Tackling Incidence of Mental Disorder in Nigeria

Martins Ifijeh writes that the World Mental Health Day, which is commemorated every October 10, has again brought to the fore the burning issues of mental disorders in the country and the need for government and other stakeholders to put enabling steps in place to address it

Globally, the World Mental Health Day, is commemorated every October 10. This year was no different as Nigeria joined the rest of the globe to mark the day which was tagged, ‘Young People and Mental Health in a Changing World’. It brought to the front burner cases of increase in depression and other forms of mental disorders in Nigeria, with the bottom line being that government and other stakeholders must put enabling measures in place to manage and reduce the anomaly.

A recent study by the World Health Organisation (WHO) has shown that one in four people globally will be affected by mental or neurological disorders at some point in their lives; that is at least 1.7 billion persons worldwide. Across the world, not fewer than 450 million people are currently suffering from such condition; making mental disorder one of the leading causes of ill-health and disability globally.

Mental health has been ranked the fourth leading cause of global disease burden, while it is estimated that it will rank second by 2020, lagging behind only ischemic heart diseases.

Despite being an alarming public health issue due to the large population affected, studies have shown that mental disorder is not taken as a priority, especially in low and middle-income countries like Nigeria, where it is highly misunderstood.

Forms of Mental Disorders 

Often times when mental disorder is mentioned in Nigeria, what comes to mind is the picture of insane men and women with particular spectrum of behaviour not in conformity with the general form of living. It is believed the typical naked and dirty person on the street who picks everything in sight and talks periodically to himself is the ideal person with mental disorder. But that category is just a small part of mental disorder even though it could be referred to as the extreme case of the health condition. Other forms, according to the WHO are depression, anxiety, schizophrenia, drug addiction, bipolar disorder, eating disorder, among others.

Statistics for Nigeria

Several indications show that over 60 million Nigerians have one form of mental disorder or the other with only about 20 per cent of persons in such category seen to have the obvious forms of it, which includes what the ordinary Nigerian refers to as madness, schizophrenia, and perhaps extreme case of drug or alcohol addiction; a reason that has largely made mental disorder in the remaining 80 per cent or 48 million Nigerians ignored or poorly understood.

To be exact, the WHO in 2017 said 7,079,815 Nigerians suffer from one of the most ignored and misunderstood form of mental disorder in the country – depression.

This, according to the world health body, represents 3.9 per cent of the entire population of the country, thereby making Nigeria the most depressed country in Africa. Globally, Seychelles has the lowest number of depressed persons with just 3,722, according to WHO.

It also said 4,894,557 Nigerians, that is 2.7 per cent of the population, suffer anxiety disorders. The country is closely followed by Ethiopia with 4,480,113 sufferers, Democratic Republic of Congo with 2,871,309, South Africa with 2,402,230, and Tanzania with 2,138,939 sufferers.

Tackling Depression

While all forms of mental disorders are being advocated against by the health body as priority by all member nations, including Nigeria, it is believed that the poorly misunderstood types, especially depression, should be tackled head on before they silently destroy mankind. Depression is the leading cause of disability globally, as well as the leading cause of about 800,000 suicide deaths in the world. It is also the second leading cause of death in 15 – 29 year-olds globally.

For Nigeria, with the over seven million depressed persons in the country, and the increasing suicide rates and attempts, experts believed the rising suicide trend can be drastically reduced by understanding depression, which they have termed a preventable and treatable ailment.

They said when understood by the society and spotted on time; every Nigerian developing the condition can timely seek help before it reaches the extreme consequence, suicide. According to WHO,  depression is not just a feeling of sadness but a real illness which affects the brain, adding that feeling of sadness could easily go away, but depression is a serious health condition that requires proper treatment and counseling.

Experts Speak 

Experts are of the opinion that the country has the potential to slow down the growing prevalence of the health condition if it understands that many otherwise ‘healthy’ Nigerians are depressed and are in dire need of help. They also believed that if government and other stakeholders give priority to mental health management, the prevalence would reduce.

For Doctor of Psychiatry, and Founder, Mental Balance Initiative, Dr. Reuben Oyaregbulem, failure of clinicians to identify and diagnose depression has somewhat gave seal among the society and healthcare providers that it does not exist. He said the worst part of being depressed in Nigeria was that the victim often suffers the ailment alone without a clear signal of help from either the society or even health providers.

He noted that when the depression has reached a certain level where they have concluded no one will ever understand them, the next thing is to commit suicide or harm themselves. This he said was why it is a silent killer that must be addressed. He said many Nigerians often believe depression is an elite or ‘white man’ sickness, and that it can be cured with bottles of beer, sticks of cigarette or sexual intercourse.

“Depression is not just a feeling of sadness which goes away easily. It is a tough feeling with an established imprint in the brain. It is also not stress that will go away. Agreed that stress could trigger it but the best way out of it is to treat it head on,” he said.

The former Medical Director, Federal Neuropsychiatric Hospital, Yaba, Rahman Lawal, told THISDAY in an earlier interview that one of the challenges in tackling mental health generally, including depression, was that there were myths and misconceptions surrounding psychiatric illness in Africa, especially in Nigeria.

He said: “There are people who refuse to visit the hospital or bring their sick ones for treatment, because they believe psychiatric illness is a spiritual issue. Hence, they would prefer to take such patients to spiritual healing homes or faith organisations so as to get cure through spiritual means. Majority only take neuropsychiatric hospitals as their last resort.

“You know when cases are not presented on time, they are often more difficult to treat. This is one of the reasons people don’t present their cases to the hospital, thereby preventing such sufferers from getting proper medical attention. So, what I do is that when I come across such persons, I tell them to bring their sick loved ones to the hospital whilst educating them that there are drugs for the treatment of the illnesses.”

The Grim Picture

Statistics show that Nigeria has only about 150 Psychiatrists to care for over 180 million Nigerians; that is one psychiatrist to 1.2 million Nigerians. It also shows that there are five mental health nurses to 100,000 Nigerians.

Lawal said the country has only eight neuropsychiatric hospitals, but believe state governments should complement the efforts of the federal government by establishing state psychiatric hospitals in their various states.

These statistics however show that Nigeria is not yet ready to tackle issues of mental health head on. To make matters worse, Nigeria has no clearly defined mental health policy. Perhaps the federal, states and local governments also are of the opinion, just like most Nigerians that the insane man on the street who talks to himself and sleep on dirts, is the only one with mental disorder, hence no need to give it priority.