When the term ‘mental disorder’ is mentioned, what comes to mind? An insane person? An incurable disease? A supernatural curse? A reflection of personal weakness? Unfortunately, misconceptions about mental health remain deeply ingrained in Nigerian society which significantly fuels stigma and neglect.
A mental disorder is an illness characterized by notable behavioural and psychological expression, which is linked with either a distressing symptom or impairment in functioning in one or more major areas.[1] These include depression, anxiety disorders, schizophrenia, bipolar disorder, and neurodevelopmental disorders such as autism. An estimated 40 million Nigerians experience mental health conditions in their lifetime, yet most receive little to no treatment.[2] The World Health Organization reports that Nigeria has a high prevalence of depressive and anxiety disorders with Total Years Lived with Disability of 7.6% and 2.8% respectively.[3] These contribute significantly to the national disease burden. Despite these alarming statistics, mental health remains one of the most overlooked aspects of healthcare in the country.
What Are the Challenges?
The mental health crises in Nigeria can be attributed to various factors. One of the major factors is the severe shortage of mental health professionals. With approximately 250 psychiatrists serving a population of over 200 million, access to specialized care is nearly nonexistent for many Nigerians.[4] The cultural and social stigma surrounding mental disorders further compounds the issue, as many individuals turn to traditional healers and religious interventions before considering clinical treatment. The fear of being labelled ‘mad’ discourages people from seeking help, leading to suffering and social isolation.
The uneven distribution of mental health resources across Nigeria is another pressing challenge. Mental health services are grossly underfunded, and certain regions, especially the northeastern part of the country, are critically underserved. This region, which has been significantly affected by conflict and displacement, has minimal mental health infrastructure despite the high prevalence of trauma-related conditions among its residents.[5] Suicide rates further underscore the urgency of this crisis. In Nigeria, the suicide rate stands at 6.9 per 100,000 people, yet attempted suicide is criminalized under Section 327 of the Criminal Code Act.[6,7] The extremity of this law extends that children as young as seven can be arrested, tried and prosecuted. Instead of offering care and support, the law punishes individuals in distress, making it even harder for them to seek help.
What Can Be Done?
Addressing Nigeria’s mental health crisis requires a multifaceted approach that includes expanding education, integrating mental health services into primary healthcare, enacting legislative reforms, and increasing public awareness. Mental health education should be incorporated into medical, nursing, and public health programs to equip non-psychiatric professionals with the necessary skills to identify and manage mental disorders. Task-sharing strategies, where community health workers are trained to provide basic mental health interventions, could help bridge the gap created by the shortage of psychiatrists.
Several layers of barriers have led to underutilization of the available mental health services. Ironically, Nigeria do not only have limited mental health resources but they are poorly utilized. Integrating mental health services into primary healthcare centres is important, especially in underserved regions. This would allow individuals to access care within their communities rather than relying on distant, specialized facilities. In areas affected by conflict or natural disasters, mental health support should be an essential component of emergency response efforts. Providing psychosocial support to displaced individuals and survivors of traumatic events can help prevent the long-term psychological impact of such crises.
Moreover, policy reforms must accompany these efforts. The Mental Health Act 2021 marked a significant step forward in replacing the outdated Lunacy Act of 1958, which treated mental illness as a criminal issue rather than a health concern.[8] This Act will promote and protect the lives of people with mental disorders. However, without proper implementation strategies, the law risks being ineffective. Therefore, suicide should be decriminalized so that individuals struggling with their mental health can seek professional help without considering suicide or fearing legal consequences.
Also, collaborative efforts involving essential groups in the society are very important. The Government should ensure adequate implementation of the Mental Health Act and training of future healthcare providers to increase the psychiatrist-to-patient ratio. Traditional and religious leaders should be involved in mental health education to challenge deep-rooted misconceptions within local communities. Public awareness campaigns, especially on social media, can play a vital role in breaking the stigma and encouraging people to seek treatment. Training mental health advocates across various age groups would also promote early intervention and foster a culture of understanding and support.
Conclusion
Mental disorders must be recognized as a public health priority, on par with other major non-communicable diseases such as cancer, diabetes, and cardiovascular diseases. The global economic and social costs of poor mental health care are too high to ignore. As a nation, we have made commendable efforts towards achieving a supportive mental health environment but the journey is far from over. Meaningful progress will require sustained commitment, investment, and a shift in our societal attitudes. To eliminate the shame associated with mental illness as there is none for physical health; the change begins with You and I. A mentally healthy Nigeria is possible, but it starts with acknowledging the problem, confronting stigma, and ensuring that accessible and effective care is available for all.
REFERENCES
Encyclopaedia Britannica (2010) Encyclopaedia Britannica. 15th edn. Chicago: Encyclopaedia Britannica.
Onyemelukwe, C. (2016) ‘Stigma and mental health in Nigeria: Some suggestions for law reform’, Journal of Law, Policy and Globalization, 55, pp. 63–68.
World Health Organization (2019) Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: WHO. Available at: https://iris.who.int/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf (Accessed: 18 November 2024).
Association of Psychiatrists of Nigeria (2018) Association of Psychiatrists of Nigeria – Home Page. Available at: https://www.apn.org.ng/ (Accessed: 11 March 2025).
Mohammed Said, J., Jibril, A., Isah, R. and Beida, O. (2015) ‘Pattern of presentation and utilization of services for mental and neurological disorders in Northeastern Nigeria: A ten-year study’, Psychiatry Journal, pp. 1–5. doi:10.1155/2015/328432.
World Health Organization (2019) Suicide worldwide in 2019: Global Health Estimates. Geneva: WHO. Available at: https://www.who.int/publications/i/item/9789240026643 (Accessed: 20 November 2024).
Legalnaija (2019) ‘What is the penalty for attempted suicide in Nigeria’, Legalnaija, 13 May. Available at: https://legalnaija.com/what-is-penalty-for-attempted-suicide/02900951941647681314/#:%7E:text=Section%20327%20of%20the%20Criminal,to%20imprisonment%20for%20one%20year (Accessed: 11 November 2024).
Nigeria Health Watch (2023) ‘From the Lunacy Act to the First Mental Health Act in Nigeria: Five Takeaways’, Nigeria Health Watch, 8 February. Available at: https://articles.nigeriahealthwatch.com/from-the-lunacy-act-to-the-first-mental-health-act-in-nigeria-five-takeaways/ (Accessed: 11 November 2024).
