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Normalising mental health needs in Nigeria: A wake-up call

When researching the African feminists healing praxis for the African Women’s Development Fund’s (AWDF) Mental Health and Emotional Wellbeing Knowledge Series in 2021, I stumbled upon a shocking discovery. The federal government of Nigeria has almost entirely neglected mental healthcare throughout its 61 years of independence.

There has never been a comprehensive mental health act, which addresses citizens’ mental health needs. Mental health conditions, such as intergenerational traumas, depression, anxiety disorders, suicidal thoughts, substance abuse, chronic psychological and neurological illnesses, or other social/emotional disturbances, have no progressive law or infrastructure guiding their treatments.

Photo by Femi Amogunla

The problem at a glance

Mental health issues are a global phenomenon, affecting millions (if not billions, as I believe accurate statistics are lacking) worldwide. Mental illnesses are likewise becoming more rampant in the 21st century due to the increasing contemporary challenges, complicated by technological advancement, historical traumas, perennial violent conflicts and extremism, poverty, and inequalities, COVID-19 pandemic, climate change, work pressure, and other human complexities.

Nigerians living with unresolved multigenerational trauma from legacies of slavery and colonialism, as well as everyday struggles, have to endure no access to adequate psychosocial services.

The mental health enactment available to Nigerians is the age-old outdated colonial lunacy act of 1958, which replaced the lunacy ordinance of 1916. The lunacy act is steeped in stereotypes, stigmatisation, discrimination, dehumanisation and forced psychiatric treatments. It practically inhibits the holistic understanding of mental illnesses.

Prevailing traditional and religious methods are also complicating mental health knowledge. Religious interventions deem mental disorders spiritual or demonic to be exorcised or beaten out of the “afflicted”. Mental health patients are dehumanised, abused, chained and forced to drink medicine in unsanitary asylums. These horrific depictions of mental health conditions and cures have led untreated or escaped patients to roam the streets naked and abandoned.

Medically, Nigeria has about 350 trained psychiatrists to attend to any mental health concerns arising among 200 million inhabitants. The overworked psychiatrists, who have not yet succumbed to the brain drain effect, are decrying the poor funding and dwindling labour force.

Psychological treatments are also costly, and overmedicated psychiatric management is a possibility. In addition, private psychologists are expensive, health insurance won’t cover the cost of mental health treatment, and other holistic techniques are not mainstream.

The COVID-19 pandemic presented an opportunity for the Nigerian government to get a better understanding of their citizens’ mental health needs. The telling effects of isolation and loneliness on mental wellbeing, and a plethora of domestic violence incidents during the lockdowns should have served as a wake-up call to revisit its paused mental health and substance abuse bills.

However, it became a missed opportunity to instate comprehensive mental health legislation. Likewise, neither the World Health Organization’s universal mental health coverage initiative nor the Nigerian youth drug abuse endemic influenced the federal government to pragmatism.

A glimpsed solution

Not all levels of governance have failed mental health services in Nigeria. For instance, the Ekiti state government recently passed a non-discriminatory mental health service bill. The act declared zero-tolerance for stigmatization, marginalisation, and abuse, demonstrating a deeper understanding of mental health issues. While this is at the state level, a ripple effect championed by the federal government is crucial.

Public awareness that shows anyone can be affected by mental health conditions is equally vital, including psychologists who are breaking their silence on their own mental illnesses. As neuroscientists have shown the intricate link between mental and emotional health, awareness and education are essential to changing limiting perceptions. It can help bring an end to the inhumane treatment of people declared “lunatic”, “insane” or “mad” by society while collectively pursuing inclusive healing.

Non-state actors are spearheading ongoing inclusive healing efforts and courageous conversations to demystify mental health conditions and promote holistic care practices. This extends to collective actions at prioritising mental and emotional health through non-western transnational mechanisms such as modern and ancient storytelling, art, dance, music, meditation and yoga therapy techniques.

For example, through feminist organizing, AWDF, Feminist Republik, and others, are diving into healing justice to transform historical trauma and violence on the bodies, minds, and spirits of African womxn who continue to battle oppressive systems, burnouts, and exhaustion that come with enduring activism. The dedications and concerted efforts by these African feminist organisations supporting womxn-led self and collective wellbeing have a lot to impart political leadership.

Similarly, organisations, such as iAfrika and Neem Foundation, are advancing healing cultures in Africa and bringing more to knowledge production. For instance, Neem has developed broad psychosocial responses for survivors of extremist attacks, through holistic handling of posttraumatic stress disorder (PTSD), anxieties and other shock-induced traumas. iAfrika is partaking in holistic research and praxes for historical trauma and intra/interpersonal healing. The Nigerian government can tap into these citizen-led Ubuntu-full empirical explorations and practices to guide their mental health act and its implementation.

A nuanced mental health act that grasps peoples’ psychological and neurological needs is necessary for all-encompassing healing pathways. Comprehensive mental health law backed by sustaining implementation will assist people in holistically navigating day-to-day struggles or complicated situations. Integrating mental health needs into primary healthcare is imperative for people to thrive and governing institutions can no longer sit back, fold their arms, and do nothing.

This article first appeared on King’s College London’s Website as a contribution to KCL Mental Health Week’s event.