Mental health advocates have raised concerns over persistent gaps in the implementation of Nigeria’s Mental Health Act, saying the absence of a dedicated Department of Mental Health, inadequate data and limited access to quality care continue to undermine efforts to improve mental healthcare in the country.

The advocates spoke at a mental health symposium organised to promote conversations around mental health and commemorate World Mental Health Day.

Founder, Mandate Health Empowerment Initiative and convener, Association of Mental Health Reform Organizations in Africa (AMHAR), Ameh Zion Abba, said the passage of the National Mental Health Act had not translated into the level of reform expected by stakeholders.

Abba said, “We have seen that up until now, the issue around some of the core five objectives of that piece of legislation are still pending, and it is a problem.”

He identified the absence of a Department of Mental Health in the Federal Ministry of Health as one of the major gaps, saying such a department would provide strategic leadership for mental health funding, domestication of the Act and implementation of mental health programmes across the country.

According to him, another major challenge is the lack of comprehensive and current mental health data in Nigeria.

“We haven’t seen commitments from government. We haven’t seen commitment from international donors and partners operating in Nigeria to give commitment to funding mental health research in the country,” she said.

Abba said the country also needed to address gaps in access to quality care and protection of the rights of persons with mental health conditions.

He noted that although mental health had been integrated into some primary healthcare centres through the National Primary Health Care Development Agency, more needed to be done to ensure that people could actually access the services.

He also called for a more humane approach to the treatment of people with mental health conditions in healthcare facilities, communities and families.

Founder, Mental Health With Ditty Foundation, Adedotun Esan said mental health should be integrated into primary healthcare, while capacity should be built among people to provide mental health first aid.

Esan, who said she started the organisation five years ago after his own experience of struggling to access mental healthcare, also called for greater attention to mental health in workplaces and schools.

She said, “Mental health should become integrated into primary healthcare. Mental health needs to be in primary healthcare and we can build capacity in people to provide mental first aid, and also for the workplace and schools.”

Earlier, Country Director, CDHR Global Disability Inclusion Nigeria, Abdulazeez Musa, said people with lived experience of mental health conditions must have a greater role in shaping policies and programmes affecting them.

Musa, who spoke on the theme, “Whose Voices Shape Mental Health Policy in Nigeria?”, said there was a need to distinguish between participation and meaningful participation in mental health policymaking.

“Participation is inviting someone to attend a meeting. However, meaningful participation is ensuring that their views shape decisions that emerge from the meeting,” he said.

He urged policymakers and organisations to involve people affected by mental health challenges in designing policies, implementing programmes, monitoring outcomes and holding systems accountable.

According to him, people with lived experience possess knowledge that should be recognised as expertise in policymaking.

Musa said, “We must be careful not to confuse participation with meaningful participation. Participation gives someone a seat. Meaningful participation is influence.”

He also called for greater openness in discussing mental health, saying silence and stigma could make mental health challenges more difficult to address.

Also speaking, co-founder, Women in Public Health Leadership for Africa, Dr Charity Usifo Chenge, said Nigeria had made progress in opening up conversations around mental health, but needed to move from policy development to implementation.

She said the country now had both a policy framework and an Act, adding that stakeholders must close what she described as the “know-do gap”.

“Now we have an Act. It’s time to act. We need to begin to act out the policy using the power that the Act has given us,” she said.

Chenge stressed the importance of primary healthcare in implementing mental health policies, saying integration at the primary healthcare level was crucial because that was where most Nigerians accessed healthcare.

She also called for sustained awareness campaigns to reduce stigma and encourage more people to speak openly about mental health.

The advocates maintained that effective implementation of existing policies and legislation, adequate resources, stronger data systems and meaningful participation of affected persons would be critical to improving mental healthcare in Nigeria.

BY Lucy Ladidi Ateko