Addressing Mental Health Challenges and Inadequate Services in Nigeria
By Nonso Attoh (Lecturer, Faculty of Law, University of Nigeria)
Approaching the main gates of the University of Nigeria, Enugu Campus every morning, you are confronted with the sight of ahalf-naked, elderly-looking woman sleeping next to the gutter, surrounded by a motley assortment of garbage and clutter. Dishevelled, dirty, hair unkempt and obviously abandoned, it is apparent that she has converted that little corner of the earth as her home and abode.
She presents a striking contrast to the motto proudly emblazoned on the University main gates “To restore the dignity of man”, less than ten meters away from her abode. Everybody walks or drives past, including University officials and government officials, the sight commonplace, merely a normal part of living in a Nigerian city.
Further evidence of a systemic neglect of mental health in Nigeria is found in religious and spiritual circles. Located in the interior of Ogbunike in Anambra state Nigeria,a religious ministry specializes in deliverance of mentally ill patients and boasts of being registered with the state government. On entering the ministry, the first sight that accosts one is typically a number of patients, chained to the ground, under the trees or in some uncompleted and unroofed structures. These patients are not released from the chains no matter the weather conditions.
On the days of deliverance, the patients are soundly beaten with palm-fronds which are acclaimed to have the power to drive away the demons that cause mental problems. After the beating, the proprietor of the Ministry will apply certain “holy” pungent liquidsinto the eyes and nose of the patients, commanding them to sniff it in or else face more beating. This is apparently painful and I later discovered that the “holy” liquids are compounded with alcohol and can harm the eyes.The rights of the patients to a dignified and effective treatment are clearly non-existent.
According to a 2006 WHO-AIMS Report on Mental Health Systems in Nigeria, there is considerable neglect of mental health issues in the country. The case scenarios outlined above authenticates the assertion of the WHO-AIMS Report above.
Although Nigeria formulated a Mental Health Policy document in1991,addressing mental health issues and its components which include advocacy, promotion,prevention, treatment and rehabilitation, it has however not been revised since then. Further, no formal assessment has beenconducted to check its level of implementation.
Moreover, Nigeria is still governed by antiquated colonial mental laws, which are manifestly out of sync with current realities and best practices in mental health treatment.A 2003 bill for a mental health act passed a public hearing and was adopted by the Senate, but was not passed by the House of Representatives and be adopted into law before the end of the last administration. It is unclear whether negotiations are still on-going to ensure passage of the Bill.
There is a significant level of prevalence of mental illness in Nigeria. In 2007, according to the World Health Organisation, there were 20 percent of Nigerians suffering mentally and with a population of 150 million, this translates to the fact that about 30 million Nigerians are suffering from mental disorders.A visit to the Federal Neuro-Psychiatric Hospital, Enugu on any day of the week would also confirm the rising rates of mental illness amongst Nigerians as manifested in the high rates of daily admissions and outpatient who attend daily for check-up with the doctors.The seriousness of the challenges facing our nation is further highlighted by rising number of the suicide cases recorded in our institutions of higher learning.
Although it has never been doubted that mental health problems have major impacts on disability, mortality and health care systems, other substantial economic consequences are also being identified. In the long run, even simple cases of depression have been found to adversely impact employment and ultimately reduce national productivity.
We are therefore losing so many potential contributors to our national development through mental illnesses, many of which can be easily taken care of. Unfortunately, our intended Mental Health Act fails to address some of the most salient issues towards tackling the mental health challenges in Nigeria.
Issues of mental health in Nigeria are indeed multifarious and need very deliberate, specific and concerted actions. Poverty and consequent stresses associated with poor infrastructure in Nigeria, human rights protections, the pervasive role of religion in a lot of mental problems, accreditation and regulation of faith healers and traditional healers, and availability and accessibility of mental health care facilities are fundamental issues that have to be addressed in order to effectively grapple with the mental health challenges of Nigerians.
It is our suggestion that more effort must be made by the Nigerian government to realise the importance of mental health. Development of strategiesin order to meet the challenges of mental health in Nigeria is necessary. A re-consideration of the proposed Bill, and more concerted attempts to pass a Bill that addresses the issues surrounding mental illness including those peculiar to the Nigerian experience, is crucial. The mentally ill woman in front of the University gates and the mentally ill in religious ministries and other institutions where they undergo inhumane and degrading treatment remain Nigerians and must be provided with basic mental health services and human rights protections guaranteed by law.
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