Behind the Smile: Mental Health Awareness and its reality in Ethiopia
- Zebeaman Tibebu
- Apr 16
- 5 min read
Why Awareness Isn’t Just Important – It’s a Lifeline
In a busy street in Addis Ababa, a young man sits quietly on a bench by the roadside. His eyes are distant; his smile, barely there. He’s not bleeding. He’s not coughing. He has no fever or signs of infection. But he is suffering.
His pain doesn’t show up on lab tests. His mind is searching for solace- a break from life, from the struggle, from the scrutiny, from the fight. He has been fighting his demons to no resolve.
He doesn`t scream for attention. Every passerby sees his insincere smile and assumes he`s fine – maybe even lucky. ‘He must have so much to be grateful for’ they think.
But he is the unspoken soldier in his own war, silently fighting relentless depression, desperately trying to grasp the tiniest thread of hope. He wonders what’s broken inside him to make him fall this hard. He’s no longer the pillar for his loved ones – he feels like their burden. It’s not that he didn’t try — he just didn’t succeed.
Everyone expects him to be tough—because life is tough. So, he hides his scars, masks his pain, and buries his fears.
Until the fight becomes too much to bear....
He smiles.
This smile is just misleading, he is just contemplating suicide, quitting the fight. He is but step awa from taking his life.
Yet, it is real — and it is deadly.
This is the face of mental illness in Ethiopia: invisible, silent, and too often ignored.
The Silence
Mental health disorders affect one in five people globally, and Ethiopia is no exception. According to estimates, 14.9% -27.6% of Ethiopians live with a major mental illness or substance use disorder. Mental disorders accounted for about 4.0% (4.5% female vs. 3.5% male) of the total burden of diseases from all causes in Ethiopia. But what if this is only the tip of the iceberg? Unlike broken bones or high fever, mental illness doesn’t always get diagnosed, let alone treated. In many cases, the patient might not even understand there is something wrong with him, like the young man in the story. It is just mental illness.
Take Hanna, a mother from Mekelle. Her story is heartbreakingly common:
“I have always been happy and healthy in my life. Until something terrible happened to me: my only child died. After that dramatic episode, my life hasn’t been the same. I kept thinking about him, and couldn’t sleep at night. I felt so sad and would be so nervous, and my heart would beat very fast. This made me so worried I thought something bad was going to happen to me as well.”(testimonial from WHO page)
Hanna was lucky that she visited a health center where there is a specialized mental health professional. She was diagnosed with depression. She was listened to and not judged. She was supported, not shamed. With time, she began to recover.
The Spectrum
When people think of mental health, they mostly assume overt sadness and dramatic psychotic behaviours. But Mental health doesn’t wear a single face. It isn’t always sadness, tears, or visible breakdowns. Sometimes, it’s silence — the kind that builds invisible walls around a person. Other times, it’s excessive talkativeness. For some, this talkativeness might be a psychological defence strategy, where someone desperately tries to fill the void inside with noise. For others, it may stem from manic episodes, where racing thoughts and boundless energy spiral beyond control.
Mental health problem spans beyond the notorious depression. It includes mood disorders, personality disorders, psychotic conditions, and more. Some individuals experience hallucinations, hearing voices or interacting with figures only they can see — false entities that feel frighteningly real. Others may carry deep trauma. They relieve the worst moments they wish to forget.
Social anxiety, paranoia, and obsessive fears — these are just as real and just as debilitating. For some, the struggle isn`t even emotional; it is physical. Headaches, fatigue, insomnia, chest tightness, appetite changes, and even seizures can be the manifestations. These are not just symptoms of physical ailments, they can be cries for help from a distressed mind. Alas! These manifestations are common in cultured conservative communities where mental health is not readily accepted.
It could go for years in disguise, undiagnosed and unnoticed- even by the person experiencing them. Hence, recognizing this wide spectrum of mental health symptoms is essential.
The Weight of Stigma
In Ethiopia, mental illness is often explained in terms of the supernatural. There is a cultural misunderstanding of mental illness that fuels fear, shame, and silence in most cases. People isolate themselves. Families hide their suffering.
The result? Over 90% of people with mental illness receive no formal care.
The stigma is compounded by limited access to services, especially outside Addis Ababa. A psychiatrist is termed as ‘ye ebd doctor’, meaning doctor for the crazy. Amanuel Specialized Hospital, a renowned mental health hospital, is termed as ‘ye ebd hakimbet', meaning hospital for crazy ones. Hence, who dares claim to have a mental illness and be treated at a psychiatrist at Amanuel Hospital. They fear the scrutiny and ostracization, which further worsen their mental condition.
A Turning Point: Government Commitment and Strategy
But there is hope. The Ethiopian government has shown a strong commitment to improving mental health care. Ethiopia has adopted a national mental health strategy since a successful pilot program between 2010 and 2013. The second national Mental health strategy has been launched since 2020. MhGAP has been in action since 2014. The Ethiopian Ministry of Health has designed a five-year strategic plan (2020–2025) termed the National Mental, Neurological, and Substance Use Health Program (NMNSP). The aim is to consolidate progress and further reduce the burden of mental, neurological, and substance use (MNS) disorders.
Media: The Missing Link in Mental Health Advocacy
The media holds enormous power to educate — or to reinforce stigma. For too long, mental health coverage in Ethiopia was virtually nonexistent. But this, too, is changing.
📺 Mainstream Media Efforts
National broadcasters like Erq Ma’ed and Ye Aemro Tena now air mental health content weekly.
Documentaries and TV segments mark events like World Mental Health Day.
Films like Serryet and Selanci portray trauma, psychosis, and depression with realism and empathy.
📸 The Rise of Social Media
Social media is a double-edged sword. It can perpetuate sitgma and misinformation further complicating the mental health awareness gap. On the other hand, Mental health awareness tips like this one can be spread to increase awareness. We can use social media to empower people on mental health. By involving individuals with lived experiences, designing inclusive campaigns, and building interactive mental health platforms, we can educate, support, and heal.
What Can You Do?
✅ Talk about it – Share your story or support someone else’s.
✅ Challenge the stigma – Educate others and push back on harmful language.
✅ Use your platform – Whether it’s TikTok, Telegram, or TV — let your voice be a bridge.
✅ Support policy – Advocate for mental health funding and inclusion in primary healthcare.
✅ Collaborate – Work with NGOs, media, and ministries to amplify the message.
Takeaway!
Let’s build an Ethiopia where Hanna’s story is no longer rare. Where mental health is met with compassion, not confusion.
The future of our mental health depends on what we do today.
Let’s break the silence. Let’s stand together and fight for the mental health of every Ethiopian.
🟢 If you or someone you know is struggling, reach out. Speak up. Help is possible. Healing is real. And you are not alone. 🟢
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