Where is our National Mental Health Policy?

Did you know that for the past 15 years,(2003) a bill for the establishment of Mental Health Act is yet to be passed into law by the Nigeria National Assembly since its first introduction (by Sen. Ibiabuye Martyns-Yellowe and Sen. Dalhatu Tafida but was later withdrawn in April 2009). Four years later, precisely on March 20, 2013, the bill was re-introduced to the National Assembly by Hon. Samuel Babatunde Adejare and Hon. Solomon Olamilekan Adeola. Till date the bill is still lying "fallow". I keep asking why?

"Though mental health policies are aimed at addressing mental health issues in Nigeria, in-depth information on mental health service in Nigeria is non-existent. This makes it difficult to identify areas of needs, coordinate activities of advocacy groups, and to make informed decision about policy direction. In effect, there is continued neglect of mental health issues as well as the many challenges that results from it in spite of existing government policy"---Gureje, Oye (2006). WHO-AIMS Report on Mental Health Systems in Nigeria

The lack of national focal prints have left policy makers/key stakeholders (with the strength, technical &political credibility for policy change/implementation or with potential blocking power) without a clear concept on mental health and it's impact on overall health. With major implications for access to mental health care services for about 20 million Nigerians suffering from mental illness. A good number of them go without professional assistance.

Did you also know that Nigeria have a National mental health policy (NMHP) ? Do we even have a mental health budget in the first instance? Till date, I have not been able to get answers to this bugging question. I remember cracking my head over items health budget should cover, given that my plans to write on Nigeria' mental health budget and policy have been on hold (since 2014), for more "pressing/catchy" stories for my dear readers (It is not easy to "sell" mental health news in Africa, trust me. Over the years, 9jaMindWorks have been pioneering free mental health literacy platform with successes in building teaming avid readers. Thank you all). 

Quick Facts

• Mental health policies is a framework of the government highlighting its vision towards dealing with mental and neurologicaldisorders in Nigeria ( Michelle, Funk, 2017) 
• Nigeria's mental health policy was first formulated in 1991 and updated in 2013 
• Its components include advocacy, promotion, prevention, treatment and rehabilitation(Federal, Ministry of Health). 
• The Federal Government of Nigeria adopted a health policy which placed provision of mental health services at the Primary Health Care level. This policy updated policy also reaffirms the commitment to provision of quality services that are accessible to most people in the country. . 
• The proposed Mental Health Act  (MHA) (2003, 2009&2013 bill introduced to the National Assembly) protects the rights of persons with mental disorders, ensure equal access to treatment and care, discourage stigma and discrimination and set standards for psychiatric practice in Nigeria.
• The Bill makes provisions for access to mental healthcare and services, Voluntary and involuntary treatment, Accreditation of professional and facilities, Law enforcements and other judicial issues for people with mental illness, Mechanisms to oversee involuntary admission and mechanism to implement the provision of Mental health Legislations. 

The NMHP was developed through a collaborative process which included a wide range of stakeholders in mental health in Nigeria. National Mental Health Action Committee under the FMOH using examples from other countries with similarities in social and economic contexts, as well as evidence-based, best practice guidelines. Much of the content was based in experience in practice of members of the committee in various service settings. With consultation for significant input from professional groups, government departments, NGOs and service users.

Call to Action: Community-based Mental Health Services 

I keep asking where is our mental health policy? Rusting on the government shelves? Or lying "fallow" on cyber space as it applies to the accessible soft copies online? What could be wrong?  Implementation! Implementation! Implementation!- which is significantly dependent not just on government funding. 

This is my call to real action given the current insecurity in the North-East(NE) and Middle belt demands urgent attention not only to address the physical health needs of high number of Internally Displaced Persons (IDPs) in Nigeria and neighboring countries like chad equally demands urgent Mental health and Psycho social Support (MPSS). MPSS is now one of the short-term intervention programs being implemented by International donor agencies to address the psychological impacts of insurgencies in the troubled regions across Nigeria , Africa and other parts of the world. Why is the Nigeria mental health policy is not being implemented? What is stopping the passage of the mental health bill which will consolidate the on-going MPSS efforts?

Photo Credit: NAFDAC( National Agency for Food and Drug Administration and Control )

Nigeria needs more mental health advocates and experts with technical skills on policy intelligence, diagnosis &follow-up on key stakeholders (institutional/individual) with the strength, technical &political credibility for policy change/implementation or with potential blocking power. 

The lack of implementation (NMHP) and non-passage of the proposed Mental Health Act (MHA) has been a major set back for advocacy efforts in Nigeria, especially on Child and Adolescents Mental Health (CAMH), where there is dearth in research, data and scanty advocacy groups in Nigeria and Africa. Given the current realities on psychological implications of the humanitarian crisis for IDPs, with women and girls being the most affected, I keep asking why have the National Assembly declined passage of the mental health bill? The government should make significant changes on the roles it plays on top priority areas of delivering a long-term MPSS responses to cope from current insecurity crisis and economic crisis. 

The Mental Health Policy and MHA are also major keys to developing programs and national   mental health literacy campaigns aimed at empowering Nigerians to talk openly about mental illness, recognize symptoms, utilize local resources, and seek help. 

9jaMindWorks have been leading actions on mental health literacy campaign since 2014, creating free public education/awareness on mental health concepts, causes, prevention, treatment, care and support.

As part of efforts to close mental health gaps across cultures/countries/continents, I have been very relentless and determined in pushing for/advocating for the government, National Assembly, other institutions as well as individuals to urgently take action to address the silent crisis in the mental health sector. Despite these, the successes recorded have been slow but steady in 9jaMindWorks special focus at reaching broader Nigerian,  African audiences(countries with low attention to mental healthcare at the top) with the overall aim of  breaking mental health barriers (myths/stigmatization/funding etc). 

Implementation of the Mental Health Policy in conjunction with the Mental Health Act(Law, when passed) will address the current mental health gap through creation of improved access to mental health treatment and preventative services nationwide, in particular, good quality community-based services with decentralised hospital support on provision of mental health services at the Primary Health Care level. 

What are the cost implications for funding this call to action and what have been the trends on Nigeria mental health budget? This will be the focal point for discussion in  up-coming articles.

Many readers of this blog  are yet to openly comment or participate on mental health issues. I begin to wonder if the concepts are too broad or complicated, or it is a case of being unsure what to say, fear of being associated with a "madness" blog? Why not join us in breaking mental health/illness stereotypes by endeavoring to comment and if not sure what to ask, subscribe via email or like our facebook page:9jaMindWorks.

Do share your views on the comments section. Also send email to joyceanthonia@gmail.com or 9jamindworks@gmail.com. 

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