MENTAL HEALTH INTERVENTION IN NIGERIA
The magnitude of mental disorders and the links established between mental health, physical health, and the socio-economic development of society make mental health a major public health issue. In 2001, the World Health Organization (WHO) estimated that mental disorders affected approximately 450 million people worldwide.
However, resources have, until now, been invested almost exclusively in care and rehabilitation services, and the field of mental health, which aims to strengthen psychosocial skills and prevent the onset of mental disorders, has been poorly supported. Mental health intervention has to do with the steps taken by individuals, government, or non-governmental organizations to provide the needed assistance to people living with mental illness.
In Nigeria, the disparity between the need for mental health services and the supply of mental healthcare services is palpable. Although the country has made some advances to tackle mental health problems, developing health-related policy and legislation, there have been challenges concerning training, research, financing, policy implementation, etc. Most of the major challenges include the following;
Challenges Of Mental Health Intervention In Nigeria
- Lack of mental health workers and poor facilities
Three out of every five persons, an estimate of about 50 million people living with serious mental illness in Nigeria, cannot access adequate medical care and attention due to the short supply of medical services and facilities. During the 2020 world mental health day, the Nigerian medical association stated that only 350 psychiatrists are available to serve the Nigerian population of over 200 million people, which is similar to 250 numbers of psychiatrists estimated by Dr Taiwo Sheikh, the president of the psychiatrists of Nigeria. This has resulted in a continuous hike in the number of persons living with mental disorders.
- Cultural and religious beliefs
A survey conducted by the Africa Polling Institute (API) in collaboration with EpiAFRIC shows that many Nigerians still attribute the cause of mental illness to some supernatural forces, evil spirits, voodoo, etc. Poor public education and mental health awareness have led to this misconception, forcing many people to seek treatment outside the medical fields, such as traditional herbalists and religious healers. The recovery process of people living with mental disorders has also been said to be deterred by cultural and religious stereotypes.
- Poor financing
Mental health in Nigeria has been poorly financed, despite the 15% benchmark that was allocated and agreed upon by leaders of the African Union (AU) in April 2001. This has resulted in many Nigerians paying for medical services from their pocket. The situation is worse at the state and local levels, with the government contributing only 29% and 8%, respectively, out of total government expenditure in the health sector.
How To Overcome The Challenges Of Mental Health Intervention In Nigeria
To deal effectively with this major societal issue – mental health, we must give full attention to the field of prevention/promotions and awareness of mental health. To this effect, adequate facilities and personnel must also be put in place. Here are a few recommendations that can add credibility to the access and availability of mental health services in the country if properly executed.
- Integrating mental health into primary health care
Primary care usually serves as the first point of contact with the patient within the healthcare system. Mental health care has been provided through the primary healthcare system for quite a long time in many countries all over the world. Countries such as Argentina, Australia, Belize, Chile, India, Iran, Saudi Arabia, South Africa, Uganda, Ireland, United Kingdom, among others, have recognized mental health as an integral part of primary care.
Providing mental health care and treatment through primary health care improves accessibility, affordability, cost-effectiveness, and promotes respect for human rights – all of which result in healthier outcomes for patients. We urge the establishment and integration of mental health care in rural communities with strong primary care networks that can provide complementary care in close coordination with secondary and tertiary care centers.
In addition, this setting can be used to train psychiatric residents as well as nursing and medical students in rural areas. In this way, mental health challenges in the country can be addressed in a positive manner.
- Legislation and policy formulation
Mental health support and integration into primary care are most effective when they are complemented by adequate resources, strong leadership, and effective governance. Through the WHO mental health action plan 2013–2020, a global target has also been set: by 2020, 50% of the countries must have developed or updated their mental health laws to conform with regional and international human rights instruments. Comprehensive and efficient integration of mental health services in Nigeria’s public health system requires reforming its outdated laws and formulation of policies that will lead to the establishment of a mental health commission whose mission is to support and protect persons with mental health needs.
- Human resource training and competencies
In order to increase the workforce of psychiatry and mental health support professionals, there needs to be more training institutions. Also, routine public education, outreach, training programs, and specialist supervision should be provided to assist other healthcare providers in recognizing mental health disorders and referring patients accordingly. Associations of Psychiatrists and the Nigeria Medical Association (NMA) can offer free training and outreach to general physicians and nurses on mental healthcare.
- Research and development
In Nigeria, the availability of information and research about mental health services are scarce and un-documented. This has contributed to the neglect of mental health issues in the country. In order to make informed decisions about policy directions, identify appropriate interventions, and monitor progress, the government and NGOs must make more investments in research and development. The goal is to trigger national surveys about the subject area so as to enable the development of policy directions, blueprints, and legislation based on facts and evidence.
For the mental well-being of the populace, there is an urgent need for coordinated efforts from the government, policymakers, and international organizations to implement these recommendations for better, more accessible, and affordable mental health services.
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