Hesperian Health Guides

Serious mental illness (psychosis)

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HealthWiki > A Health Handbook for Women with Disabilities > Chapter 3: Mental health > Serious mental illness (psychosis)


Women with disabilities are at risk for mental illness if they have:

  • had mental health problems in the past.
  • lost family members or are separated from their families.
  • witnessed violence or have violent partners.
  • little social support.


A woman with a disability may be mentally ill if she has any of these signs:
  • She hears voices or sees things that others do not hear or see (hallucinations).
  • She has strange beliefs that interfere with daily life (delusions)—for example, she thinks her neighbors are trying to kill her.
  • She no longer cares for herself—for example, she does not get dressed, clean herself, or eat.
  • She behaves in a strange way, like saying things that make no sense.

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Similar signs can be caused by some diseases, poisoning, medicines, drug abuse, or damage to the brain. People who are not mentally ill sometimes act in ways that make others question their mental health, particularly if these behaviors are related to beliefs or traditions that are not shared by the entire community. For example, if a woman says she received guidance in a “vision,” she may be drawing upon traditional sources of knowledge and guidance—not suffering from hallucinations or mental illness. These signs are more likely to be signs of mental illness if they come so often and are so strong that a person has difficulty carrying out daily activities.

Getting care for mental illness

Although in most places family members care for those who are mentally ill, it is best if the person can also be treated by a trained mental health worker. In some situations medicines are necessary, but they should never be the only treatment.

Traditional healers often play an important role in treating mental illness. A healer who comes from the same community as the person with the problem may know her and her family, understand her, and have a clear idea of the stresses she has experienced. Some healers use treatments or rituals that can help a woman overcome her problem.

No matter what treatment is given, a person with a mental illness should always be treated with kindness, respect, and dignity.

a man speaking in sign language to a woman.
Juanita, you don't need to worry about anything. I will look after the children.
The most important part of any treatment is the support and care of family and friends.
Ask these questions before deciding on a treatment for mental illness:
  • What is the purpose of each step in the treatment?
  • What is expected to happen?
  • If the person is not a danger to herself or others, can she get mental health care while living at home or living together with others in her community?
  • Will the family be involved in the treatment?
  • Is the person providing treatment respected in the community?
  • Do any of the treatments cause side effects, physical harm or shame?

If someone must be treated in a hospital, always ask for a tour of the facility before leaving her there. Make sure the hospital is clean, that patients are safe and can have visitors, and that they will get regular treatment with trained mental health workers. Patients should be free to move about, unless they are a danger to themselves or others. Also, make sure you find out what must be done to release the person from the hospital later.

Mental health facilities can have the same barriers as other buildings and services that make it difficult for people with disabilities to move around and communicate. See ideas about improving access to all health services.