‘Nigerians still confuse depression for spiritual problems’
Richard Adebayo, Consultant psychiatrist and clinical psychologist at Federal Neuropsychiatric Hospital, Yaba, Lagos, tells BusinessDay’s Anthonia Obokoh that while depression is on the rise among Nigerians leading even children to commit suicide, many still think it is a spiritual problem, excerpts:
Depression is the leading cause of disability worldwide, what is your take on it?
Depression affects millions of people all over the world; it is the most common form of mental disorders in the whole world, Nigeria inclusive.
It affects a lot of people cutting across the continents, religion, culture, all classes of people. So the notion that is the leading cause of disability and of one is commonest form of disorder is true.
How prevalent is depression in Nigeria?
Depression will affect not less than 20 per cent of any population in their life time, so that is life time prevalence can affect figures higher than 20-25 per cent have been quoted of the population that will suffer depression at one stage or the other in their life.
Depression is very common in elderly, young and children, the presentation varies, it differs from the way children manifests to the way adults manifest.
The way depression manifests in children especially in adolescent and teenagers may not be exactly the same way we see in adult population .Unfortunately we have children who even take their lives, one was reported recently who committed suicide. So depression is one of the leading causes of suicide whether in children or adults.
What are the available services for those depressed in Nigeria?
Well as I said earlier, up to 20-25 per cent of people will suffer depression at one stage of their life time. unfortunately majority of these people maybe misdiagnosed and even those with clinical cases of depression, a lot of them will not be able to get the access to appropriate treatment in their life time because as we are aware of the medical experts and health facilities are very scarce in Nigeria. There are so many places, especially the rural population whereby we do not have health officials to attend to them.
What is the perception of depression in Nigeria?
Well people tend to use the word depression loosely, but even for those we can attribute their depression to be mental disorders a lot of times people think those depressed are weaklings, but the truth is depression does not go with personality.
Even men suffer depression, but women tend to suffer depression more than men. But there are men who have what is called masked depression, with their masculine ego, it seems everything is alright, but they are suffering from depression, but often time, we hear of men who also commit suicide, 80 per cent of men suicide is attributed to depression. It can be in different dimensions, someone can look irritable, aggressive, road rage, little thing fears off, yet the person is suffering depression.
Are perceptions of depression changing in Nigeria?
The perception is changing gradually though in a slow range, a lot of people who are depressed attribute it to one thing or the other.
Especially when they have somatic or bodily complaints these sensations in the body, most of these funny complaints are actually evidence of underlined depression and once they get some treatments and they are not getting well, they attribute to some spiritual or diabolical problems but it is not in all cases they are spiritual, sometime it is just simple form of depression people are suffering from, but because they cannot fathom why they are suffering from those things, so they attribute it to some other means and they suffer needlessly.
How can the human right of people with mental health be promoted and protected?
Until Nigeria is able to enact the law on mental health like the Mental Health bill that we have been struggling for years to see the light of the day with the national assembly and Mr. President will eventually sign it into law, hopefully, that will guaranty the rights of patients with mental disorder, but right now especially if a patient with severe depression or psychosis and no longer in contact with reality and judge such to be dangerous to themselves and are forcefully brought to the hospitals, so it appears their rights to be sometimes violated.
To what extent should the mental ill patient is to be violated, preserve their rights and liberty, these are grey areas, but When a mental health law is enacted, that will guaranty a lot of protection.
The mental health act that is been used in Nigeria presently, was the one gotten from the colonial masters. So it is long and out dated, I believe a mental health bill when passed into law will go a long way in protecting and promoting the rights of patients, especially depressed patients in particular.
What has been the government’s contribution to mental health care in Nigeria?
Government established psychiatric hospitals about 6 or 8 and most of the departments of psychiatric in the federal teaching hospitals and also the state government. Some of the hospitals have dedicated psychiatric hospitals but even though the government is trying, what we have is inadequate for the teaming population.
The facilities we have to take care of about 16 million people in Lagos state are drastically not sufficient, the facilities and personalities cannot adequately take care of the population, but we are still fortunate in Lagos state, some states just have one or two consultant psychiatrists, sometimes no clinical psychologist. Most states cannot boost of ten psychiatric nurses.
What we supposed to have is to integrate mental health into the primary health Centre’s that would go a long way in solving the gaps of these problems; I am not advocating that more psychiatric hospitals should be built in local government or states, but mental health should be into the existing over seven hundred primary health centers in the country and a lot of middle kindred health workers can function in those areas and treat common cases of mental disorders ,only the server cases will be referred to the tertiary hospitals.
So mental health should be entrenched, inculcated into the primary health Centre’s all over the country, which will go a long way in meeting the mental health needs of the patients.
What are other disturbing issues that you feel adequate attention should be given?
The enactment of mental act which we have been trying to push across to the national assembly for some years but it has not seen the light of the day.
Funding, if we say the health sector is even generally underfunded, mental health hospitals are grossly underfunded. The funding to mental health hospitals are far cry from what is supposed to, so it is not encouraging.
A lot of our specialists are moving in droves to the western world, because of lack of facilities, some are trained, but there is no space where they can function, we are losing so many of our professionals to other countries and it is not fair to our country.
The problem of decayed infrastructure is one-hundred and ten years old. We have old facilities that should be upgraded and improved upon, but we have shortage of fund.
It is time people should realise that government alone cannot do it. Individuals, organized private sector, organizations should also be involved in mental health care, just like some of them are been involved in malaria, tuberculosis, polio and HIV, I think they should also show concerns to mental related health issues.