Opinion: Of the 60 million mentally ill Nigerians – By JOEL NWOKEOMA

Nigeria’s Minister of Health Isaac adewole

“Mental illness is on the increase in Nigeria. Generally, people are becoming more and more stressed due to the hardship and difficulties we have in the country. They do not have money, so an increasing number of people are engaging in self-medication. More people are abusing alcohol and drugs like Tramadol and Cannabis sativa”

– Consultant Psychiatrist at the University of Ilorin Teaching Hospital, Dr. Baba Issa, February 25, 2018

On Monday, the Federal Ministry of Health raised the alarm that the spectre of mental illness was haunting Nigeria as about 30 per cent of Nigerians were suffering from mental illness. Experts note that the various manifestations of mental illness are depression, bipolar affective disorder, schizophrenia and other psychoses, dementia, intellectual disabilities and developmental disorders including autism.

That figure, to put it in a clearer perspective, translates to 60 million of the estimated 200 million population of the country. Which means that were all the mentally ill people in Nigeria to be confined to a definite territory and classified a distinct country of their own, they will be more populous than Spain 46 million, Canada 36 million, Morocco 35 million, Ghana 28 million, Australia 24 million and The Netherlands 17 million.

When the World Mental Health Day was commemorated on October 10, the World Health Organisation released a study that claimed that one in four people in the world would be affected by mental or neurological disorders at some point in their lives; that is at least 1.7 billion persons, making mental disorder one of the leading causes of ill-health and disability in the world. Asides, authors of a new report published on October 9 in The Lancet to mark the World Mental Health Day revealed that depression and anxiety were on the rise in all countries of the world and claimed that mental illness would cost the global economy £12 trillion yearly by 2030.

Given the above grim facts, it is interesting that beyond the alarm raised, all the Permanent Secretary of the ministry, Abdulaziz Abdullahi, said at the Mental Health Action Committee and Stakeholders’ Workshop held in Abuja on Monday, was, in a tinge of lamentation, that, “the attention given to mental health disorders in Nigeria is inadequate. The level of awareness of the Nigerian public on mental health issues is also understandably poor, and with lots of misconceptions.” There was no outline of what the government was doing or would do in terms of policy options and strategies to be adopted to address this present worrisome and depressing reality.

It was only the Director of Public Health, Dr Evelyn Ngige, who made a tepid attempt at offering a semblance of an insight into what appeared as government’s understanding of the weight of the matter. But the director herself was merely prescriptive, characteristic of the medical doctor he is, rather than utter anything of note. He said, “Considering the current economic situation in the country, the above statistics are damning and in light of the recent suicidal episodes recorded in parts of Lagos (which are obviously a tip of the iceberg), it forces a rethink in our general attitudes to mental health and questions our current maintenance of the status quo.” The director was silent on the fate of the Mental Health Bill 2008 sponsored by Senator Anthony Manzo, aiming to replace the anachronistic Lunacy Act, 1958, which is lying somewhere in the National Assembly, not passed, a decade after. and would not also claim ignorant of the extant legislative lacuna in the management of mental health in the country.

But that was before she bemoaned that the “committee on mental health failed to achieve its goal because of lack of funds.” It is a subtle way of pointing finger at the direction of government as the enabler of the disconcerting development. This is demonstrated in government’s yearly budgetary allocation to the health sector. In the 2018 budget, for instance, the total sum allocated to health is N340.456bn out of a total national budget of N8.612tn. This represents just 3.95 per cent of the total budget. It has been the trend for the last decade.

The consequence of this indifference of government to the health sector funding over the years is that health care facilities and mental health care professionals in the country are not enough or well-equipped to handle the burden of mental illness. The statistics are too grim to consider. Nigeria has only about 150 psychiatrists to care for over 180 million Nigerians; that is a ratio of one psychiatrist to 1.2 million Nigerians. Records also show that there are five mental health nurses to 100,000 Nigerians while the country has only eight neuropsychiatric hospitals.

Recently, the Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, disclosed that it treated no fewer than 36,000 mental patients in a year, 50% of which came from Ogun State alone while 15% each came from neighbouring Lagos and Oyo states.

However, what was left unsaid at the event, by the distinguished speakers, was how government at all levels, or bad governance, contributed to the growing rank of mentally ill Nigerians in recent years. As the opening quote of Dr. Baba Issa of the University of Ilorin Teaching Hospital, indicated, life and living in Nigeria in the last decade have pushed quite a number of the citizenry to the edge. The National Bureau of Statistics revealed recently that a total of 7.956 million Nigerians became unemployed between January 2016 and September 30, 2017. With an estimated 500,000 graduates churned out every year from the country’s tertiary institutions without any real prospects of gaining employment, more so when youth unemployment rose to 52.65 per cent by Q4 2017, from 49.7 per cent in the preceding quarter, translating to 22.64 million persons aged between 15 and 35 years old either jobless or underemployed, according to the National Bureau of Statistics, combined with an increasing number of company closure in the country as a result of inclement economic environment, it is not unexpected that depression has taken hold of a sizable number of Nigerians especially the youth.

In 2017, the WHO said 7,079,815 Nigerians suffered from one of the most ignored and misunderstood forms of mental disorder in the country – depression. The figure, according to the world health body, was 3.9 per cent of the entire population of the country, thereby making Nigeria the most depressed country in Africa. The WHO further noted that, Seychelles had the lowest number of depressed persons with just 3,722 in the world. Besides, 4,894,557 Nigerians, representing 2.7 per cent of the population, suffered anxiety disorders. Nigeria is closely followed by Ethiopia with 4,480,113 sufferers, Democratic Republic of Congo with 2,871,309, South Africa with 2,402,230, and Tanzania with 2,138,939 sufferers.

A combination of job loss and unemployment results inevitably to poverty. That was the verdict the report by the Brookings Institution gave earlier this year when it said Nigeria had already overtaken India as the country with the largest number of extremely poor people in early 2018.

There is nothing as traumatising and mentally torturing as when someone is too poor to meet one’s expanding basic needs and is still made to endure the torment of failed governance as is evident in Nigeria. On a lighter mood, someone quipped elsewhere that there are fewer things that can predispose somebody, especially a person in need, to mental illness like hearing from a top government official that the sum of N3.5m is spent a month to feed someone held by the same government in confinement or the perfidies that take place in the name of governance in Nigeria.

At least, 800,000 people die every year due to suicide and it is the second leading cause of death among the 15-29 year age bracket. Nigeria is ranked fifth in the world by the WHO on its annual suicide list, according to a study by the Spectator Index on July 29, 2018. So, it is obvious we have a devastating time bomb on our lap.

Experts believe the rising suicide trend in Nigeria can be drastically reduced by understanding depression, which they term a preventable and treatable ailment.

But if as Ngige said earlier the current state of the economy is a factor in the rising mental illness in the country, the onus is on  government to revive the economy to create the enabling environment for job creation for the teeming unemployed to save the citizens from preventable death.Punch

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