Mental health challenges are on the increase across Nigeria, with depression, suicidal behaviours, drug use and abuse as well as psychotic disorders all featuring prominently. Across the lifespan, such as in childhood, conditions such as autism, intellectual disability and attention deficit hyperactivity disorder are also increasingly common. Unique conditions pertaining to women for instance, include depression and psychotic disturbances occurring during pregnancy or in the aftermath of childbirth – such as postpartum depression. And while we all pray to live to a ripe old age, we also run the risk of developing mental health conditions of old age such as dementia.
These mental health challenges are very common, with the world health organization (WHO) estimating that one in every four persons will be at risk of a mental disorder at some point in time in their lifetime. Thus, if we estimate our population to be around 200 million Nigerians, it stands to reason therefore, that about 50 million Nigerians are at risk of having a mental disorder at some point in time in their lifetime. Increasing rate of drug abuse is often associated with a concomitant increase in crime rates. Thus, it should not be surprising that there is an increase in insecurity and crimes in our society over the years.
Unfortunately, despite the clear evidence of the important mental health challenges facing us as a society, several barriers block the provision of urgent attention to these issues. Chief among these barriers is the societal shame, stigma and discrimination that is often associated with a diagnosis of mental disorder. Often, the underlying problem is that of ignorance and misconceptions around what mental disorders are, what causes it (spiritual attack or a medical disorder) etc. Thus, most affected persons and their families suffer silently and secretly or turn to traditional and spiritual healers for help, instead of seeking treatment from mental health professionals.
The role of the government is pivotal in addressing these issues. Mental health is clearly neglected and not on the agenda of government at several levels – federal, state, or local government. Thus, several states do not even have a designated desk officer for mental health, not to talk of even having a mental health plan or agenda for her citizens. Yet, we recall that the WHO definition of health is a state of complete physical, mental, and social wellbeing. So, neglecting mental health is akin to neglecting one third of health, as defined by the WHO.
Lagos state is the notable exception here and she deserves all the plaudits for her gains over the years. The first state to establish a desk office for mental health, develop a state mental health policy and recently, a mental health law – while the rest of the country continues to grapple with the obsolete Lunacy Act of 1958. A 500 bedded state Mental Health Institute that will provide clinical services as well as drive policy and research is also under construction. The state has clearly set out to address the mental health needs of her citizenry in a systematic and evidence-based manner, by providing the governance framework to deliver quality mental health services.
And on the 18th January, 2022, the state held the second edition of her Livable City Conference – the first having being held in 2013. The theme for this year’s excellent conference was “Responding to the Mental Health Needs of a 21st Century Megacity” and it featured experts from across multiple disciplines and from all over the country. It also showcased excellent public-private collaboration to brainstorm on the best ideas for addressing the mental health challenges of the state.
The extent of political support enjoyed by this project was exemplified by the presence of the Deputy Governor, Dr Kadri Obafemi Hamzat; the Honorable Commissioner for Health, Prof Akin Abayomi; Representative of the First Lady of the State as well as the Wife of the Deputy Governor amongst others.
The numerous mental health challenges of all Nigerians cannot be simply wished away by behaving like the proverbial ostrich or living in denial. Open conversations around mental health issues are long overdue and campaigns such as the ‘Unashamed Campaign’ of the Asido Foundation are very much in line with the current needs of our society.
However, overcoming the longstanding barriers of ignorance, shame and stigma associated with mental disorders require a concerted and strategic approach to tackling them. And we have to give plaudits to the Lagos State Government for leading the way and showing other states that these issues can and should be addressed.
It is our prayer that the numerous suggestions and output from the intellectual engagements of the 2022 Lagos Livable City Conference will be taken on board and implemented for the improvement of mental health services to her citizens. And that other states will also borrow a leaf from the giant strides of Lagos State.
DR JIBRIL ABDULMALIK
Tribune Article for the column “Your Mental Health & You”
Thursday, 20th January 2022