Introduction
In Nigeria, as in many parts of the world, there has been a long-standing focus on addressing physical and mental health issues within the public health agenda. A study conducted in 2020 and published in BMC Public Health did a systematic review that examined the health system challenges and opportunities for addressing non-communicable diseases (NCDs) in Nigeria. It highlights the predominant focus on infectious diseases within the Nigerian health system and the limited attention given to NCDs. The study emphasizes the need for a shift towards a more comprehensive approach that addresses both physical and mental health concerns within the public health agenda. It provides insights into the current gaps in the Nigerian health system and presents opportunities for integrating mental health into the existing infrastructure to improve overall health outcomes [1].
However, it is essential to recognize that mental health is an integral part of overall well-being and should be given equal attention. In a study done in 2015 and published in BMC Health Services Research, findings of a demonstration project that aimed to integrate mental health into primary care in Nigeria using the Mental Health Gap Action Programme (mhGAP) intervention guide were presented. The project focused on training primary care providers to identify, manage, and provide basic treatment for common mental disorders. The study highlights the significance of integrating mental health into primary care settings and the positive impact it can have on improving overall well-being. It emphasizes the need to address mental health alongside physical health concerns to achieve comprehensive and equitable healthcare in Nigeria [2].
This thought piece aims to shed light on the importance of bridging the gap between physical and mental well-being in Nigeria’s public health agenda, specifically focusing on mental health considerations.
Recognizing the Impact of Mental Health:
Mental health encompasses emotional, psychological, and social well-being. It affects how individuals think, feel, and act, and it also influences how they handle stress, relate to others, and make choices. The burden of mental health disorders in Nigeria is substantial, with millions of people affected by conditions such as depression, anxiety, and substance abuse. Ignoring mental health can lead to adverse outcomes, including reduced productivity, impaired quality of life, and increased risk of physical health problems.
Integrating Mental Health into the Public Health Agenda:
To bridge the gap between physical and mental well-being, it is crucial to integrate mental health into Nigeria’s public health agenda. This can be achieved through several key strategies:
- Raising Awareness and Reducing Stigma:
Public education campaigns should aim to increase awareness about mental health, challenge societal stigmas, and promote empathy and understanding. This can help foster a supportive environment for individuals seeking help and reduce barriers to accessing mental health services. An article written in 2015 and published in the African Journal of Psychiatry provided an overview of the challenges and opportunities in addressing mental health in Africa, including Nigeria. It emphasized the need for public education campaigns to increase awareness and reduce the stigma surrounding mental health. The publication discussed the importance of promoting understanding and empathy to create a supportive environment for individuals seeking mental health services [3].
In another article written in 2019 and published in Mental & Prevention, the writer explored perceptions of mental health-related stigma in Nigeria and discusses potential remedies to combat stigma. It emphasizes the importance of public education campaigns in challenging negative attitudes and promoting understanding. The publication also discusses the role of media in disseminating accurate information and shaping positive attitudes toward mental health [4].
There are several campaigns and programs in Nigeria that aim to raise awareness and reduce the stigma surrounding mental health. Here are a few notable examples include;
- “Walk Against Depression”: This campaign, organized by the Mental and Environmental Development Initiative for Children (MEDIC), focuses on raising awareness about depression and promoting mental health in Nigeria.
- “Mentally Aware Nigeria Initiative (MANI)”: MANI is a non-profit organization that works to reduce stigma and promote mental health through various programs and campaigns.
- “She Writes Woman”: This organization aims to create safe spaces for women to discuss mental health issues, reduce stigma, and provide support. They organize events, workshops, and storytelling sessions that encourage women to share their experiences and seek help when needed.
- “Strong Enough Foundation”: This foundation focuses on empowering young people, particularly in schools and universities, to address mental health issues. They conduct awareness campaigns, workshops, and training sessions for students, teachers, and parents to promote mental well-being and reduce stigma.
- Strengthening Mental Health Services:
Adequate investment in mental health services is essential. This includes increasing the availability of trained mental health professionals, ensuring the availability of essential medications, and improving the infrastructure for mental health care delivery. Integration of mental health services into primary healthcare settings can enhance access and early intervention. A publication done in 2020 featured in the Mental Health Policy & Economics gave a systematic overview to examine the literature on integrating mental health into primary care in Nigeria. It highlighted the importance of adequate investment in mental health services and the integration of mental health into primary healthcare settings to enhance access and early intervention. The publication provided insights into the potential benefits, challenges, and strategies for integrating mental health services into the existing healthcare infrastructure [5].
A study published in 2018 in the Journal of Mental Health, assessed the knowledge of primary healthcare workers in Nigeria regarding the integration of mental health into primary care. It underscored the importance of investing in training programs to equip healthcare workers with the necessary skills and knowledge to provide mental health services. The publication supports the argument for strengthening mental health services through workforce development and integration into primary healthcare settings [6].
The Nigerian government has taken several policies and proactive measures to strengthen mental health services in the country. Here are a few notable examples include;
- The National Mental Health Policy: the Nigerian government developed a National Mental Health Policy that provides a framework for the organization, management, and delivery of mental health services in the country. The policy aims to promote mental health, prevent mental disorders, and ensure access to quality mental health services for all Nigerians.
- Mental Health Act: Nigeria passed the Mental Health Act in 2022, which provides a legal framework for the protection and promotion of the rights of individuals with mental health conditions. The act covers various aspects such as mental health care, treatment, and rehabilitation, as well as the establishment of mental health facilities and services.
- Mental Health Strategic Plan: The Federal Ministry of Health in Nigeria developed a Mental Health Strategic Plan that outlines the priorities, strategies, and action steps to strengthen mental health services. The plan focuses on key areas such as human resources for mental health, access to care, promotion of mental health, and community-based mental health services.
- Promoting Prevention and Early Intervention:
Prioritizing prevention strategies can help identify and address mental health concerns early on. This involves implementing school-based mental health programs, workplace wellness initiatives, and community-level interventions that promote mental well-being and resilience. An article featured in School Mental Health examined the state of school mental health services in Nigeria, emphasizing the importance of implementing school-based mental health programs as a preventive measure. It discussed the policy context, challenges, and opportunities for integrating mental health into schools and highlights the potential impact of early intervention in promoting mental well-being among students [7].
Furthermore, a WHO publication provided guidelines and evidence-based strategies for promoting mental health and providing mental health care in schools. It emphasizes the importance of early intervention and prevention in educational settings and provides practical recommendations for implementing school-based mental health programs [8]. A review featured in the International Journal of Environmental Research and Public Health examined workplace interventions aimed at promoting mental health. It discussed various strategies, such as mental health awareness campaigns, stress management programs, and workplace well-being initiatives. The review highlights the significance of early intervention in the workplace and provides insights into effective approaches to prevent mental health issues and promote well-being among employees [9].
- Addressing Social Determinants of Mental Health:
Recognizing that social determinants impact mental health is crucial. Public health efforts should aim to address socioeconomic disparities, promote education and employment opportunities, improve living conditions, and tackle gender inequality, as these factors have a significant influence on mental well-being. A WHO publication explored the social determinants that influence mental health outcomes. It provides evidence-based insights into the impact of socioeconomic factors, education, employment, housing, and gender inequality on mental well-being. The publication emphasizes the importance of addressing these determinants through comprehensive public health approaches [10]. A systematic review done in 2006 examined the association between suicide rates and socioeconomic characteristics of geographical areas. It underscores the importance of addressing social determinants, such as income inequality and poverty, in mental health interventions. The findings highlight the need for comprehensive strategies to tackle social inequalities and promote mental well-being [11].
- Collaboration and Partnerships:
Successful integration of mental health into the public health agenda requires collaboration between government agencies, healthcare providers, community organizations, and other stakeholders. Building strong partnerships can facilitate the development of comprehensive strategies and ensure the efficient allocation of resources. An article featured in The Lancet focused on scaling up mental health services in low-income and middle-income countries. It emphasizes the need for collaboration and partnerships among various stakeholders, including governments, NGOs, and local communities. The article highlights successful examples of collaborative efforts in expanding mental health services and calls for sustained partnerships to achieve comprehensive coverage [12].
In a similar light, a study did a meta-analysis examining the effectiveness of collaborative care models for depression. It emphasizes the importance of collaboration between primary care providers, mental health specialists, and patients in delivering integrated care. The study demonstrates that collaborative care models lead to improved outcomes and highlights the value of partnerships in addressing mental health conditions [13].
Conclusion:
It is time to recognize that mental health is as important as physical health in Nigeria’s public health agenda. Bridging the gap between physical and mental well-being requires a concerted effort to raise awareness, strengthen mental health services, promote prevention and early intervention, address social determinants, and foster collaboration. By taking these steps, Nigeria can enhance the overall well-being of its population, reduce the burden of mental health disorders, and pave the way for a healthier, more resilient nation. It is time to prioritize mental health and give it the attention it deserves in Nigeria’s public health landscape.
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[11] Rehkopf, D. H., & Buka, S. L. (2006). The association between suicide and the socio-economic characteristics of geographical areas: A systematic review. Psychological Medicine, 36(2), 145-157.
[12] Eaton, J., et al. (2011). Scale up of services for mental health in low-income and middle-income countries. The Lancet, 378(9802), 1592-1603.
[13] Gilbody, S., et al. (2006). Collaborative care for depression: A cumulative meta-analysis and review of longer-term outcomes. Archives of Internal Medicine, 166(21), 2314-2321.