Of the 60 million mentally-ill Nigerians
“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
Penultimate 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.
A figure of 30%, 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 confined to a definite territory and classified a distinct country of their own, they would be more populous than Spain, 46 million; Canada, 36 million; Morocco, 35 million; Ghana, 28 million; Australia, 24 million; and The Netherlands, 17 million.
Disturbingly, when the World Mental Health Day was commemorated on October 10, the WHO 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 some 1.7 billion persons, making mental disorder one of the leading causes of ill-health and disability in the world. Besides, 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 £12tn yearly by 2030.
Given the above grim facts, it speaks volumes that beyond the alarm raised, all the Permanent Secretary of the health Ministry, Abdulaziz Abdullahi, said at the Mental Health Action Committee and Stakeholders’ Workshop held in Abuja that day, 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 scary 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 she is, rather than uttering anything of note. She 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.” Well said, but 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 still lying somewhere in the National Assembly a decade after. She would not also claim ignorant of the extant legislative lacuna in the management of mental health in the country.
Earlier in her presentation, she had bemoaned that the “Committee on Mental Health failed to achieve its goal because of lack of funds.” Obviously, that is a subtle way of pointing a 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, representing just 3.95% of the total budget. This has been the trend for the last decade.
The consequence of this official indifference to 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 cater for over 180 million Nigerians; a ratio of one psychiatrist to 1.2 million Nigerians, one of the worst in the world. Records also show that there are five mental health nurses to 100,000 Nigerians while there are no sufficient number of neuropsychiatric hospitals in Nigeria.
The implications of this are damn depressing. 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 was how government at all levels, or bad governance in particular, contributed to the growing rank of mentally-ill Nigerians over the years. As the opening quote of Dr. Baba Issa of the University of Ilorin Teaching Hospital, aptly indicated, life and living in Nigeria in the last decade have pushed quite a number of Nigerians 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. The figure has since increased. 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% by Q4 2017, from 49.7% 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 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% of the entire population of the country, thereby making Nigeria the most depressed country in Africa! 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, it was claimed. Nigeria was 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.
If you look well, there is a mentally-ill Nigerian around the corner, stressed out by the poor state of the economy and sundry matters. All that is needed is a trigger to manifest. 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.
There is nothing as traumatising and mentally torturing as when someone is too poor to meet their expanding basic needs and are still made to endure the torment of failed governance as is evident in Nigeria. On a lighter mood, 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 custody or the perfidies that take place in the name of governance in Nigeria.
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.
But if as Ngige posited earlier the current state of the country’s economy is a factor in the rising mental illness of Nigerians, the onus is on government to revive the economy to create an enabling environment for job creation for the teeming unemployed to save the citizens from preventable death. It is high time government walked its talk of diversifying the economy away from oil and gas in order to unleash the hidden potenial in other sectors to create jobs that could move many a Nigerian away from depression. Life can be made a bit less brutish for Nigerians by the government.