Enyi Anosike is a Public Mental Health professional, and a trustee of the Public Health Foundation of Nigeria. He writes this special piece on mental health in Nigeria on behalf of the Foundation.
Nneka is known to everyone in the neighbourhood, but is hardly seen. Her family keeps her well hidden from the public, uncertain how to explain her wild stories and apparently irrational behaviour. She has been taken to so many churches; the family has long since lost count. Prayers have not healed her, nor has the old woman in the village said to cure ‘these things’. The family have nowhere else to go and have settled for containment and isolation. Nneka is however not alone. She is one of thousands of Nigerians with mental illness that we have chosen to ignore.
There is perhaps no better time than now to begin to have a focused and sustained conversation about the state of mental health care in Nigeria. Register for the Webinar “Mental Healthcare in Nigeria” holding on the 12th of December at 5 p.m. Nigerian time HERE.
Ours is a country in which much has changed over time, about the way we live and interact with each other, as well as the manner of engaging with our various endeavours. As active participants within the global community, we are in thrall to a fast-paced and rapidly changing world with its myriad benefits, from technological advancements to innovative ways of solving complex problems. We are also subject to shifts in population dynamics due to migration from predominantly rural areas to burgeoning cities.
Our embrace of these profound changes is however not without its downsides. We are also at increased risk of rising stress levels, isolation, and the ravage of loss of livelihood and status. These serve as precipitating and perpetuating factors for severe and enduring mental illness, which has the potential to rob us of personality and productivity. Stigma and discrimination continue to serve as seriously potent factors that exacerbate the population’s lack of knowledge about mental illness, and its lack of proper engagement with mental health services.
An added concern is that as surely as some things have changed in Nigeria, some things stay the same. In spite of the country’s investments aimed at improving the health sector, its healthcare system remains quite weak and fragmented.
Systems of delivery of good quality and needs-based health care across the three tiers of government – federal, state and local authorities – are dismal. Poorly resourced states and local governments retain autonomy over funding, commissioning and oversight of population-centred health services, including mental health services. Ours is a severely challenged health care system with mental health care at the very bottom of our list of priorities.
Nigeria has eight psychiatric hospitals and departments of psychiatry in 12 medical schools. These serve a population of some 170 million people. At any given time, there are around 200 fully qualified psychiatrists in the country, providing mental health care in mostly urban areas.
Suffice it to say that given the challenges faced by the health sector overall, and mental health services in particular, the country is hardly in any position to say that it is providing adequate needs-based, populating-centred mental health care to its citizens.
The Public Health Foundation of Nigeria (PHFN), a not-for-profit organisation of public health professionals, is contributing its voice to the growing calls for improvements in the quality and availability of mental health care being provided to citizens of Nigeria. This is in line with its stated raison d’etre, which is using expertise from within its ranks and partnering with others to improve the health of the Nigerian people.
PHFN is having its maiden webinar series on mental health care in Nigeria on the 12th of December 2015. It will be eliciting the expertise of two eminent academics in the field of Psychiatry, Professor Oye Gureje and Professor Roger Makanjuola, to discuss the challenges and opportunities faced by Nigeria’s health sector as it grapples with mental health services provision.
The webinar is designed to allow for insights into the history and evolution of mental health services development and delivery in Nigeria. It will include highlighting the challenges faced with providing sustainable population- centred mental health care. It will take a critical look at the current availability of the health workforce required to deliver good quality mental health care which is the right of every Nigerian.
It will explore the role of government thus far in the area of mental health care. This will include the extent of resource provision and the robustness of legislation which should guarantee investments and protects patients’ rights, including human rights.
It will examine the focus of research in this field, and what opportunities there are for exchange of knowledge and ideas that serve to improve the quality and availability of mental health services.
Lastly, it will avail participants of a service user’s journey through the mental health care system. It will highlight the service user’s perspective on extent of the care that was received, and what suggestions he/she has about improving mental health service provision.
The Public Health Foundation of Nigeria hopes that this webinar would contribute to better informing the populace about the state of affairs regarding mental health care in Nigeria. It also intends that the information and ideas elucidated would sensitize stakeholders including government to better focus investments and improve engagement.
It hopes that the opportunity of a focused and constructive conversation would better guide workforce development, partnership working and chart the course of much needed advocacy in the area of mental health care.
Register for the Webinar “Mental Healthcare in Nigeria” holding on the 12th of December at 5 p.m. Nigerian time HERE.