The COVID-19 pandemic has had negative impact on the mental health of Nigerians in more ways than one. With this in mind, it is therefore no surprise that the theme for World Mental Health Day 2021, tagged: Mental health care for all: let’s make it a reality, is apt for the COVID-19 times.

The pandemic has not only disrupted and altered lives, but exposed social and economic inequalities that contributed in large measure to the spread of the virus. Such inequalities are also at the core of underlying health conditions which correlate with excess deaths across countries.

Experts are of the view that aside from the risk of infection with the coronavirus, vulnerable populations such as unemployed adults, youth, the elderly and frontline healthcare workers have experienced an increased risk of mental health symptoms and disorders

Experts are of the view that aside from the risk of infection with the coronavirus, vulnerable populations such as unemployed adults, youth, the elderly and frontline healthcare workers have experienced an increased risk of mental health symptoms and disorders.

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The experts say that people are greatly affected with the impact from stressors such as lockdowns, self-isolation and quarantines, infection fears, inadequate information, job and financial losses, stigma and discrimination, among others.

Having recognised this fact, the World Health Organisation in its new Mental Health Atlas report paints a disappointing picture of a worldwide failure to provide people with the mental health services they need, at a time when the COVID-19 pandemic is highlighting a growing need for mental health support.

The latest edition of the Atlas, which includes data from 171 countries, provides a clear indication that the increased attention given to mental health in recent years has yet to result in a scale-up of quality mental services that is aligned with needs.

Director-General of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus expressed concern that despite the evident and increasing need for mental health services, which has become even more acute during the COVID-19 pandemic, “good intentions are not being met with investment.

“We must heed and act on this wake-up call and dramatically accelerate the scale-up of investment in mental health, because there is no health without mental health.”

He hinted that none of the targets for effective leadership and governance for mental health, provision of mental health services in community-based settings, mental health promotion and prevention, and strengthening of information systems, was close to being achieved.

In 2020, just 51 per cent of WHO’s 194-Member States reported that their mental health policy or plan was in line with international and regional human rights instruments, way short of the 80 per cent target. And only 52 per cent of countries met the target relating to mental health promotion and prevention programmes, also well below the 80 per cent target. The only 2020 target met was a reduction in the rate of suicide by 10 per cent, but even then, only 35 countries said they had a stand-alone prevention strategy, policy or plan.”

Reacting to this worrisome situation, the President, Association of Psychiatrists in Nigeria, APN and Professor of Psychiatry, Prof. Taiwo Lateef Sheikh, said that studies show that 20-30 per cent of Nigeria’s population suffers from mental health challenges.

“Common mental disorders we encounter everyday include, anxiety, depression, psychosis, substance use disorders, mental disorders in pregnancy and child birth, childhood psychological/developmental disorders, suicide among others.”

Sheikh blames some of these mental disorders on the stress Nigerians deal with on daily basis, “Bloomberg currently ranked Nigeria as the most stressful country to live in the world, based on multiple factors in the living environment. To an average Nigerian, stress is the norm; ‘Just deal with it!”.

He explained that no clearly defined budget allocation for mental health in the national health budget, “allocation for health amounts to only 3.65 per cent of 2016 budget and about 3.3 per cent of the health budget of the central government goes to mental health, with over 90 per cent of this going to institution-based services provided through eight stand-alone mental hospitals. There is enormous inequity in the distribution of mental health services and available resources.

“The number of serious cases receiving no treatment during the last 12 months in developed countries varies from 35.5 per cent to 50.3 per cent. This “treatment gap” in Nigeria is as high as 85 per cent (this is referred to as the “mental health gap”)!

Further he said: “Today; we have about 300 psychiatrists in Nigeria and over 1, 000 Nigerian psychiatrists outside Nigeria! Brain drain! Mental health has come a long way in Nigeria, but we are yet to achieve systemic change for universal access to effective, qualitative and affordable mental care.

“The signing of the mental health bill into law is a critical investment in mental health in Nigeria that will guarantee access to effective, compassionate and quality mental health care that we desire,” Sheikh said.

Managing Director, Federal Neuro-Psychiatric Hospital, Yaba, Lagos, Dr Olugbenga Owoeye, in his own contribution said that Nigeria needs a documented mental health policy to tackle the menace in the country noting that the prevalence is one in four individuals.

According to Owoeye: “It is usually formulated to cover a long period of about 5-10 years. It should be an initiative of the government and, the higher the level of government involvement, the higher its chances of success.

“This document will provide a framework and also give priority to the treatment. It will help to develop mental health services in a coordinated and systematic manner. It will help to identify key stakeholders and allow different stakeholders to reach an agreement.”

Owoeye also stated that people with mental health disorders need equity and should not be discriminated against on the basis of their mental illnesses.

He called for the integration of mental health services, saying that “Mental health services work best when integrated into other health care services at all levels instead of stand-alone facilities,” Owoeye added.