Are we aware of Nigeria’s mental health policy?

These are enough reasons in many decent places for one to visit a Psychiatrist for mental evaluation and counseling. Many people in Nigeria are currently facing same experiences or had experienced it before. This underpins why Nigeria should have a good mental health policy that is effectively and efficiently implemented for all Nigerians. Until Tuesday […]

These are enough reasons in many decent places for one to visit a Psychiatrist for mental evaluation and counseling.
Many people in Nigeria are currently facing same experiences or had experienced it before. This underpins why Nigeria should have a good mental health policy that is effectively and efficiently implemented for all Nigerians. Until Tuesday 29th April 2014 I wasn’t aware that Nigeria has a draft National Policy for Mental Health Services Delivery. A copy given to me by John Minto the Managing Director of Gede Foundation during a lunch meeting. I was made to believe that it was presented and adopted by the National Council on Health in August 2013.
My aim today is to provide excerpts from the 22 page document and proffer next steps that should be done to move this policy to the next level.
World Health Organization (WHO) has define mental health as “broad array of activities directly or indirectly related to the mental well-being component included in the WHO’s definition of health: “A state of complete physical, mental and social well-being, and not merely the absence of disease”.
It is related to the promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorder………and It is defined as a state of well-being in which every individual realizes his or her own potential, and  can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
It was shocking to read a portion in the policy that says “there are less than 150 psychiatrists in the country (around 1 per 1 million populations) and very few neurologists, with many newly trained specialists leaving the country to work abroad.
There are around 5 psychiatric nurses per 100,000 population and only very few other mental and neurological health professionals like clinical psychologists, social workers, neurophysiotherapists, and occupational therapists………and the systems that support delivery of services are currently weak, with poor availability of psychotropic drugs and lack of incorporation of mental and neurological health measures in health information systems.”
This is wake up call for everyone interested in promotion of mental health to rally around this policy and support its implementation.
The Policy Guiding Principlesare;
1.    Governance and accountability; the implementation of this policy will require cooperation between the Federal, State and Local governments of the Federation.
2.    Human Rights and Inclusion in Social Life; The stigma, discrimination and social exclusion that is commonly experienced by people with mental health problems is addressed in this policy through ensuring equitable access to care, and specific activities aimed at challenging negative attitudes in the population.
3.    Inter-sectoral Partnerships; Many sectors, agencies and individuals have important contributions to make for mental and neurological health, and partnerships are essential.  
The Health Sector; The organization of the health sector for the delivery of effective and human MNS service shall be guided by the following principles:
1.    Primary Care; Most people with mental or neurological disorders, including those living in towns with teaching hospitals or psychiatric hospitals, will need to be seen and cared for by members of the primary care unit.  
2.    Decentralised community oriented comprehensive services; Nigeria would like people with mental or neurological disorders to be cared for as close to home as is compatible with health and safety of the public.
3.    Referral Pathways: Primary, secondary and tertiary cares are more efficient and effective if there is good communication between them.
4.    Good practice guidelines; Good practice guidelines are an invaluable adjunct to improving care and establishment of good practice at all times.
5.    Partnerships within the health sector; The MNS strategy will be linked with and integrated with overall health policy and health sector reform so that there are no inherent conflicts between general health and MNS reforms.
6.    Research; Nigeria, like all other countries, can benefit from the readily accessible international evidence base. However, there are crucial questions which can only be answered by local research and a coordinated MNS research programme should be planned and undertaken.
Rationale for Reform;
•    The burden of mental illnesses; Mental and neurological ill health is a major contributor to disability across the world.  Five of the ten leading causes of disability world-wide are neuropsychiatric disorders.  
•    Mental disorders are common in Nigeria as they are everywhere else in the world, and contribute to disability, mortality, loss of economic productivity and poverty.  The prevalence of psychosis is at least 0.5% of the general population, and the prevalence of common mental disorders (depression, anxiety, hysteria, and somatisation) is at least 10%, with increased rates in highly deprived groups.
•    Parental illness contributes to intellectual and emotional consequences for the next generation of Nigerian children.
In conclusion it is worth noting that now that we have a draft policy, it is imperative that it is disseminated widely across Nigeria and move ahead to develop its 5 year costed strategic plan which articulate strategies, objectives, key activities, indicators for performance monitoring and evaluation as well as agree on funding mechanisms  which is vital for its implementation.
All comments to DrAminuMagashi at [email protected]