The Hidden Cost of Untreated Mental Health in Nigerian Communities – A Professional’s View – Godwin Ugbor

The hidden cost of untreated mental health conditions in Nigeria is one many Nigerians shy away from. The Nigeria’s National Mental Health Act 2021 replaced the Lunatic Act of 1958, which governed the administration of mental health services in Nigeria. The current Act (2021) represented a departure from the archaic Lunacy Act with its focus on the detention of people with mental health illness. The 2021 Act established a framework for the promotion of mental health, prevention and treatment of mental health conditions, protection of rights, access to services, and regulations of mental-health facilities and professionals.

From a professional’s perspective, the sad reality, however, is that the implementation of the Act 2021 has been plagued by numerous systemic gaps. Historically, mental health services in Nigeria has continued to receive less attention than infectious diseases, malaria, and other diseases. This challenge is compounded by the overall poor health sector funding by the government. Again, stigma and misconceptions continue to pose a daunting challenge to accessing mental health services in Nigeria. Mental health disorders are still associated with shame, spiritual explanations, or fear of discrimination, thus reducing demand for formal services. People rather seek help from prayer houses, herbal practitioners and related sources. Another systemic gap confronting the provision of mental health services in Nigeria is the paucity of qualified mental-health professionals. The country has relatively psychiatrists, psychologists, psychiatric nurse, social workers, and other specialists. To deepenthe woes of people with mental health challenges in the rural communities, the limited available mental health services are concentrated in the urban areas of the country. Similarly, the weak integration of mental health services into primary healthcare further restricts access to mental health services for people in the communities.

Translating Nigeria’s well-designed mental health policies to optimal service delivery remains a mirage. There is often a gap between policy formulation and actual service delivery. Thesereasons are not farfetched. In fact, the failure of mental health policies is traceable to the systemic gaps, some of which have been aforementioned. Nigeria is still resource-challenged with regards to delivery of mental health services. Insufficient financial investment in mental healthcare represents an overwhelming challenge that contributes to policy failure in Nigeria’s mental health subsector. Related to this challenge is the corruption around non-release and criminal diversion of funds allocated to mental healthcare in the budget. It is worth noting that mental health is not one of the public health programmes and thus receive minimal funding support from international donor agencies in Nigeria.  

Weak coordination among the various tiers of government namely federal, state and local government, resulting in weal implementation of the policies at these levels of government. Only a handful of states in Nigeria operate psychiatric hospitals thus limiting the implementation of the policies and restricting availability of services to people especially at the community level.

Good policies requires qualified personnel to effect their implementation.  Shortage of trained mental health personnel contributes to failure of policies in the mental healthcare in Nigeria.

Lack of political will to implement the policies another factor responsible for the failure of policies and legislation around mental health services in Nigeria. Top politicians and personnel of the government access healthcare including mental health services outside Nigeria. For this reason, they do not commit to ensuring the implementation of mental healthcare policies in the country.

The hidden institutional costs of the foregoing are multidimensional and far-reaching. The poor funding of Nigeria’s health sector is a major factor in the brain drain being suffered in the sector. Healthcare professionals including mental health specialists keep leaving the country in droves. This exacerbates the already stifling human recourses in that subsector. The implication is that few specialists are burdened with the tasks of meeting the mental health needs of the teeming population of people with mental health challenges. The resultant heavy workload and long working hours expose the service providers to stress and burnout. Related to this is the poor delivery of service resulting in worsening cases of mental health disorders among the people.  

About the author

Godwin Ugbor is a development strategist grounded in the field of psychology and global health. His work centers on public health, humanitarian response, human rights, and social development. He writes directly tas a professional versed in the complex realities faced by the communities in Nigeria.

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