• Over 40m Nigerians suffer mental disorder
•Lament low budget for disorder
By Olasunkanmi Akoni, Chioma Obinna, Funmi Ajumobi, Gabriel Olawale, Dania Onozure, Providence Adeyinka, Elizabeth Adegbesan & Juliet Umeh
Experts and stakeholders yesterday in Lagos stressed the need to demystify the stigma associated with mental health disorder toward an effective, practical, affordable, and compassionate mental health care system in Nigeria.
They spoke at the maiden Vanguard Mental Health Summit, with the theme: “Mobilizing for Systemic Change and Better Mental Health Care in Nigeria,” held at the Eko Hotel and Suites, Victoria Island, Lagos.
At the summit, one of the speakers and President of the Association of Psychiatrists in Nigeria, APN, Prof. Taiwo Sheikh, said treatment gap in mental health cases had grown to as high as 85 per cent.
Prof Sheikh spoke just as chairman of Lagos State Primary Healthcare Board and chairman of the summit, Prof. Akin Osibogun, expressed concern over increasing cases of mental health issues in Nigeria, disclosing that more than 40 million Nigerians were suffering from mental health disorder.
Lagos expanding mental health treatment
Speaking at the summit that attracted over 100 experts, panelists and other participants, Lagos State Commissioner for Health, Prof. Akin Abayomi, said the state was expanding management and treatment of psychiatric related ailments with a 500 bed hospital facility, aimed at offering succour to people suffering from the disorder.
Abayomi also informed of plans by the state to construct a 1000-bed annex for rehabilitation, adding that process was ongoing to ensure that mental health treatment was covered by the State Health Insurance scheme.
He said: “In Nigeria, we have obsolete law which dated back to 1920 and was last reviewed in 1964 and was domesticated in Lagos State. The law is to make people with mental health disorder to be removed from our general observation and confined to facilities where the general public is unable to observe them. That is a barbaric way of dealing with mental health and in Lagos State, we have developed the process of transforming the process.
“We all know that Lagos State is a very stressful environment with high level of mental stress and probably the most important place to make such aggressive move. For us to have paradigm shift, we look at international bench mark and we engage the stakeholders and after the extensive process, we enacted Lagos State Mental Health Law.
“This is the first modern mental health law in Nigeria and we are still waiting for federal law but we need to move quickly. We are going to increase investment in mental health and establish Lagos mental health lifeline to scale up integration of mental health care into our tertiary, secondary and primary healthcare delivery system.
“As we speak, we are promoting integration of mental healthcare services into the Lagos State Health Insurance Scheme, under it, people with mental health disorder can receive consultation and therapy.”
40m Nigerians suffer mental disorder
Similarly, Professor Osibogun expressed concern over increasing cases of mental health issues in Nigeria, disclosing that more than 40 million Nigerians were suffering from mental health disorder.
Osibogun said the situation was worsened by the current insecurity in the country, adding that the country continually experienced brain drain in area of medical expert.
He noted that the predicament of people suffering mental health related issues were compounded as a result of stigmatization, discrimination, denial and lack of understanding.
“Recent estimates suggest that not less than 40 million Nigerians have one mental issue or the other and we have less than 200 psychiatrists in the country at the last count. I honestly don’t know how many are left after the current wave of brain drain.
“Mental health issues have generally suffered from denial, lack of understanding, stigmatization and discrimination which are all compounded by a difficulty in initiating a public discussion of the issue,” he said.
Osibogun, who commended Vanguard Media Limited for being a socially responsible organization, said: “This reputable media organization has succeeded in bringing together an array of distinguished professionals from different but inter-connected sectors to brainstorm on the issues and proffer possible solutions.”
Stop self-stigmatisation —Dr Kadiri
Also, the Medical Director and Psychiatrist-in-Chief, Pinnacle Medical Services, Dr Maymunah Kadiri, charged Nigerians managing mental health to stop self-stigmatisation.
Kadiri argued that self-stigmatisation does more harm than societal stigmatisation.
According to her, “self-perceived stigmatisation refers to the negative attitudes, including internalized shame, that people with mental illness have about their own condition. Stigma not only directly affects individuals with mental illness but also loved ones who support them, often including their family members.”
Kadiri also contended that negative self-attitudes and beliefs towards people with mental health condition were common, describing “stigma as when someone views someone in a negative way because the person has distinguishing characteristics or personal traits that are thought to be, or is a disadvantage, a stereotype.
“Stigma can lead to discrimination which is obvious and direct, such as someone making a negative remark about your mental illness or your treatment. It may be unintentional or subtle, such as someone avoiding you because the person assumes you could be unstable, violent or dangerous due to your mental illness. You may even judge yourself,” she added.
She itemized stigma into three stages, such as “Social or Public stigma which involves the negative discriminatory attitudes, self-stigma and institutional stigma. Institutional stigma is more systematic, involving policies of government and private organizations that intentionally limit opportunities for people with mental illness.”
According to her, ”common signs of stigma include paying more attention to the symptoms and effects of mental illness than you do on other aspects of yourself, cut yourself over-thinking the words, actions, and non-verbal behavior of others, knowing that you are not measuring up. Notice self-derogatory thoughts running through your mind among others.”
Explaining how to cope with stigma, she said the person should get treated.
“Don’t let stigma create self-doubt and shame, don’t isolate yourself or equate yourself with your illness. Then join a support group like local and international groups. Also, get help at school and speak out against stigma,” Kadiri added.
Mental health treatment gap in Nigeria hits 85%
Similarly, the President, Association of Psychiatrists in Nigeria, APN, Prof. Taiwo Sheikh, said treatment gap in mental health cases had grown to as high as 85 per cent.
He noted that the number of serious cases receiving no treatment during the last one year in developed countries varied from 35.5 per cent to 50.3 per cent.
He said there was no clearly defined budget allocation for mental health in the national health budget.
He said: “The number of serious cases receiving no treatment during the last 12 months in developed countries varies from 35.5 percent to 50.3 percent. This “treatment gap” in Nigeria is as high as 85% (this is referred to as the “mental health gap”).
”There is no clearly defined budget allocation for mental health in the national health budget, allocation for health amounts to only 3.65 percent of 2016 budget and about 3.3 percent of the health budget of the central government goes to mental health, with over 90 per cent of this going to institution-based services provided through eight stand-alone mental hospitals.
”There is enormous inequity in the distribution of mental health services and available resources.”
Sheik, who noted that mental health was now considered one of the most neglected areas of health, where over 70 per cent of patients with mental health problems/disorders seek unorthodox interventions before orthodox care, stressed that there were 0.09 psychiatrists, 4 psychiatric nurses, 0.02 clinical psychologists and 0.02 social workers per 100,000 persons.
He said: “Today; we have about 300 Psychiatrists in Nigeria and over 1000 Nigerian Psychiatrists outside Nigeria. Mental health has come a long way in Nigeria, but we are yet to achieve systemic change for universal access to effective, qualitative and affordable mental care.
”The signing of the mental health bill into law is a critical investment in mental health in Nigeria that will guarantee access to effective, compassionate and quality mental healthcare we desire.”
Going forward, he stressed the need to increase mental health funding through direct budgetary allocation and integration of mental health into primary care; passage of mental health bill into law; revision of 2013 national mental health policy and develop national strategic plan for mental health.
Sheik stated: “It is estimated that 20-30 per cent of Nigeria’s population suffer mental health challenges. Common mental disorders we encounter everyday include: anxiety, depression, psychosis, substance use disorder, among others
“The Nigeria mental health system lacks provision for targeting actions to tackle the precise needs of groups who have been historically neglected, such as women, children, elderly, homeless and the very poor. Such specific focus is necessitated by the likelihood of these groups’ having different risk factors, mental disorder prevalence, and help-seeking behaviours.”
Over N1bn illicit drugs seized from dealers —NDLEA
On his part, the chairman, the National Drug Law Enforcement Agency, NDLEA, Brigadier- General Mohammed Buba Marwa, retd, disclosed that his administration had seized illicit drugs worth over N1billion from suspected dealers in the fight against drug abuse.
The NDLEA boss described the summit as “apt” at a time when mental health crisis caused by various factors was ravaging a good number of Nigeria’s population
Marwa, who was represented by Assistant State Commander, Lagos State Command, NDLEA, Marcus Ayuba, stated: “Under the current administration in the fight against drug abuse, the NDLEA has seized illicit drugs from various dealers worth N1 billion so far.
“Substance abuse is one of the major factors that predispose people to mental health challenge. It is sad to note that substance abuse especially the abuse of hard drugs has become prevalent in our country today.
“Recently, a survey conducted by the United Nations office on Drugs and Crime, UNODC, on drug use, ranked Nigeria as the highest in drug use prevalence in the world. While some countries have average of 4.5 to 5 per cent drug abuse prevalence rate, Nigeria has 14.3 per cent prevalence rate in drug use.
“This is no doubt a worrisome development which also worsens the mental health burden of our citizens, especially the youths.
“Notwithstanding the enormity of the challenge at hand, I am, however, optimistic that concerted efforts by relevant stakeholders will bring about a positive change.
“It is in the light of the above that I want to commend the Vanguard Media Limited for blazing the trail by organizing this summit on mental health. It is a right step-in the right direction.
“The theme is also apt, especially at a time like this when many Nigerian youths ravaged by mental health challenges are seeking rehabilitation in our rehabilitation facilities and other private rehabilitation facilities across the country.
“I believe that bringing up the challenges to the front burner today will precipitate a wholesome societal approach that will ameliorate the travails of the emerging challenges.”
In the same vein, Lagos Chairman, Nigeria Medical Association, NMA, Dr. Adetunji Adenekan, said: “For too long, mental disorders have been largely overlooked by health system, and by this I mean all stakeholders involved, such that the millennium and development goals, MDGS, conspicuously omitted mental healthcare and it took the introduction of sustainable development goals many years later for mental health to be given its rightful place of recognition.
“This is despite the fact that mental health disorders are found in all countries, affecting men and women in all stages of life, the rich and the poor, rural and urban settings. Lack of political will and up-to-date legislation, inadequate resources, overburdened health services, resistance from policy makers and health workers, cultural as well as religious beliefs and practices have hindered the development of coherent mental health system.
“Also the misunderstanding about the nature of mental disorders and their treatment has also complicated the progress. Some people assume people with mental disorders are violent and unstable and, therefore, should be locked away, whereas majority of them are nonviolent and capable of living productively within their communities.
“There are several factors that are critical to ensure better mental health care in Nigeria and this includes building of community mental health services, developing mental health services in general hospital, integrating mental services into primary health care, building informal community mental health services, employment of trained and skilled practitioners, among others.”
We want to demystify mental health issues —Adefaye
Earlier in his remarks, Vanguard’s General Manager/Editor-in-Chief, Mr Gbenga Adefaye, while welcoming participants, explained that Vanguard, with a proven track record of initiating discourse around issues of public relevance that inspire community interest while engaging conversations for sustainable change, deemed it fit to organise the event to demystify mental health issues in the country.
Speaking on the theme, Adefaye said the primary agenda of the summit was the development of a sustainable national mental health agenda through participatory engagement.
He said: “The Vanguard Mental Health Summit is aimed at initiating change in the management of mental health in Nigeria by improving knowledge, mobilizing leadership, and fostering collaboration at all levels.
“The summit will advance the conversation about mental health challenges, successes, and opportunities at the individual, family, workplace, group, community and national levels.
“The main goal of this maiden Summit is not to start another conversation; it is to continue the existing one. This is about elevating that conversation that is already on to national level and bring mental illness out of the shadows.
“We want to let people living with mental health challenges know that they are not alone, and that it is not the end, and that with the support and commitment of all, there is hope.
“Too many Nigerians who struggle with mental health illnesses are still suffering in silence. This needs to stop. Through interventions like this Summit, we can take out some of the pain and give a new sense of hope.
“We need to do better in recognizing mental health issues among us, and making it easier for those affected to seek help. Today, we are kick-starting a new type of campaign, designed to change attitudes about mental illness. For years now, our mental health system has struggled to serve the people who depend on it.
“For many people who suffer from mental illness, recovery can be challenging, but what helps more than anything, what is going to give Nigerians strength is the knowledge and assurance that they are not alone and that help is available.
“We are breaking the silence, and demystifying mental health issues. This is what Vanguard is doing.”
Among experts and participants at the event were Dr Taiwo Lateef Sheikh, President, Association of Psychiatrists of Nigeria, APN, Lagos State Primary Healthcare Board, Prof. Akin Osibogun, Dr Maymunah Yusuf Kadiri, MD/CEO Pinnacle Medical Services, Lagos, Ms Titilayo Tade, Training Coordinator, Suicide Research Prevention Initiative, SURPIN, Dr Siju Iluyomade, Founder Arise Women, and Dr Olugbenga Owoeye, MD Psychiatric Hospital, Yaba.
Others were Prof Ralph Akinfeleye, Health Communication Specialist, Dr Martin Agwogie, Founder/Executive Director, Global Initiative on Substance Abuse (GISA), Dr Oluseun Peter Ogunnubi, Consultant Psychiatrist /CEO Grace Cottage Clinic, Ilupeju, Lagos,. Mrs Sade Ajayi, Trustee, WAITT Organization, Mrs Ebun Anozie, Executive Director, COPE, and Dr Veronica Nyamali, Vice President, APN
Also at the event, were Wife of the Minister of Works, Dame Abimbola Fashola, Lagos State Commissioner for Information and Strategy Mr Gbenga Omotoso, Commissioner for Women Affairs and Poverty Alleviation WAPA, Mrs. Bolaji Dada, Mrs Funmi Adesegun, Wife of former Ogun Deputy Governor/Proprietress, Mrs Mories Atoki, CEO ABC Health, Folashade Ambrose-Medebem, Director, Community, Public Affairs & Sustainable Development Lafarge Africa PLC, Dayo Israel, Permanent Board Member, SUBEB, and Mr Andrew Agada, Principal, King’s College, Lagos
Others were, Mrs Lai Koiki, Executive Director, Greenspring Schools, Lagos, Dr. Tokunbo Yakubu-Oyinloye, Principal, Queen’s College, Mrs Oye. Chrisland College, Olufunsho Owasanoye, Executive Director, Human Development Initiative, Toun Okewale – CEO Women Radio, Mr Wellington Mpofu – Marketing Director, Radisson Blu Hotel, Alhaji Shehu – Chairman, Mile12 Market, and Sam Ohuabunwa – President, Pharmaceutical Society of Nigeria, PSN,
Also, at the event were Dr Osahon Enabulele, President, Common Wealth Medical Association, Prof Chris Bode Chief Medical Director, Lagos University Teaching Hospital, Prof Wale Oke, Provost College of Medicine, Lagos University Teaching Hospital, Dr. Adedamola Dada, Medical Director, Federal Medical Centre, Ebute Metta, Fidelis Ayabae, President, PMGMAN /Fidson Healthcare Limited and Dr Veronica Oluyemisi Nyamali, Vice President APN, Consultant Psychiatrist/Psychiatric Rehabilitation Specialist, Federal Neuro-Psychiatric Hospital, Yaba, Lagos
Participants also included Dr Femi Olugbile, Former Permanent Secretary, Lagos Ministry of Health Consultant Psychiatrist, Dr Adetunji Adenekan Lagos State Chairman, NMA, 28. Dr Oluwajimi Sodipo, Chairman, Medical Guild, Dr Anthony Omolola – Former President, Chairman Association of General Private Medical Practitioners, AGPMPN/Chairman, Advisory Board of Nigerian Healthcare Excellence Award 2021, Dr. Jimmy Arigbabuwo, Chairman, Association of General and Private Medical Practitioners of Nigeria (AGPMPN), Dr Jimi Coker, Medical Director, Lagoon Hospital, Dr Nneka Nwaobi, Executive Director, Children Living with Cancer Foundation and Akintayo Olumide, Past President, PSN
Equally at the event were, Dr Ibijoke Sanwoolu, First Lady of Lagos State, Dr. Samuel Adekola, Chairman, Association of Community Pharmacists of Nigeria, Dr Madewa Adebajo, Medical Director, Alimosho General Hospital, Ms Obiageli Ubahakwe, COO, Exhima Realty Company Ltd, Sola Okeowo, CEO Chevron Nigeria Ltd, and Jibola Ponmile, Hon Commissioner for Establishment, Pensions and Training, Lagos State.
Similarly, Mr Fidelis Ayabae, CEO, Fidson Healthcare Ltd, Mrs Buki George, Founder, Healthplus Pharmaceuticals, Mrs Mojisola Animasaun, Founder, St. CYRIL’S Cancer Centre, Ms Joyce Ugbosu, Director, Lakewood British School, Dr. Yinka Opeke, CEO, Smart Gas & Petroleum Ltd, Mr Fola Tinubu, CEO , Primero Transport Services, Mrs Joke Chukwuma, School Director, Children’s International School, Lekki, Professor Gbenga Ogunmoyela, President, Consumer Advocacy for Food Safety and Nutrition Initiative (CAFSANI) Nigeria, Folake Adeniyi, HR Director, Oracle Corporation, Mrs Yinka Ogunde, Principal Consultant, Edumark Nigeria, Mrs Azuka Chukwuelue, Supply Chain Director, Kimberley Clark Nigeria, Ayo OBE, Partner, Ogunsola Sonibare Legal Practitioners & Notary Public, Mrs Ekua Abudu Akinsanya, co- Founder, Greenwood House School, Mrs Anike Oye, Administrative Director, Chrisland Schools, and Olufunmi Lanre Phillips, GM, HR & Corp Services, Shoreline Natural Resources Ltd, were in attendance.