Mental health system in Nigeria, One sin too many

By Caleb Onah

The Federal Neuro-Psychiatric Hospital in Yaba, Lagos State, Nigeria, looks peaceful from the outside, but inside this centuries-old facility – one of six psychiatric centres in Lagos and one run by the federal government of Nigeria – tensions are high. At the outpatient clinic, an experience I will never forget as a young mental health counsellor fresh out of college. The line of people waiting to see the doctors was so large that it spilled out into the corridor. The number of cases is so overwhelming that Dr. Adegbaju, a psychiatrist and other mental health professionals rushed to take care of an agitated patient, who had to sleep in the hospital for the past two days. In the emergency room, a patient named Jide languished in queues since 7 a.m.

It wasn’t noon yet at Yaba Hospital’s Neuro-Psychiatric Hospital, but business went on as usual. Since 2018, the hospital has seen a more than 20% increase in the number of new patients suffering from various types of mental illness, and a 60% increase in the number of patients struggling with drug addiction, alcoholism and cravings for other psychoactive drugs. According to the World Health Organization (WHO), 1 in 4 Nigerians (approximately 50 million people) suffers from some form of mental illness. Not long ago, the President of the Psychiatric Association of Nigeria (APN), Taiwo Obindo, noted in September 2022 that more than 60 million Nigerians suffer from mental illness. Obindo and the head of the Department of Psychiatry at the West African Medical College of the Nigerian branch told the Nigerian News Agency (NAN) in Abuja one Sunday.

“Mental health care is in bad shape as we have over 60 million Nigerians with various mental illnesses and only 10% of them can get proper care, we end up with over 90% of people unable to access care, and this group is called the mental illness treatment gap,” says Obindo. He said this gap stems from a variety of factors, such as a lack of understanding in which people don’t have accurate information about the causes and treatment of mental illnesses.

The 2023 World Population Assessment shows that Nigeria, the sixth largest country in the world with 222,666,814 people, has the highest number of depression cases in Africa and ranks 15th in the world in terms of suicide frequency, according to WHO. There are fewer than 150 psychiatrists in this country of 200 million people, and WHO estimates that less than 10% of Nigerians with mental disorders have access to the care they need.

A study conducted by the African Institute in collaboration with EpiAFRIC found that many Nigerians still associate mental illness with demons, witchcraft and related supernatural causes. This misconception leads many people to seek treatment from religious leaders, healers, and the like. According to Nigerian mental health expert Aisha Bubah, “People have no idea about mental health and its origin but presume faith, superstitious belief and evil. And people’s ideas about mental health are always extreme cases”. In 2019, Human Rights Watch reported that thousands of people with mental illness live in shacks in facilities designed for treatment, often run by missionaries. These centres are the only option available to many families.

The people of Nigeria have to live with the unresolved, multi-generational traumas caused by the legacy of slavery and colonialism, as well as the daily struggles for sustenance and survival, and lack of full access to psychosocial services. As we’ve seen before, our overworked psychiatrists, psychologists, therapists, social and other healthcare workers who have yet to succumb to the effects of brain drain, condemning funding shortages and a shrinking workforce.

Psychological treatments are also very expensive, and in addition, private psychologists are expensive, health insurance does not cover the cost of mental health treatment, and other comprehensive techniques are not common. However, decades after mental health regulatory reforms were delayed in legislative chambers with failed overhaul efforts in 2003 and 2013; President Muhammadu Buhari finally signed into law the Harmonised Mental Health Bill through both Houses of Parliament in January 2023. The signing appears to be a parting gift to Nigerians from the President who is also the first Post-Independence Mental Health Act/Act and will also replace the Insanity Act 1958. The new law emphasises the rights of people with mental disorders and addictions, such as the right to basic and constitutional human rights without discrimination, regardless of cause, nature or severity of mental disorders, and bans the expulsion of persons with mental disorders from residence or workplace due to a mental disorder. According to the bill, patients should be treated in the safest and least restrictive environment, receive follow-up care and rehabilitation, and have access to psychotropic medications and psychophysical therapies.

The Mental Health Act also addresses issues such as patient confidentiality and autonomy, access to patient data, labour rights for persons with mental illness, treatment plans, consent of minors to treatment, voluntary and involuntary hospitalization of persons with mental illness, and ad hoc courts. Recommendations. compulsory treatment. The telling effects of isolation and loneliness on mental wellbeing, and a plethora of domestic violence incidents during the present economic hardship should have served as a wake-up call to fully implement the current mental health and substance abuse bills. However, this has turned out to be a missed opportunity to introduce comprehensive mental health legislation.

Likewise, both the World Health Organization’s global mental health insurance initiative as well as the prevalence of substance abuse among young Nigerians have led the federal government to be pragmatic. Also, families, parents, teachers, and religious leaders have failed to understand the seriousness of what children, adolescents, and young adults sometimes experience and how this affects their relationship with their children, pushing them to the brink of loneliness, emptiness, depression and even worse, by committing suicide.

Today, despite the signing of mental health laws and legislation and the traditions of people and institutions all over the world, implementation remains an ongoing ‘sin’ for many years. 10 years. There are many issues that limit the application of fundamental rights to rather common mental health legislation. These problems continue to interfere with the administration of justice for claims of rights that would benefit from expedited hearings and proceedings. Continuing to contribute to the conversation about the flaws in justice.

Aside from the technical challenges, there are constant problems and ‘sins’ we face as a nation: a lack of knowledge of governance and a strong civic culture of mental health and its ignorance of application in our society. Many Nigerians do not receive good psychological education, particularly about citizens, to fully appreciate citizenship and the rights, duties and responsibilities of being a citizen. Therefore, they do not value and do not properly understand their rights. On the other hand, the savvy few use this knowledge, authority, or influence in violent ways. For example, using law enforcement as a tool for harassment, intimidation, or intimidation. Security and freedom of movement and freedom of speech.

Our country’s political elites seem to be included in this trend as are corporations and individuals whose motives are largely based on economic considerations. In many cases of mental health rights violations, people resort to self-help, alternative treatments, and often the perpetrators of psychological abuse go unpunished. Poverty is another challenge to the enforcement of mental health rights. A large percentage of Nigerians live in extreme poverty and therefore cannot afford the necessities of life. These abused Nigerians, despite being victims of some form of abuse, are unable to claim their rights due to being too poor, resulting in their inability to pay for psychologists, psychologists, therapist, psychiatrist, mental health counsellor or good legal representative.

Though various NGOs have consistently risen to the challenge in this regard, there is a limit to which they can go considering the massive population of the citizenry and limited funding at the disposal of many NGOs. Also, enforcement of judgments of the ECOWAS Court, as already stated in Article 19(2) of the Protocol (A/P1/91), Article 24(2) and (3) of the Supplementary Protocol and Article 22(3) of the Protocol and Article 5(2) of the ECOWAS Revised Treaty mandates member states has been another major problem and this relates to the fact that neither the ECOWAS Revised Treaty, Supplementary Protocols or other legal instruments makes provision regarding the means of enforcing the issued writ of execution where member states as Nigeria fail to voluntarily comply with the terms of the judgment of the Court. Nigerian judiciary systems especially over the years are reluctant to enforce the judgments of ECOWAS Court and this poses a difficult challenge for the judgment creditor to reap the fruits of the judgment in mental health.

Caleb Onah is a Digital Psychologist & writer with over 5 years of hand-on counseling services to individuals and groups and can be reached at calebandonah@gmail.com

By Christiana Ekpa

The lead Aspirant for the position of the 10th House of Representatives, Hon. Muktar Aliyu Betara has assured all Members-elect across party lines of his resolve to carry everybody along if elected.

Hon. Betara who doubles as the incumbent Chairman, House Committee on Appropriations gave the assurance during the expanded consultation with various leaders and members of State Caucuses during the Lesser Hajj in Saudi Arabia.

The meeting was attended by returning and newly elected National Assembly members from Adamawa, Katsina, Kaduna, Gombe, Jigawa and Bauchi States, respectively.

The House Appropriation Committee Chairman who is currently in the holy land to perform the lesser Hajj (Umrah) ahead of the completion of the Ramadan Fast is using the opportunity to meet and consult members-elect to advance his campaign

Photographs sighted shows the Borno-lawmaker meeting and interacting with fellow lawmakers at his apartment in the holy city of Makkah on Monday evening.

Some of the Members-elect who attended the meeting pledged

•Assures members across your party lines of equal participation

unflinching support for Hon. Betara, applauded his leadership quality and support provided over the years to his contemporaries irrespective of religious, ethnic and party affiliation.

One of the lawmakers who spoke after the meeting said: “We are here on solidarity support for our Leader and esteemed Colleague for heeding to the clarion call to provide quality leadership.

“We are all aware of the significant roles played by Rt. Honourable Muktar Aliyu Betara played in the emergence of successive Speakers and Principal Officers in the current and successive Assemblies.

“Most of us are also aware of his resolve to shelve his ambitions of becoming the Speaker in the previous Assemblies and as a loyal party-man aligned with the Party’s zoning arrangement.

“For those in the know of how things panned out in the outgoing Assembly, I can tell you for free that Honourable Betara played significant role in averting serious crises althrough, which helped in stabilizing this Assembly.

“But as human beings, we are not too surprised what is playing out now. As you can see, so many of them forget so soon.

“Let me ask you this question, have you ever seen Honourable Betara bully any of his Colleagues either as the Chairman of Defence or Appropriations? But all we are asking for is that the Memberselect should be allowed to exercise their franchise as provided by the Standing Order and relevant sections of the 1999 Constitution (as amended).

“For us as a formidable Team and Caucuses, we have all it takes to rally required support for Honourable Betara and of the assurance that whatever plays out will be in his favour insha Allah during the inauguration of the 10th Assembly,” he assured.

The lawmakers who are expected to be sworn-in in June, 2023 acknowledged the high sense of humility demonstrated by Hon. Betara whom they described as an Achiever, Bridge-builder, unifying factor, Team Player, Detribalised Leader of uncommon virtues and Role Model.

They maintained that Hon. Betara remains the most popular Aspirant in the the Speakership race, given his generous disposition and responsiveness to members’ welfare, hence the resolve of making the returning and newly elected to support his ambition.

OGP: Citizens’ groups verify open governance commitment areas for Kaduna State

From: Femi Oyelola, Kaduna

Some citizens’ groups on Tuesday verified the commitment areas they nominated to inform the third State Action Plan (SAP) for its Open Government Partnership (OGP).

The verification meeting, held in Kaduna, was supported by Partnership to Engage, Reform and Learn (PERL), a governance programme of the United Kingdom Foreign, Commonwealth and Development Office (FCDO).

The OGP is a multilateral initiative that aims to secure concrete commitments from governments to promote open governance, empower citizens, fight corruption, and harness new technologies to strengthen governance.

The Kaduna State Government joined the OGP in 2018 and developed its first Action Plan, 2018 to 2020, while the second Action Plan, 2021 to 2023 elapsed in March.

The first action plan focused on open budget, citizens’ engagement, and access to information, open contacting, and ease of doing business.

The second action plan focused on open budget, open contracting, citizens’ engagement, strengthening social protection systems and improving service delivery in health and education sectors.

To ensure sustainability of open governance in the state, citizens’ groups in March met and nominated some commitment areas to inform the third State Action Plan of the OGP.

Mr Philip Yatai, Citizens Cochair, OGP Technical Working Group (TWG) on Strengthening Social Protection systems said that the objective of the meeting was to review and validate the nominated commitment.

Yatai added that the meeting was also to set agender and develop strategy for the civil society members of the third State Action Plan drafting committee.

The OGP Citizens Co-chair in the state, Hajiya Hadiza Umar, described the verification as critical to getting the bye-in of the new administrating taking off on May 29.

Umar explained that the meeting provides citizens in the state to nominate commitment areas that resonate with the public to inform the third state action plan.

She noted that the co-creation principle of the OGP between the government and citizens had strengthened citizens’ participation in governance, thereby strengthening transparency and accountability.

“This is a critical moment for us as citizens to continue to have a space at the discussion table for inclusive and people-oriented governance.

“Let us make the best use of the opportunity by ensuring that whatever commitments we are verifying are critical, deliverable and will get the buy-in of the incoming government,” she said.

On his part, PERL State Lead Facilitator, Mr Abel Adejor, stressed the need for citizens to consolidate on the gains so far recorded from SAP I and SAP II.