What is Mental health?
Mental health as a concept encompasses our psychological, social and emotional wellbeing, and actually serves as a determining factor in the way we feel, think and act. Maintaining a healthy mental health status is important as it plays a key role in how we embark on our daily activities, relate with others around us, make decisions and handle situations. Any condition(s) that directly disrupts our mental state to a significant extent can be termed as a Mental Health Disorder. Examples of mental disorders include less complex forms such as clinical depression and anxiety, and more complex forms like bipolar disorder, schizophrenia, obsessive compulsive disorder, and a number of others.
Importance of Mental health awareness
The prevalence of mental health disorders among the world’s population has been rising quickly in recent times, and it is estimated that by the year 2030, mental disorders will be as common and disabling as diseases like AIDS, Diabetes, Alzheimer’s disease, and so on. In Nigeria alone, about 20-30% of the population suffers from mental disorders, which is a very significant proportion of individuals. Unfortunately, the level of medical and social attention accorded to mental health is far below expectations, considering the prevalence of mental disorders in the country.
According to the 2006 report from the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS), there is a considerable neglect of mental health issues in Nigeria, and very little of the national expenditure on health is allocated to mental health treatment and security. Not much awareness is created about mental health conditions, and due to the large neglect of mental health issues, it is quite common in the country to see a lot of individuals with mental disorders roaming the streets without any medical attention, while those that actually receive some form of healthcare do so in poorly equipped mental health centers and traditional ‘healing homes’. The number of suicidal episodes in the country have been climbing much recently, especially among youths, of which a major contributing factor is the poor tertiary educational system and unemployment problems.
At the rate which mental disorders are currently rising, it is only a matter of time before the number of mental health conditions will greatly outweigh other diseases and place further strain on the already fragile Nigerian healthcare system.
Challenges Associated with Mental Health in Nigeria
Perhaps, the biggest challenges facing mental health in Nigeria are the unavailability of essential medications and infrastructure for the treatment of mental patients, along with a shortage of experienced Psychiatrists and Physicians to handle the variety of mental health conditions that are prevalent in the country. There is also a poor level of public awareness about the severity of mental disorders and the need for appropriate medical and social attention, hence, the reason why stigmatization against mentally challenged persons is very rampant in the country. The stigma associated with mental disorders goes beyond the patients and even extends to the Psychiatrists, which is the reason why few medical professionals choose to specialize in psychiatry, thus, compounding the shortage of mental healthcare professionals.
Another major challenge to mental health security is the apparent inability to enact and implement effective policies that will address the shortcomings of the healthcare sector in terms of mental health. A policy for the delivery of mental health services was developed in 2013, but this has not been fully effective, leaving several key aspects of mental health unattended to by the Federal Ministry of Health. The scarcity of non-governmental organizations (NGOs) that support mental health security efforts is also a contributing factor, as most health-related NGOs are focused on other aspects of healthcare such as infectious and non-infectious diseases, sexual and reproductive health, terminal illnesses, malnutrition, and so on. Other factors that greatly impede mental health security include economic, psychological and social stressors such as the high unemployment rate among university graduates, the poor and demanding system of education, and a lack of certain basic amenities, making daily activities more difficult and unbearable.
The COVID-19 pandemic served to further worsen mental health states on a global scale, as the lockdown measures triggered a number of mental conditions like depression, loneliness and anxiety, and even aggravated the already existing mental disorders of various patients. This resulted in an increased demand for mental health services which could not be met as many hospitals channeled their efforts towards the COVID-19 response, while mental health facilities were shut down as part of the lockdown measures.
Of the many challenges to adequate mental healthcare in Nigeria, the most saddening is the mode of treatment meted out to mentally ill patients across several mental health facilities in the country. It has become a common practice in many rehabilitation centers to chain and lock up mentally challenged people in a bid to restrict their movement. Most times, these patients are completely confined to a particular spot for months or years in overcrowded and unhygienic conditions, and sometimes, they are forced to eat, sleep and pass excreta in the specific place they are confined to. On many occasions, they are physically and emotionally abused by beating or flogging, and are often forced to take medications or meals against their will. As a result of the physical, emotional and psychological distress suffered by mental patients, along with the associated stigma, a lot of people with mental health conditions refrain from seeking medical help at mental rehabilitation centers, thus, further impeding the goal of ensuring mental health security.
Possible solutions to Mental health security challenges
It must be emphasized that mental health is a key aspect of primary healthcare, hence, there is a need for improved provision and funding of mental health initiatives at the federal, state and local levels. This involves the establishment of more rehabilitation centers that are well-equipped to adequately handle mental health cases, as well as the creation of intensified training programmes for psychiatrists and other mental health professionals, and also the introduction of incentives into their payment scheme to encourage and motivate them in their job of caring for mentally challenged individuals. Proper mental health policies should be enacted and implemented by the Nigerian ministry of health to ensure the efficacy and continuity of mental health projects, and also ensure the abolition of all abusive treatment methods, while preserving the fundamental human rights of mental patients before, during and after their rehabilitation. National developmental measures also need to be implemented to improve the standard of education, employment and provision of basic amenities in the country in order to relieve the impact of economic stressors on the citizens and reduce the frequency of mental health issues.
Improving public awareness about mental health conditions should be made a priority, and NGOs have a key role to play in this by helping to organize nationwide physical and virtual awareness campaigns to educate citizens about the need to preserve the dignity of mentally challenged persons by avoiding stigmatization and offering them the needed support. In addition, people should be regularly advised on the right practices that can help maintain their mental wellbeing, and should also be encouraged to seek help when faced with mental challenges. In national emergency situations such as the current COVID-19 pandemic which requires social distancing measures, efforts should be made to shift from physical healthcare to telemedicine in order to ensure continued provision of mental health services to those in need without compromising the safety measures.