Nigeria’s mental health sector is in the midst of a slow but significant transformation. From telehealth platforms connecting therapists to clients nationwide, to community-based outreach in schools and conflict zones, access to services is expanding. Public conversations once silenced by stigma are now taking place in classrooms, podcasts, and advocacy forums.

The Mental Health Research and Policy Hub (MHRPH) is at the forefront of this shift, building what could become the country’s most comprehensive mental health directory, offering free therapy in underserved communities, and producing toolkits for practitioners to integrate rights-based care. “People are starting to ask the right questions, not just about treatment, but about their rights and dignity,” says founder Benmun Damul.

But as access grows, experts warn that quality, safety, and accountability are still inconsistent. Without mechanisms to enforce ethical standards, protect patient rights, and ensure equity in care, more people could be exposed to unsafe or substandard treatment.

The 2021 National Mental Health Act replaced colonial-era legislation, promising safeguards against inhumane treatment, better regulation of involuntary admissions, and integration into general healthcare. However, these protections risk remaining largely symbolic. “The Mental Health Act makes bold promises on paper,” notes legal researcher Hazel King. “But without enforcement, regulation, and avenues for redress, people’s rights are left unprotected in practice.”

In reality, many Nigerians still turn to unregulated private clinics, underfunded public hospitals, or informal spiritual centres – some of which engage in practices that violate both national law and international treaties. The workforce shortage deepens the crisis: fewer than 300 psychiatrists serve a population of over 200 million, and most other trained professionals are clustered in urban centres.

Promising community-based and peer-led approaches are emerging, especially in conflict-affected areas, but they remain underfunded and excluded from the national system. Mental health receives less than three percent of the federal health budget, making sustained reform difficult.

Advocates say a national licensing system for all providers – public, private, traditional, and faith-based – is critical. Such a system would hold providers to consistent standards and give patients formal avenues for complaints.

For reforms to succeed, stakeholders stress that mental health must be reframed as a public health and social justice priority. This means investment, regulation, professional self-policing, civil society monitoring, and recognising communities as co-creators of care.

Nigeria’s mental health movement is gaining momentum, but its success will be measured not just by access, but by the safety, dignity, and justice experienced by those who seek care.