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Experts advocate integrated approach to mental healthcare

By Sola Ogundipe

EXPERTS in mental health have called on the Federal government to immediately put in place an integrated approach for management of mental and physical health ailments in the country. The call was made on the basis of an established link between psychiatric conditions and chronic health conditions.

Making the call last week in Lagos, Chief Medical Director of the Federal Neuro-Psychiatric Hospital, Yaba, Dr. Taiwo Ladapo, said it was only through the integration of mental and physical healthcare that the concept of total health as described by the World Health Organisation could be attained.

Ladapo who spoke during a seminar to mark the 2010 World Mental Health Day with the theme: “Mental Health and Chronic Physical Illnesses: The Need for Continued and Integrated Care” enumerated the need for team approach as intervention strategy in treatment and management of chronic psychiatric disorders in the country.

During the event organised by the hospital in collaboration with the Association of Friends of the Psychiatric Hospital, Yaba, Ladapo remarked that the integrated health approach was non-negotiable. According to the MD, admission rate at the hospital had increased in recent times, thanks to advocacy and awareness and education and knowledge. “So many people are coming on their own to see psychiatrics and psychologists unlike in the past when people were afraid to come into the compound.”

He said, presently, the hospital which runs a 24_hour emergency service, has 12 consultants and 47 resident doctors to cater for an average intake of 25 new cases daily. “We need policies for discharging mental health services. Right now there are no policies.”

He recalled that mental health is a global priority and that it was high time a realistic approach to its management was adopted in Nigeria. “This year’s theme is apt because we believe mental illness is a chronic illness on its own and can be comparable to any of the other long-term chronic illnesses such as diabetes, hypertension , cancer, asthma, sickle cell disease and arthritis, etc. So if government is funding treatment for diabetes and hypertension and other chronic ailments, it should also fund treatment for mental health.”

On the link between mental disorders and chronic illnesses, he said just as a diabetic or hypertensive patient would attend clinic for many years, so also would a psychiatric patient. “This would reduce stigma and enable the patient receive adequate treatment. In our hospital, we have been able to integrate treatment for diabetic and hypertensive patients with mental health treatment.”

He said the fact that there is stigma associated with mental illness further highlights the need for better integration between mental and physical healthcare to help people improve the management of co-existing mental and physical illness.

“It is noteworthy that some aspects of psychiatric treatment has been integrated into the NHIS and here, some departments such as the laboratories, x-ray and psychology are registered under the scheme. We also run a community clinic manned by consultants and a physician and we refer patients with diabetic and hypertensive conditions to attend the clinic.

Also speaking on the essence of integrated healthcare approach, Head of the hospital’s Clinical Services Department, Dr. Oluyemisi Ogun, asserted that the mind and body are connected, hence the link between mental and physical health.

“There can be no health without mental health and equally there can be no good physical health without mental health,” she argued. “Chronic illness and mental health are linked. The frequent co-existence of depression and chronic illness identified by the World Federation for Mental Health highlights the need for integrated care within the health service.”

She said many people who have severe mental health problems have poorer health outcomes than the rest of the population and people living with long-term physical conditions have poor mental health outcome. “There is need for plan and policy to be framed to implement primary care for mental health. There needs to be adequate earmarking for financial human resources to ensure the availability of services to maximum number of individuals.”

On this year’s theme, she explained that it was part of the drive by theWHO to enable clinicians promote well being by focusing on management of mental and physical illnesses. The process, she observed, should involve not only the Ministry of Health, but also Ministries of Youth and Social Welfare, Women Affairs, Education and Communication.


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