By Sam Okpaku
Mental health and illness business and development: Some reflections.
ALTHOUGH I have spent over five decades abroad studying and working in various countries, my home country remains Nigeria. A few weeks ago, I visited for a very brief period. During this visit one of the most frequent lamentations I heard was concern over the rise of teen and youth suicide (a trend which is happening in the US and possibly globally).
Some individuals qualified their observations with “this is not Nigeria”. It is justified to be concerned about this trend as it may be a harbinger of other things to follow. There are speculations that this trend could be attributable to high youth unemployment (a university degree does not guarantee a respectful job), the use of street drugs and exposure to foreign and alien culture via the internet and social media.
Incidentally, I recall a radio interview I did many years ago with Professor Alfred Opubor, a former Head of the Department of Communications at the University of Lagos. He posed a question to me. The question was whether a country could be “depressed”. I equivocated but I have struggled over that question for many years. I believe a partial answer can be found in the various happiness studies that have been carried out initially in Bhutan and then elsewhere. Basically the Gross National Happiness of a population is obtained by the results of a survey of a community.
The survey questions include items on religious behaviour, health, education, community vitality, balanced time use, psychological and mental wellbeing. In contradistinction to the Gross National Product, GNP, the Gross National Happiness, GNH, emphasizes life satisfaction and wellbeing rather than economic success and growth. However, a major cause and consequence of mental illness is poverty. I left Nigeria in 1962. This was a time of strife and political uncertainties. I recall returning to Onikan (Lagos) from the Anglican Girls School in Surulere where I taught science prior to going to university.
As the school van came close to the Lagos Race Course there was a Black Maria. It was reported that Chief Obafemi Avolowo, one of the early architects of Nigerian Independence had been arrested and was being taken to jail. Because of the passage of time, my memory of events at that time may not be 100 per cent accurate anymore. Nevertheless, it is fair and accurate to say that with independence came a nationwide euphoria. There were emphases on the African and Nigerian personalities.
We were often loud and we exuded much confidence and pride. Since then the population has exploded. Lagos alone is estimated to be above 20 million in population. Accompanying this rise in population is the rise of social ills like kidnapping, armed robbery and human trafficking. It is painful to see young Nigerian women in places like India and Italy as victims of human trafficking and slavery. All of this is against a background of growth and modernisation in some areas. So what is the relevance of the above as it relates to the business community and mental health and wellbeing of the nation.
As I have indicated, poverty can be a cause and consequence of mental illness. A thriving economy is good for business investments and economic stability. As enshrined in the UN Development Goals and the Sustainable Development Goals, mental health has pertinence for several of the goals. Examples include eradication of poverty and hunger, reduce child mortality, improve mental health, and combat HIV/AIDS.
In terms of the sustainable goals of development many African countries have lagged behind and are not close to the targeted goals. There are many reasons for this. The African continent is plagued with political unrest, famine, floods, and other consequences of climate change; witness flooding in South Sudan and Mozambique, the expansion of the Sahara Desert, the drying up of Lake Chad and Lake Victoria. All of these complied with political conflicts and unrest have adverse effects on the Gross National Happiness and mental health across Africa. Many African countries contribute very little of their annual budgets to mental health.
Some African countries have only one or two psychiatrists. In addition, stigma associated with mental illness remains great in many parts of Africa and to be fair and objective the role of stigma is worldwide. This is in spite of the fact that mental illness is common place and that it remains largely undiagnosed and untreated in many communities. I frankly do not know any extended family that is untouched by one or another form of mental illness or emotional distress. In fact, I have previously suggested that an individual cannot love unless he or she has the capacity to be depressed.
Similarly, to experience anxiety in one form or the other is part of human existence. I do not believe that any individual has complete control over their interpersonal relationship, emotional and economic need at all times. So, what can the business community do? Business leaders and stakeholders should be familiar with the development goals, the sustainable goals and the social determinations of health.
Basically the social determinants of health emphasise that there are social factors such as poverty, unemployment and lack of housing which play a role in community mental health. For at least a humanitarian basis, the major businesses like banks, oil companies, construction companies, may contribute positively to a national agenda. (An example is the Autism Programme sponsored by the GT Bank.) In addition, the major business can contribute to a health work environment by providing:
*Access to both physical and mental health education to include stress reduction and management
*Access to mental health services
*Training and education in mental health first aid to their human resources department.
Furthermore, bearing in mind that mental illness tends to begin at a young age (from around 1-5 years). Businesses can invest in the education and training of young people to guarantee a future strong, healthy and qualified work force. In addition, businesses can assume a leadership role and collaboration with other stakeholders, (Christian, Muslim, and other religious organisations) and respond to the humanitarian, economic and development challenges and opportunities in mental wellness education and community development.
Although, human capacity and mental health work force is scanty in some Nigerian communities, there are opportunities to emulate the use of local and cultural resources that have been used elsewhere in Africa. I am referring to, for example, the Nero Strategy in Uganda and the Friendship Bench in Zimbabwe. In the Nero Strategy grandparents assist in the rehabilitation of adolescents with emotional distress, while in the Friendship Bench lay women are trained to provide counselling for depressed women in a supportive and nonthreatening approach.
A healthy workforce is an economical and sound proposition. In the US, for example, it is estimated that 20 per cent of the labour force is experiencing significant mental disorder and substance abuse, which conditions cost businesses there about $80 to $100 billion annually. The World Health Organisation estimates that depression and anxiety cost the global economy about $1 trillion annually.
While some of the underlying statistics for these estimates may be contested and conceding that there are significant cultural and environmental differences between Nigeria and the US, the toll of mental disorders on the Nigerian labour force is bound to be significant.
Finally, small and big business leaders should remember that if they have a role in the development of the community in which they do business it can be a win-win situation.
Dr Okpaku is President of the Centre for Health, Culture and Society, Nashville.