Although mental health problems are widespread in many countries in Africa, they rarely receive the attention they deserve. Stigmatization is a common factor that makes patients reluctant to seek mental health care in most African countries.
Today, as knowledge about mental health increased, some African countries, such as Ghana, Kenya, South Africa, Uganda, and Zambia, began passing legislation and laws to safeguard the rights of individuals who have mental health problems.
In 1916, Nigeria, Africa’s most populous country, enacted its first mental health legislation, which was called the Lunacy Ordinance. This legal framework was revised in 1958, under the name Lunacy Act, to grant magistrates and medical professionals the authority to detain individuals with mental health problems.
In 1991, Nigeria’s first mental health policy was established, and its elements included promotion, advocacy, prevention, treatment, and rehabilitation. While in 2003, the National Assembly of Nigeria received a mental health bill to address the many defects of the 1958 law, which were associated with a misunderstanding of mental health issues and a scarcity and ineffectiveness of treatments available at that time; however, the bill was withdrawn in April 2009. Despite being reintroduced in 2013, the bill was not passed into law due to a lack of support.
Furthermore, Nigeria’s health and development policy agenda has historically disregarded mental health; additionally, factors that affect mental health are poorly understood, discrimination and stigma are pervasive, services are inadequately staffed, and individuals who struggle with mental health issues are often mistreated. Owing to the limited understanding of mental health disorders at the primary healthcare level, caring for individuals with mental health issues is often entrusted to family members.
Unfortunately, there is a dearth of mental health specialists (300 psychiatrists for over 200 million people in Nigeria). Coupled with the inadequate infrastructures and negative public perceptions of mental health problems. This prevents nearly 80% of people with serious mental health needs from receiving the care they need.
The scarcity of public education about mental health has led to many myths and misconceptions, and a low public acceptance of people with mental health issues. Besides, cultural and religious preconceptions has substantial impact on the healing process of people with mental health disorders.
Fortunately, Nigeria has now embarked on a major change: on Jan 5, 2023, the Nigerian President signed the Mental Heath Bill 2021 into law, replacing the outdated 65-year-old Lunacy Act. Although this law reflects the political will in Nigeria regarding the need to improve mental health care, the aim of Nigeria’s National Mental Health Act 2021 can only be achieved through effective implementation.
Funding is one of the crucial steps for effective implementation. Additionally, other issues should also be addressed, for instance, increasing the financial allocation for mental health services in relation to the total healthcare expenditure. Actual commitment of the Nigerian Government will be needed for a correct execution of the legal framework, via the provision of financial, material, and human resources.
More than a quarter of the Nigerian population has mental health issues; since legislation alone will not change practices, the improvement of mental health services has to be waged on several fronts. Globally, cultural attitudes and priorities have a substantial role in determining health practices. As a result, awareness campaigns as a tool to support the rights of people with mental health problems should be a major priority for civil society organizations, educational institutions, and community leaders.
We need to educate the public about adequately treating people with mental health disorders, about these people’s rights and the duties of their families, and about the general obligations of the government and society. Continuous efforts to reduce the stigma of mental health issues include the distribution of information, and the promotion of knowledge and understanding among both family members and society as a whole, through newspaper articles, the organization of seminars and discussion groups, and the distribution of pamphlets.
Human resources for mental health are low in Nigeria, with only 0.15 psychiatrists per 100,000 population, and need support in terms of numbers, protection, and finances. An effective approach would be the training of non-specialist mental health workers under the supervision of mental health specialists and the strengthening of their capacity for detecting, treating, and managing mental health disorders through stepped care and collaborative task sharing.
The update of laws and regulations enables nations to consider mental health care as an essential part of primary care. The integration and the offering of mental health care and treatment in primary care will improve accessibility, affordability, and cost-effectiveness while advancing human rights.
Additionally, the development and integration of community-based rehabilitation centers in rural areas and the creation of a strong primary care system that offers additional care in close coordination with secondary and tertiary care facilities are very crucial.
Table of Contents
Frequently Asked Questions
1. Is there a mental health act in Nigeria?
Yes, there is a Mental Health Act in Nigeria. The most recent one is the National Mental Health Act of 2021.
2. What is the budget for mental health in Nigeria?
The exact budget for mental health in Nigeria can vary from year to year, but historically, mental health has not received a significant portion of the overall healthcare budget. Efforts have been made to increase funding for mental health services, but it’s still considered inadequate compared to the scale of the mental health needs in the country.
3What is the mental health situation in Nigeria?
The mental health situation in Nigeria faces various challenges. Mental health problems are widespread, affecting more than a quarter of the population. However, there is a lack of awareness, stigma, and limited understanding of mental health issues. Services are often understaffed, and there is a scarcity of mental health specialists. Many people with mental health issues don’t receive the care they need due to these barriers.
What are the costs of mental health care?
The costs of mental health care in Nigeria can vary depending on the level of care and the specific services needed. Generally, mental health care costs include expenses related to diagnosis, treatment, therapy sessions, medication, and hospitalization if required. However, the overall costs can be high due to the shortage of specialists and resources, and these costs can further discourage individuals from seeking proper care.
Read and download the mental Health Bill here