Mental health policies in Nigeria

The lunacy ordinance in Nigeria was first authorized in 1916. It is a law that allows medical practitioners and magistrates the power to detain anyone suffering from mental illness which was amended in 1958, which was renamed as the lunacy Act 1958.[8]

A Mental Health Bill was presented to the National Assembly of Nigeria in 2003 but was withdrawn in 2009 after no considerable progress.[8] The bill was reintroduced again in 2013 but yet to be enacted.[8]

Nigeria's mental health policy was first formulated in 1991. Its components include advocacy, promotion, prevention, treatment and rehabilitation.[9] In 2003, a bill for the establishment of Mental Health Act was introduced 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 Dalhatu Tafida but was later withdrawn in April 2009.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. The Bill 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.[8][9]

Over 13 years since the bill was introduced to the National Assembly, it is yet to be passed into law. In the absence of this act, traditional and spiritual healers relate most mental illness to spiritual attacks with no diagnoses. This has created avenues for the dehumanization and extortion of mentally challenged in the country. On 18 February 2016, a neuropsychiatrist Memumah Yusuf Kadiri appealed to Nigerian lawmakers to expedite action on the mental health bill pointing out that Nigerians still see mental health as a taboo because the country still adheres to the lunatic act of colonial legacy.[10]

OAUTHC in Ile-Ife, Nigeria.

The first mental hospitals in Nigeria are the Calabar Lunatic Asylum in southeastern Nigeria, and Yaba Lunatic Asylum in southwestern Nigeria.[11] The latter, renamed Yaba Mental Hospital in 1961, and again given its current name Yaba Psychiatric Center ( Federal Neuro Psychiatric Hospital,Yaba) in 1977, admitted its first batch of 14 patients (8 women and 6 men) on 31 October 1907. The Yaba Lunatic Asylum which was situated in the former headquarters of the Nigeria Railways. In 1915, it became overcrowded, and some cells in Lagos prison were turned into Lunatic Asylum. Dr. Crispin Curtis Adeniyi Jones, a Nigerian Physician and also an official of the Lagos Medical Service became the first Director of the Lagos Lunatic Asylum.[11]

Neuropsychiatric Hospital Aro, Abeokuta started as an asylum on the 13th of April, 1944 with 13 health attendants from the then Yaba Asylum ad five mentally ill patients. In 1948, the present site of Aro Neuropsychiatric Hospital of 732 acres was acquired for the hospital to carter for the overpopulation being experienced at the Lantoro annex. The renowned late Professor Thomas Adeoye Lambo (OFR) headed the main hospital at new site and brought the institute into through the creative 'Aro Village System' of treating the mentally ill.[12] The institute became a WHO Collaborating Centre for Research and Training in Mental Health in August 1979. [13]The institute has won different awards over the years - 2015 Best Primary Health Care Provider in Nigerian, 2010 Health Facility Utilization Award in Ogun state, 2007 best Specialty Hospital in Nigeria, 1999 most outstanding public sector organization in Nigerian.[13]

Federal Neuro Psychiatric Hospital, Uselu, Benin City was first created in 1963, as an asylum with pioneer staff from Neuropsychiatric Hospital, Aro, Abeokuta. It is one of Nigeria federal government funded centers for Psychiatry in Nigeria.[13]

The remaining federal government funded centers for Psychiatry are:

• Federal Neuro-Psychiatric Hospital, Calabar
• Federal Neuro-Psychiatric Hospital, Maiduguri
• Federal Neuro-Psychiatric Hospital, Enugu
• Federal Neuro-Psychiatric Hospital, Kaduna
• Federal Neuro-Psychiatric Hospital, Kware

In addition to the Federal Neuro-Psychiatric Hospital, some Nigeria universities' teaching hospitals also have psychiatric units-

• University of Benin Teaching Hospital, Edo

• University College Hospital, Ibadan, Oyo
• OAU Teaching Hospital Complex, Ile-Ife, Osun
• University of Port Harcourt Teaching Hospital, Rivers
• University of Calabar Teaching Hospital
• University of Ilorin Teaching Hospital, Kwara
• University Teaching Hospital, Jos, Plateau
• Ahmadu Bello University Teaching Hospital, Kaduna
• Usman Dan Fodio University Teaching Hospital, Sokoto
• Aminu Kano University Teaching Hospital, Kano
• University of Nsukka Teaching Hospital, Enugu

About 25-30 percent of Nigerians are estimated to be having from some sort of mental illness.[6][7] According to Nigerian Medical Association, 350 psychiatrists currently serve Nigerians with a population of about 200 million people, this was stated during the celebration of 2020 World Mental Health Day. [14] This is similar to the estimated number of 250 psychiatrists serving Nigerians claimed by Dr. Taiwo Sheikh, the president of the Association of Psychiatrists of Nigeria.[15] Shortage of mental health professionals in addition to inadequate infrastructures and poor public attitudes towards mental illness has result to about 80 percent of people with serious mental illness unable to access adequate care.[8]