Nigeria And The Challenge Of Mental Disorder

Opinion

By Bilikis Bakare

Medical experts in the country recently revealed that 64 million Nigerians suffer from one form of mental illness or the other. And despite the country’s population which stands at over 160 million, none of the psychiatric hospitals in Nigeria today has up to 1,000 beds. Also, it is disheartening to note that the country has about only 150 psychiatrists, 34 neuro-surgeons, translating to the ratio of 1 psychiatrist to over 1 million Nigerians!

The World Health Organisation, WHO, describes mental health ”as a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

On the other hand, mental disorder, mental illness or psychiatric disorder- one aspect of mental health, is a mental or behavioural pattern or anomaly that causes either suffering or an impaired ability to function in ordinary life and which is not developmentally or socially normative. It is a combination of how a person feels, acts, thinks or perceives, associated with particular regions or functions of the brain or rest of the nervous system, often in a social context.

The causes of mental illnesses are complex and vary according to the particular disorder and individuals. Genetic compositions, early development, drugs, a loss of family member, disease or injury, like traumatic brain injury or disease like cancer, mother’s exposure to viruses or toxic chemicals while pregnant may also play a part;  neurocognitive and psychological mechanisms, and life experiences, society and culture, can all contribute to the development or progression of different mental disorders in   people. But, the most common view, however, is that mental disorder tends to result from genetic vulnerabilities and environmental stressors combining to cause patterns of dysfunction or trigger disorder. Examples of serious mental disorders include, major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder, post traumatic stress disorder, and borderline personality disorder.

Mental illnesses can affect persons of any age, race, religion, or income. Therefore, mental illnesses are not the results of personal weaknesses, lack of character or poor upbringing. Signs and symptoms of mental disorder can vary depending on the particular disorder, circumstances and other factors which may include, feeling sad or down, confused thinking or reduced ability to concentrate, excessive fears or worries, extreme mood changes of highs and lows, withdrawal from friends and activities, detachment from reality (delusion), hallucination or paranoia. Other signs and symptoms are inability to cope with daily problems or stress, extreme feelings of guilt, alcohol or drug abuse, major changes in eating habits, excessive anger, hostility or violence and suicidal thinking among others.

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While it was difficult to detect those at risk of lifelong mental illnesses in the years gone by, it is now possible to detect this through a depression saliva test, an innovation that can play a major role in the early detection and prompt treatment of people at risk. No matter how glaring the effects of mental health issues are, whether it is depression, epilepsy, dementia, alcohol dependence or death, they can be managed effectively with the affected individual living a reasonably normal life. Not managing mental health in the workplace has a huge impact on individuals and is equally bad for business too, with an estimated annual cost to employers of billions of naira. And given the negative perception from employers, many applicants may feel that it is in their best interest not to disclose their mental conditions. Today, more than 73 percent of work places across the world still have no formal mental health policy.

In Lagos State, research statistics have shown that more than 2.5 million residents of the state have one form of mental disorder or the other, representing an average of more than 14.1 percent of the total population. It is in recognition of the threat posed by mental disorder that the Lagos State Government recently adopted a policy that aims to respect the rights of residents with mental illness. The objective is to guarantee social justice and equity for victims of mental illness as well as ensuring that the rights of people suffering from mental disorders are respected. This approach by the state government includes sufficient and detailed strategies aimed at reducing the impact of mental health disorders in the state.

The basic components of the state’s mental health policy include promotion aimed at conducting awareness programmes and educating the people on the effects of substance and alcohol abuse, primary care and access to services, treatment guidelines at health care level, services for people with severe mental illnesses, reduction of work place stress and the risk of suicides and human resources for mental health. Right now, the first step in  the policy is investment in mental health across the state and the recent announcement by the State Governor, Babatunde Fashola, that the state is planning to build a psychiatric hospital to complement the Federal Government owned Psychiatric Hospital at Yaba.

The deduction from the Lagos intervention is that with appropriate, effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can now significantly reduce the impact of their illness and find a satisfying  measure of achievement and independence. We have over the years allowed stigma and unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery of mental health disorder victims because the truth is that recovery from the illness is possible.

Therefore, it is time to break these barriers down. And this is where the initiative of the Lagos State Government is highly commendable. However, for the policy to be successful and achieve optimal results, it must be embraced by all stakeholders in the society. Active participation of private sector stakeholders, non- governmental organisations, religious groups, individuals and philanthropic organisations is also essential in the creation of a strong network of aftercare services.

•Bakare is of the Features Unit, Ministry of Information and Strategy, Alausa, Ikeja.

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