Stories abound of lovers murdering each other for flimsy motives, celebrities taking their own lives for mundane and unfounded reasons, students downing full bottles of pesticides to end their depressed lives. Mental health is a concern not only in Nigeria but the world over. However, the difference lies in the way, strategies, and systems put in place to mitigate its debilitating blows by countries of the world, write CHINAKA OKORO and MOSES EMORIKEN
The streets are filled with people who behave consistently incoherent, walk about naked or almost naked, look totally unkempt, and take abode in dunghills. The environs of the Murtala Mohammed International Airport (MMIA) have its sizeable population of people in this category.
In Nigeria, an estimated 20 per cent – 30 per cent of the population are believed to suffer from mental disorders. This is a very significant number considering Nigeria has an estimated population of over 200 million.
Mental illness does not show on the face, and sometimes takes time to become fully manifested in behaviour. Like malaria and other kinds of sickness, mental illness can happen to anybody with the right situations and triggers.
Mental disorders or illnesses, according to the World Health Organisation (WHO), comprise a broad range of problems, with different symptoms. However, they are generally characterised by some combination of abnormal thoughts, emotions, behaviour and relationships with others.
Association of Psychiatrists of Nigeria (APN) President Prof. Taiwo Lateef Sheikh said: “Mental illness is the cause of certain impairments or disability or handicap that can be attributable to the functioning of your brain. When it is not allowing you to fulfil your role within your socio-cultural setting, then we say that the individual is mentally ill.
“While mental health is about looking after the totality of your wellbeing in terms of physical, emotional and social in relationship with the adjustments in your life, mental wellbeing is not the same as freedom from mental illness.
“It means the ability to be able to relate in a very good equilibrium with your environment; to be able to have your own aspirations, pursue them in a very meaningful manner and contribute effectively to the society you are living. Truth is, you may not enjoy good mental wellbeing even in the absence of mental illness.
“A lot of people are carrying this around even if they have not broken down to be mentally ill. This can degenerate to mental illness because it predisposes you to very high level mental disorders.
“A person may be meeting up with his or her family, relational or occupational roles but with a lot of struggles.
“The facts that an individual has not broken down, be admitted to a psychiatric ward, or showing signs of mental illness, do not really mean they are enjoying adequate mental wellbeing. It is a danger because people don’t know you have a problem.”

QUICK FACTS and FIGURES
⦁ An estimated 264 million people globally suffer from depression, one of the leading causes of disability, with many of them also suffering from symptoms of anxiety.
⦁ Depression and anxiety disorders cost the global economy $ 1 trillion each year in lost productivity
⦁ 50 million Nigerians suffer mental health disorders, of which about 1.1 per cent are said to be HIV positive
⦁ Of employers offering effective health and wellness programmes, 67 per cent reported increased employee satisfaction, 66 per cent reported increased productivity, 63 per cent reported increased financial sustainability and growth, and 50 per cent reported decreased absenteeism.

There are more than 200 classified forms of mental illnesses. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.
Condition of mental health in Nigeria
Despite obvious signs that majority of Nigerians suffer from mental imbalance and need attention, authorities seem to lack the will to put in place adequate policies and programmes that would help in addressing the menace.
According to a WHO report released in October last year, one in four Nigerians (about 50 million people) is suffering from some sort of mental illness. It also noted that the country is ill-equipped to tackle the problem judging from the fact that there are only eight federal neuropsychiatric hospitals in Nigeria.
A Report of the assessment of the mental health system in Nigeria using the World Health Organisation-Assessment Instrument for Mental Health Systems (WHO-AIMS) Ibadan, Nigeria notes that “there is no coordinating body to oversee public education and awareness campaigns on mental health and mental disorders. There are no formal structures or provisions for interaction among mental health providers and members of staff of primary health care. Also no systematic reporting of information exists for mental health.” These are debilitating situations that have been a lot of many a Nigerian.
A mental health in Nigeria survey conducted in January, this year by Africa Polling Institute and EpiAFRIC reveals that mental ill-health has a great effect on society as it also affects an individual’s productivity and causes the reduction of health-related quality of life.
The Chief Executive Officer (CEO) EpiAFRIC, Dr Ifeanyi Nsofor, said: “Given its effects on the life of an individual, family and society, one wonders why such inadequate attention and resources are devoted to understanding and providing mental health services. The 2015 Sustainable Development Goals, by including mention of mental health in health-related goals brought mental health to the global development agenda. Yet, there is still much to be done. His view was corroborated by the Executive Director, Africa Polling Institute (API) Bell Ihua who said: “There is a need to deepen the conversation on mental health in Nigeria; and the need for government, practitioners and stakeholders to work together towards achieving the personal well-being of citizens.”
Projection
Pundits have expressed the fear that if urgent steps are not taken to reposition the nation’s health sector, which, in turn will enhance mental health in the country, there would be an increase in the level of mental illness cases than could be imagined.
Referring to the projection by the United Nations (UN) that by 2050 Nigeria’s population would further increase, the Nigeria Health Watch noted that with Nigeria’s population on the upsurge, the country will have to enhance its health infrastructure if it wants to prevent an upsurge in mental illnesses.
The WHO took a swipe at the Nigerian authorities for not doing enough in the area of mental health, 2011 WHO report said Nigeria had made “insufficient progress” towards in that regard. And by 2018, the country had allocated just 3.95 per cent of its budget to funding its Ministry of Health.
A tale of unimplemented policy
In 1991, Nigeria formulated a Mental Health Policy document which was to address mental health issues, and its components include advocacy, promotion, prevention, treatment and rehabilitation. It was later revised in 2013. Till date, the policy on mental health is seated somewhere in the ministry of health gathering dust.
Sheikh said: “We have a policy of 1991 which was revised in 2013. So we are using that 2013 revision. It is there on the shelf of the federal ministry of health and some state ministries, nobody has touched it.
“All the things incorporated in the 2013 policy that was adopted by the federal government have not been implemented. So we have a 2013 national mental health service policy and everything contained in that policy has never been implemented.
“No desk exists in the ministries at any level for mental health issues and only about four per cent of government expenditures on health is earmarked for mental health.”
The Mental Health and Substance Abuse Bill remains unpassed long after it was proposed. The bill seeks to address the problem of universal access to mental health care. It seeks to establish the National Agency for Mental Health and Substance Abuse and increase funding for mental healthcare.