Poor investment in mental health worries experts
... Remains absent in NHIS
Over the years, the issue of mental health is one dilemma that has continued to remain a huge stigma on Nigeria with many individuals, even families of victims, choosing to ignore them in the hope that the problem will get solved somehow.
This condition, in many cases, has resulted in the exclusion of such individuals from society. It has also led to loss of work, and breakdown in relationships. Families usually struggle to seek help which often times ends in vain.
As Nigeria joins other countries to celebrate ‘World Mental day’-every October 10 - to raise public awareness about mental health issues, experts have called on government to increase its investment in mental health, inclusion of mental health in the National Health Insurance Scheme (NHIS) and the passage of the draft Mental Health Bill of 2003 which is yet to be passed by both chambers of the National Assembly.
In an exclusive interview with BusinessDay, Olakunle Obagaye, senior registrar, Psychiatric Hospital, Yaba, revealed that the negative perception to mental illness in Nigeria is widespread and has led to a situation whereby people seek medicare in spiritual houses and asylums which further impairs the social integration of
those affected into the society.
While noting that poor knowledge on mental illness is common, Obagaye stated that more often than not, those suffering from severe mental illness are chained, beaten and subjected to terrible abuse, sometimes at the hands of those who they have turned to for treatment instead of taking these individuals to asylums and psychiatric hospitals for treatment.
“In spite of treatments at asylums and psychiatric hospitals, people don’t make use of such opportunities as out-of-pocket payments for medicare. This means that families would have to pay for the care of their loved ones; of which some find it very difficult to afford. Sadly, mental health is not covered in the National Health Insurance Scheme (NHIS). Don’t forget that the World Health Organisation (WHO) defines health as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.’
“While less than 15 percent is spent on health as agreed in the Abuja Declaration by African Heads of States in 2001, of this figure, less than 1 percent is allocated to mental health. The figure recommended by the WHO for mental health is 5 percent. A considerable part of the limited resources is spent on large mental hospitals and not for services delivered through community and primary health care which is rarely operational. We need to increase investment for mental health and to shift the available resources toward more effective and more humanitarian forms of services.
“In Africa, less than 50 percent of countries have a mental health policy. In Nigeria, the progressive 1991 primary health care policy states that mental health should be integrated at the primary care level. While this is not fully operational, a bill for a mental health act which was passed at a public hearing and was adopted by the Senate in 2003 is yet to pass the House of Representatives and adopted into law,” Obagaye disclosed.
On his part, Oye Gureje, professor in the Department of Psychiatry, University College Hospital (UCH), Ibadan, noted that public enlightenment to foster community acceptance of people who are mentally ill is required for all sections of the community, especially for residents of rural areas and the young.
While stating that the treatment gap for mental, neurological and substance use disorders is formidable especially in poor resource countries, Gureje disclosed that people with mental disorders have a heightened risk of suffering from physical illnesses because of diminished immune function, poor health behaviour, poor adherence to medical treatments, and social barriers to obtaining treatment.
According to Gureje, “Attitude to mental illness is characterised by intolerance of even basic social contact with people known to have such illness. In a society in which poor health facilities and poverty make the care of people with mental illness a major burden for both patients and their families, the degree of stigma experienced by individuals with mental illness suggests an unusual level of illness-related burden.”
Taking a global look at mental health, at any given time, approximately 10 percent of adults experience a current mental disorder, and 25 percent will develop one at some point during their lifetimes. More worrisome is the fact that anxiety and depression alone contribute greatly to the global burden of mental illness. Furthermore, mental disorder is associated with more than 90 percent of the one million suicides that occur annually. In reality, the number is likely to be far greater, due to common underreporting of this cause of death.
While mental disorders account for 13 percent of the global burden of disease and is to rise to nearly 15 percent by 2030, there is the need to address this social malady having a health policy in Nigeria as is the case with Gambia.
It is noteworthy to state that in 2007, the Republic of the Gambia, in collaboration with WHO, completed its first-ever mental health policy and strategic action plan. However, major objectives of the Gambia’s mental health policy include- de-institutionalisation of the Campama Psychiatric Unit; the provision of equitable, accessible, cost-effective, and good-quality mental health and substance abuse services in the community; and the promotion and protection of the rights of people with mental and substance use disorders.
The strategic action plan which provided a roadmap for meeting the
objectives of the policy include strengthening the national mental
health coordinating unit at the Department of State for Health;
mobilising resources to provide good-quality mental health services;
improving the availability, distribution, and cost-effective use of
psychotropic medicines; creating inpatient mental health units and
outpatient clinics integrated in the general hospitals; recruiting and
training a sufficient number of health workers at the specialised,
community, and primary health care levels in order to provide
good-quality mental health care at all levels; training and supporting
traditional healers in mental health.
Over the years, the issue of mental health is one dilemma that has continued to remain a huge stigma on Nigeria with many individuals, even families of victims, choosing to ignore them in the hope that the problem will get solved somehow.
This condition, in many cases, has resulted in the exclusion of such individuals from society. It has also led to loss of work, and breakdown in relationships. Families usually struggle to seek help which often times ends in vain.
As Nigeria joins other countries to celebrate ‘World Mental day’-every October 10 - to raise public awareness about mental health issues, experts have called on government to increase its investment in mental health, inclusion of mental health in the National Health Insurance Scheme (NHIS) and the passage of the draft Mental Health Bill of 2003 which is yet to be passed by both chambers of the National Assembly.
In an exclusive interview with BusinessDay, Olakunle Obagaye, senior registrar, Psychiatric Hospital, Yaba, revealed that the negative perception to mental illness in Nigeria is widespread and has led to a situation whereby people seek medicare in spiritual houses and asylums which further impairs the social integration of
those affected into the society.
While noting that poor knowledge on mental illness is common, Obagaye stated that more often than not, those suffering from severe mental illness are chained, beaten and subjected to terrible abuse, sometimes at the hands of those who they have turned to for treatment instead of taking these individuals to asylums and psychiatric hospitals for treatment.
“In spite of treatments at asylums and psychiatric hospitals, people don’t make use of such opportunities as out-of-pocket payments for medicare. This means that families would have to pay for the care of their loved ones; of which some find it very difficult to afford. Sadly, mental health is not covered in the National Health Insurance Scheme (NHIS). Don’t forget that the World Health Organisation (WHO) defines health as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.’
“While less than 15 percent is spent on health as agreed in the Abuja Declaration by African Heads of States in 2001, of this figure, less than 1 percent is allocated to mental health. The figure recommended by the WHO for mental health is 5 percent. A considerable part of the limited resources is spent on large mental hospitals and not for services delivered through community and primary health care which is rarely operational. We need to increase investment for mental health and to shift the available resources toward more effective and more humanitarian forms of services.
“In Africa, less than 50 percent of countries have a mental health policy. In Nigeria, the progressive 1991 primary health care policy states that mental health should be integrated at the primary care level. While this is not fully operational, a bill for a mental health act which was passed at a public hearing and was adopted by the Senate in 2003 is yet to pass the House of Representatives and adopted into law,” Obagaye disclosed.
On his part, Oye Gureje, professor in the Department of Psychiatry, University College Hospital (UCH), Ibadan, noted that public enlightenment to foster community acceptance of people who are mentally ill is required for all sections of the community, especially for residents of rural areas and the young.
While stating that the treatment gap for mental, neurological and substance use disorders is formidable especially in poor resource countries, Gureje disclosed that people with mental disorders have a heightened risk of suffering from physical illnesses because of diminished immune function, poor health behaviour, poor adherence to medical treatments, and social barriers to obtaining treatment.
According to Gureje, “Attitude to mental illness is characterised by intolerance of even basic social contact with people known to have such illness. In a society in which poor health facilities and poverty make the care of people with mental illness a major burden for both patients and their families, the degree of stigma experienced by individuals with mental illness suggests an unusual level of illness-related burden.”
Taking a global look at mental health, at any given time, approximately 10 percent of adults experience a current mental disorder, and 25 percent will develop one at some point during their lifetimes. More worrisome is the fact that anxiety and depression alone contribute greatly to the global burden of mental illness. Furthermore, mental disorder is associated with more than 90 percent of the one million suicides that occur annually. In reality, the number is likely to be far greater, due to common underreporting of this cause of death.
While mental disorders account for 13 percent of the global burden of disease and is to rise to nearly 15 percent by 2030, there is the need to address this social malady having a health policy in Nigeria as is the case with Gambia.
It is noteworthy to state that in 2007, the Republic of the Gambia, in collaboration with WHO, completed its first-ever mental health policy and strategic action plan. However, major objectives of the Gambia’s mental health policy include- de-institutionalisation of the Campama Psychiatric Unit; the provision of equitable, accessible, cost-effective, and good-quality mental health and substance abuse services in the community; and the promotion and protection of the rights of people with mental and substance use disorders.
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