So I’ve already established I would like to do my dissertation on the economic significance of mental health in the UK and US. I’ve been indulging (yes I mean that) in all the research and data I’ve accumulated thus far. However, tonight I’ve decided to write about psychiatry in Nigeria and the economic costs to society.
Starting with the World Health Organisation’s report on the Mental Health System in Nigeria (2006). The first sentence is ‘Information on the mental health service in Nigeria is lacking’ (which was emphasized throughout the report). Right after in the Results section it begins with ‘There is considerable neglect of mental health issues in the country’.
Apparently only a dwarfed 3.3% of government expenditure is allocated to mental health whereas within the NHS it accounts for more than 12% of the total budget. Apparently a mere 10% of sufferers receive treatment. Despite a population well over 150 million, the country has only 8 regional psychiatric centres and around 200 trained psychiatrists; one psychiatrist for every millions of residents.
In November 2011, Robert Rosenheck, MD, professor of psychiatry and public health, plus addiction specialists Theddeus Iheanacho, MD and Carla Marienfeld, MD visited Nigeria to witness the extensive challenges facing the mental health system in this West African nation. Dr. Rosenheck notes the stigma originates largely from the region’s culture and traditions.
‘If a family member exhibits symptoms that western medical professionals might associate with mental illness, available research suggests that Nigerians might think that person has been bewitched or cursed. Someone seeking help for a mental illness will likely turn to their church or a traditional healer before a medical doctor.’
There is no coordinating body to oversee public education and awareness campaigns on mental health and mental disorders. In general terms, several countries in Africa are better resourced in regard to mental health personnel. Countries such as South Africa, Egypt, and Kenya have more psychiatrists per 100,000 persons and also higher proportions of psychiatric beds (WHO, 2006). Emigration is also a significant issue in Nigeria. At least 25% of psychiatrists migrate to other countries resulting in an exodus of health care nurses. In 2005, 2,392 Nigeria doctors were practising in the US and 1,529 the in UK.
In Nigeria, the majority of admissions to mental hospitals are for Schizophrenia, Schizotypal and delusional disorders (51%) (no surprise there) and mood (affective) disorders (24%). Mental health is one of the many taboo subjects within African society and stigmatisation has acute effects on victims.
- It keeps people who are having a problem from acknowledging the problem and seeking help. This can result in major time loss, grief and devastation if left untreated.
- It also defers people from seeking help for their family members and friends. It’s all about ‘What would everyone think?’.
- Consequently, governments, organisations and communities brush the issue under the carpet and delude themselves into thinking it’s not there.
According to Director General, Institute of National Transformation, Professor Vincent Anogbogun said: ‘Nigeria will continue to have instability because we have young populations that are unemployed and the situation will be worst by 50% by 2030 due to climate change if nothing drastic is done as Nigeria is already at the critical point of failure.’
It’s disheartening to believe Nigeria has no budget, policy, framework and grant for mental health programmes. Taking care of your mental health is just as important as taking care of your physical health. Yet, it seems as if many people are yet to understand this.