Mental Health Care in Nigeria; the forgotten issue


A few good things are happening in Nigeria. One of this is the emergence of a news medium called 234NEXT….which led this weekend (04/04/09) with a topic even health professionals in Nigeria prefer to ignore – Mental Health. The title above is not mine but theirs, but I could not have put it any better. Pls click on it and read before continuing…

Mental Health Care in Nigeria; the forgotten issue…

Its great to see a Nigerian daily take on a challenging social issue as this lead story. Kudos to next!

The journal has a couple of extras to their article, my only criticism of which is that no attempt is made in stating the sources of their information.

Facts on mental health in Nigeria

One of these “facts” is that there are around 130 working psychiatrists in the whole of Nigeria. Almost all of these psychiatrists are based in one of the country’s large specialist hospitals in major cities.

A few months ago ….when the Punch reported that The Medical Director of the Federal Psychiatric Hospital, Yaba, Lagos, Dr. Taiwo Ladapo, as saying there were only 100 psychiatric doctors in the country!…I made a mental note to blog on this.

To understand what that means….lets take one of the more severe mental illnesses – schizophrenia. Schizophrenia is characterized by delusions, hallucinations, incoherence and physical agitation…There are effective interventions (pharmacological and psychosocial) available and the cost of treatment of a person suffering from chronic schizophrenia is about US$2 per month; the earlier the treatment is initiated, the more effective it will be. However, the majority of the persons with chronic schizophrenia do not receive treatment, which contributes to the chronicity….and more so in Nigeria.

It is generally agreed that rates of schizophrenia are generally similar from country to country—about .5% to 1 percent of the population….so lets do the math.…we are in trouble here.

But…where are the positives. We have a rich history in teaching and learning psychiatry. Many will know the Neuropsychiatric Hospital, Aro, established in 1954 administered by the first indigenous Psychiatrist in Nigeria, the late Professor Thomas Adeoye Lambo, the former Deputy Secretary General of World Health Organization. He was among the first clinicians to observe the ‘comparatively quick recovery, lack of chronicity, and better therapeutic response generally of schizophrenic patients’, which he attributed to the ‘favourable social and environmental factors inherent in the community to which the mentally ill are exposed in Africa’.

Lambo’s most innovative development was the Aro village system. Psychiatric patients were boarded out to 4 villages around Aro, accommodating between 200 and 300 patients from a wide geographical area. Lambo believed that those who were boarded out more quickly adapted themselves to their situation than those taken into hospital. He also thought that this was the result of their contact with a settled, tolerant, and healthy environment.

So back to the problem of today. If our health sector is in a mess, mental health services are in the extreme end of that mess. Our society does not make it any better either. Several papers have shown our society has still not come to terms with mental illness and still believe that supernatural factors are responsible for developing these conditions.

There have been several stories in the past that shocked those not in the know about how people ith mental illness are treated in several towns in Nigeria…as this on Shackled day and night. in Nigeria…

Mental health is one issue that will take a while to solve. But there is no better time to start than now…

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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