine which gender was mostly affected in each year under study and
HIV status of affected individuals
1.5 Research Questions.
 What age group is mostly affected with substance-induced psychosis?
 Which year had the highest prevalence of substance-induced psychosis?
 What are the occupations of patients admitted with substance-induced
psychosis for the period under study?
 Which gender was mostly affected with substance-induced psychosis for the
period under study and their HIV status?
1.6 hypothesis

H1 Factors contributing to substance induced psychosis significantly affect young people aged
16 to 25 on agricultural production

H0 Factors contributing to substance induced psychosis do not affect young people aged 16 to 25
at Sally Mugabe on agriculture

1.7 variables

Psychosis appears to result from a complex combination of genetic risk, differences in brain
development, and exposure to stressors or trauma. Psychosis may be a symptom of a mental
illness, such as schizophrenia, bipolar disorder, or severe depression. One of the most significant
preventable risk factors for psychosis is drug use. The amount and type of drug required to
trigger a substance-induced psychosis can vary between individual cases. Hallucinogens (LSD,
mushrooms), and amphetamine drugs (cocaine, MDMA, ecstasy) all raise your risk for a
psychotic episode

1.8. Research and Evaluation

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

Research conducted in the community has shown that mental health issues are prevalent among
individuals of all ages, genders, and socioeconomic backgrounds. A study by Smith et al. (2018)
found that 1 in 5 adults in the community reported experiencing a mental health disorder in the
past year, with depression being the most common issue. The study also highlighted the lack of
access to mental health services, long waiting times, and limited resources as significant barriers
to seeking help.

1.9 Intervention

In response to the growing mental health crisis in the community, various interventions have
been implemented to address the issue. One such intervention is the establishment of a mental
health clinic within the community health center, providing accessible and affordable mental
health services to residents. The clinic offers individual and group therapy, medication
management, crisis intervention, and referrals to specialized services.

1.10 Multi-professional work

Multi-professional collaboration is essential in addressing complex social problems related to

mental health. Social workers, psychologists, psychiatrists, nurses, and other professionals work
together to provide comprehensive care and support to individuals with mental health issues.
Collaboration between different professionals ensures that individuals receive holistic care that
addresses their physical, emotional, and social needs.

1.11 Community involvement

The community plays a crucial role in addressing mental health issues and supporting individuals
in need. Community organizations, religious institutions, schools, and businesses have come

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

together to raise awareness about mental health, reduce stigma, and provide support to
individuals and families affected by mental health issues. Community members volunteer their
time, resources, and expertise to organize events, workshops, and support groups to promote
mental health and well-being.

1.12 abbreviations

DEC......................................Drug Enforcement Commission

DSM-IV-TR......................... Diagnostic and Statistical Manual of Mental Disorders Fourth

Edition, Text Revision DSM V..................................Diagnostic and Statistical Manual of Mental

Disorders, Fifth Edition FBO.......................................Faith Based Organization

FEP........................................First-episode psychosis

GRZ.......................................Government Republic of Zimbabwe

MoGE....................................Ministry of General Education

MoH.......................................Ministry of Health

MDMA..................................Methylenedioxy-methamphetamine

NDARC.................................National Drug and Alcohol Research Centre

NGO.......................................Non-Governmental Organization

SIPD.......................................Substance Induced Psychotic Disorder

UN..........................................United Nation

USA........................................United States of America

WHO......................................World Health Organization

YLD.......................................Year Lived with Disability ZNPHI....................................Zambia

Nation Public Health Institute

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

1.13 definition of key terms

Psychosis: The term describes distorted perception of reality accompanied by delusions,

disorganized thinking or behavior and perceptual disturbances such as illusions or hallucinations.
Psychosis can be a symptom of schizophrenia, mania, depression, delirium, and dementia, and it
can be substance or medication-induced. (Ganti et al., 2016

Delusions: Are fixed, false beliefs that remain despite evidence to the contrary and cannot be
accounted for by the cultural background of the individual. (Ganti et al., 2016).

First Episode of Psychosis or Brief Psychotic Disorder: Patient presenting with psychotic
symptoms for the first time in their lives lasting for 1 month followed by a full return to
premorbid state of functioning in most of the patients. It mostly occurs following extreme stress
such as bereavement, sexual assault, etc. (Ganti et al., 2016).

Prevalence: Proportion of a particular population found to be affected by a medical condition

(typically a disease or risk factor such as smoking) at a specific time.

Population: number people in a city or town, region, country or world; population is usually
determined by a process called census.

Illusion: Misinterpretation of an existing sensory stimulus (such as mistaking a shadow for a

cat). (Ganti et al., 2016).

Hallucination: Sensory perception without an actual external stimulus. (Ganti et al., 2016).
Psychotropic: it’s an umbrella term that describes any drug (either prescribed or illegal drug) that
affects behaviour, mood, thoughts or perception (Goshal 2019).

Youth: Refers to a person aged between 15 and 35 years old. (2015 Zambia National Youth
Policy). The definition of a youth varies from community-to-community and country-to-country.
According to the 2015 National Youth Policy implemented by the Republic of Zambia Ministry
of Youth and Sport defined a youth as a male or female person aged between 15 and 35 years in
line with African Youth Charter whilst the UN defines youth as a male or female aged between
15 and 24 years. For the purpose of this study a youth will be defined as a male or female person
aged between 15 and 35 years According to the Zambia National Youth Policy

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

Hallucination: Sensory perception without an actual external stimulus. (Ganti et al., 2016).

Psychotropic: it’s an umbrella term that describes any drug (either prescribed or illegal drug)
that affects behaviours, mood, thoughts or perception (Goshal 2019).

1.14. Limitations of the study

The researcher encountered the following limitations,

1.14.1. Availability of Information

The researcher's biggest challenge was not being able to find the relevant information he was
looking for. Respondents were hesitant to provide information because they feared being
victimized. The researcher, on the other hand, assured them that the information would be kept
strictly confidential.

1.14.2. Failure to have face to face interview with employees who had leave
The researcher could not directly get in touch with other employees since they had gone for
business trips and workshops. However, the researcher used phone call to get important
information needed

1.14.3. Time constraint

Carrying out research and taking academic modules at the same time was a major disadvantage
because both studies required the researcher's full attention. However, the researcher went so far
as to travel to sally Mugabe during semester break to administer the questionnaires.

1.15 Delimitations of the study

The research focused on factors contributing to substance induced psychosis in young people and
was only limited to sally Mugabe hospital. The study focused on employees in the hospital sector
only

1.16 Lessons learned

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

Through the interventions and collaborations implemented in the community, several lessons
have been learned in addressing mental health issues effectively. One key lesson is the
importance of early intervention and prevention strategies to identify and address mental health
issues before they escalate. Another lesson is the need for ongoing training and education for
professionals and community members to increase awareness, reduce stigma, and improve
access to mental health services.

1.17 Recommendations

Based on the findings and lessons learned, several recommendations can be made to improve
mental health services and support in the community. These recommendations include increasing
funding for mental health programs, expanding access to mental health services, providing
training and education on mental health issues, and promoting collaboration between
professionals and community members. By implementing these recommendations, the
community can work towards addressing mental health issues effectively and supporting
individuals in need.

1.18 chapter summary

In conclusion, mental health issues have become a significant social problem in many
communities, causing widespread devastation and impacting the lives of individuals, families,
and communities. By understanding the background of the social problem, evaluating the current
situation, implementing interventions, collaborating with professionals, involving the
community, and learning from experiences, communities can address mental health issues
effectively and support individuals in need. It is essential for social workers, mental health

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

professionals, and community members to work together to promote mental health and well-
being and create a supportive environment for individuals with mental health issues.

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AN ANALYSIS OF NATIONAL HEALTH SERVICES RESPONSE TO SUBSTANCE INDUCED PSYCHOSIS IN
YOUNG PEOPLE AGED 16 TO 25 AT SALLY MUGABE PRIMARY SCHOOL ON AGRICULTURAL PRODUCTION

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