UPDATE: Why more Nigerians will come down with mental disorders

As the world marked this year’s World Mental Health Day, there are indications that more Nigerians will come down with one mental disorder or the other.

The reason is not far-fetched. Today, Nigerians are faced with many stressors that can trigger these mental disorders. These range from long hours in traffic, insecurity, kidnapping, incessant cases of collapsed buildings, economic hardship, strikes, and lack of access to treatment and a reliable social support system among others.

According to the president of the Association of Psychiatrists in Nigeria, APN, Prof Taiwo Obindo, not less than 60 million Nigerians are living with some form of mental disorder.

This is also as the latest report by the World Health Organisation, WHO, revealed that there is currently a 25 per cent global rise in cases of depression and anxiety following strained socio-economic circumstances associated with the COVID-19 pandemic.

The report also showed that over 116 million Africans were estimated to be living with mental health conditions pre-pandemic.

Unfortunately, in Nigeria, mental health is not given the priority it deserves. Today, there are obvious treatment gaps in mental health care coupled with the fact that mental illnesses are shrouded in secrecy due to stigma and discrimination.

Despite the magnitude of violence in the country, there is no access to what psychiatrists describe as psychological First Aid.

Psychological First Aid is a form of support for people who go through very serious experiences like kidnapping, banditry, terrorism, and catastrophic events in which they are the sole survivors.

Again, Nigeria has obsolete mental health laws, outdated facilities, and an acute shortage of psychiatrists to treat the over 60 million Nigerians suffering from the disease.

Even though Nigeria does not have enough experts for the management of the disease, the ongoing brain drain in the medical sector has compounded the satiation.  Today, only 200 psychiatrists are serving over 200 million Nigerians.

In the views of the President, Association of Psychiatrists in Nigeria (APN), Prof. Taiwo Obindo, mental healthcare in Nigeria is in a sorry state and the fact that only about 10 per cent of Nigerian patients have access to appropriate care.

“We are left with more than 90 per cent who are unable to access care and this group is called the treatment gap for mental illnesses,’ Obindo said.

Obindo, who is also the Chairman, Faculty of Psychiatry, West African College of Physicians, Nigeria Chapter, the gap was as a result of various factors like the knowledge gap in which people do not have appropriate information about the causes and treatment of mental illnesses.

Obindo said some factors hindering the management of mental illness in Nigeria included myths and traditional beliefs; inadequate mental health facilities and number of mental health professionals.

He said: “The Mental Health Bill by the mental health stakeholders led by the Association of Psychiatrists of Nigeria (APN), in conjunction with the National Assembly and the Ministry of Health was yet to be assented to by the President.  “This is the most recent effort in 30 years.”

Also speaking, Former President, Association of Psychiatrists in Nigeria, APN, Prof. Taiwo Sheikh, said the treatment gap in mental health cases had grown to as high as 85 per cent.

He noted that the number of serious cases receiving no treatment during the last year in developed countries varied from 35.5 per cent to 50.3 per cent.

The WHO on Monday raised the alarm that three years after the social isolation, fear of disease, death, and strained socio-economic circumstances associated with the COVID-19 pandemic have contributed to an estimated 25 per cent global rise in depression and anxiety.

WHO also disclosed that over 116 million Africans were estimated to be living with mental health conditions pre-pandemic.

Disclosing these in a message to mark the World Mental Health Day themed: “Make Mental Health and Wellbeing for All a Global Priority”, WHO Regional Director for Africa, Dr Matshidiso Moeti lamented that suicide rates remain particularly concerning, as are the exponential rates of alcohol use and abuse among adolescents as young as 13 years of age.

The day is marked on 10 October every year to provide an opportunity to draw attention to Africa’s large and growing burden of mental health conditions, with children and adolescents worst impacted.

Moeti said: “We need to urgently strengthen regulatory systems to close the gaps that allow such young people to easily access alcohol, contributing to heavy episodic drinking rates as high as 80 per cent among teens from 15 to 19. The situation poses a serious threat to their education while setting the stage for a lifetime of alcohol abuse, and the associated risks of noncommunicable and other related diseases.

“Inadequate financing for mental health continues to be the biggest limitation, negatively impacting efforts to expand Africa’s mental health workforce.

As things stand, there are fewer than two mental health workers for every 100 000 people, the majority of whom are psychiatric nurses and mental health nursing aids.

“With these scarce resources concentrated at large psychiatric institutions in urban areas, people at community and primary care levels are left critically underserved. For example, while two-thirds of Member States report having guidelines to integrate mental health into primary health care, fewer than 11 per cent are providing pharmacological and psychological interventions at this level.

It is heartening that up to 82 per cent of our Member States are receiving training on how to manage mental health conditions at the primary care level, with up to 74per cent reporting that specialists are involved in providing appropriate training and supervision to primary health care professionals.

African governments have also made some progress on mental health spending, which has risen to 46 US cents per person. But that is still well below the recommended US$2 per person, with mental health not featuring in national health insurance schemes.”

She said to address the challenge, member states must follow through on the implementation of commitments they made at the Regional Committee in August 2022, when they endorsed the Framework to Implement the Comprehensive Global Action Plan 2013 to 2023 in the WHO African Region.

She said the key document highlights the severe shortage of mental health services on the continent and makes recommendations for key actions by the Member States.

“Among the developments of which the Member States can be proud is the launch of Special Initiative for Mental Health frameworks by Ghana and Zimbabwe. Supported by WHO training, the aim is to strengthen relevant services at lower levels of care.