‘We are losing our bright minds to drugs abuse, misuse, suicide’

With an increase in suicide rate in Nigeria and lack of implementation of the Mental Health Act to address the scourge, the Convener of Nous Organisation, Lade Olugbemi-Ogunseyitan, who is also a lawyer, told ADAKU ONYENUCHEYA that the three arms of government need to recognise mental health as a big challenge in the country and as well ensure the implementation of a National Suicide Prevention Strategy.

‘You are a lawyer based in London and an advocate for mental health, tell us more about yourself and your organisation?
I am Lade Olugbemi-Ogunseyitan. I am a lawyer and convener of the Nous Organisation, which was established to raise awareness on mental health issues in communities. The organisation was registered in Nigeria as a non-governmental organisation and what we do is advocacy, information, education and awareness.

I interface between the communities and the clinicians. One of the key things that has bedeviled our community is that we have a higher level of stigma and negative attitude towards mental health issues. This is driven by the fear people have for clinicians. People are scared of going to neuropsychiatrists to explain how they feel.

I started the organisation so that I could break down that information to people for them to understand what depression is. It is better when someone hears it from a person, who is not a psychiatrist or a psychologist in whom they can relate with.

It actually helps as we can break the message into piecemeal for people to understand. This is what my organisation is all about. Apart from that, I am, however, very passionate about Nigerians.

As a lawyer, what triggered your passion towards mental health?
I noticed there was a big gap in information that we hold in communities on mental illness. People felt they were strictly held by clinicians and psychiatrists. I realised this was causing a lot of ripple effects on them.

Many people would have gotten help earlier, but they did not get help early enough.

Mental health is a spectrum of medium and high-class. When a person gets help at an early stage, it is easier and faster for the person to recover and then, go back to their normal life.

If the person gets help, it is good, but it may take a while for the person to get back to their normal life. When a person does not ask for help, he will not receive any, even when he is at the critical stage.

We see many mad people on the streets. These are people who would have been saved, if they knew what the signs were. I felt I had the duty to educate people, because there is a need for people to know that there is help out there and that there is no need to be ashamed.

If you hear voices and you are depressed, there is self-help, self-talks techniques and mechanisms that you can do. But if the person has insomnia or anxiety, which is one of the health challenges in our communities that we don’t recognise, we don’t even know it when a person complains of his heart beating out his chest, we don’t realise that it is actually anxiety. You cannot deal with what you don’t know. I felt it was necessary to be a crusader, to raise the alarm that there is help out there.

There are reasonable adjustments that the workplace needs to put in place because there is so much pressure. For us, the driving force was the fact that there were so many gaps in the knowledge that we have about mental health issues in the communities.

I believe very strongly that I have been called to do this. I thank God that in the last five years, He has enabled us, among other ambassadors, to speak very loudly on different platforms.

Mental health is not a priority on the Sustainable Development Goals’ Focus on Health, while other interventions are being put forward, how will this affect the nation?
Last year, I was at the United Nations (UN) where I spoke, expressing my concern about the fact that we have all the Sustainable Development Goals that have been earmarked and Goal Three is on health.

Under this goal, mental health is captured but it is way behind. We have maternal health, polio, malaria, sexual transmitted disease and family planning, all under health. Though, mental health is mentioned, but it is not on the forefront.

There is no visible health without mental health. Do you realise that if a woman has post-partum depression, for example, she is not going to cope and take care of that child? Do you realise that if you take care of malaria and that person has depression or anxiety behind it, the illness will come back?

Our minds and bodies are very much in it together. You can treat the body, but if the mind is not alright, that treatment will not be fast and that ailment might come back again.

I felt that there was a need to go out and raise the alarm, not just in the community and clinical level, but also on any platform that I have. That is why we put together a national conference on mental health.

There is a gap in knowledge about mental health, how can people identify and address this issue?
The gap is in information and people are scared because for a long time, mental illness has always been something that was treated like a shroud.

They would cover it and would not always talk about it, until recently, we had a few organisations that spoke up. We still have a lot of international figures on it.

We have heard people talk, even in the last two years, about mental health. This is, actually, helping to open peoples’ eyes, especially in Africa with the misinformation and misrepresentation we have heard of mental illness, which is when people look unkempt, eat and drink from the gutters, or are violent and run away from their homes.

People can dress well and still have mental issues. The mind is an entity on its own. There is a need for us to talk about it, even if we have that body very well-dressed up. When the mind is not alright, the body cannot be perfect.

I believe the gap can be closed through information, awareness and education.

What is the situation of mental health in Nigeria? Are we experiencing an increase or decrease?
The situation is very critical and that was why we had a stakeholders’ meeting. As for suicide prevention, there are several others that we need to do. This is affecting the younger generation. That is why we see the rise in suicide, because the support services are overstretched.

We have 200 psychiatrists in Nigeria, a nation that has over 200 million population. That is one psychiatrist to one million people. This is the scariest thing. Even if we say we need to respond appropriately, who are the people that would respond?

The psychiatrists are not enough to take care of the problem. That is why we need to have a strategy to break it down. It is very critical. The earlier we start to talk as a nation, the better for us. I am somebody, who does not believe that we have to wait for the government to do everything for us.

There are some little things that we can do in our little corners. There is what we call private -public partnership – the three P’s that the United Nations is driving. There are many organisations that have made good money. Their corporate social responsibility (CSR) should go towards such things. That is one of the reasons I am here in Nigeria, because I know it is critical.

If the situation continues like this without the implementation of the Mental Health Act, what will be Nigeria’s future?
That is why we are sounding the alarm. We cannot afford to keep quiet. We need to come out to see what we can do to change the narrative. We are not going to affect the whole Nigeria, if we do, we would thank God. If my boat can head to as far as Borno, Port Harcourt, Zamfara State, I thank God. But the little corner that I am, let me make a change.

I have noticed that Nigeria has defied statistics that most of the national economists have given. About 50 years ago, people said Nigeria would break as a nation. People predicted that Nigeria would not stand as a nation. We have defied all odds.

For the fact that we are here today, I have hope. We are a fantastic people, who are very intelligent and resilient, we go against all odds and where people are breaking down we are still standing up, believing and struggling. Even though I must acknowledge that some of us are corrupt, however, we are the most resilient people. We cannot give up on Nigeria.

What are the barriers to finding solution to mental health challenges in Nigeria?
We talked about language, stigma and pressure on the resources and the fact that you have one psychiatrist to one million people. We also talked about non availability of facilities as well as culture and tradition.

I think that tradition is one major obstacle. It is the fact that our tradition still drives a lot of the stigma and the secrecy around it. That is, if a person was mentally ill, for example, traditionally, the person would be described as someone who comes from a background with mental issue or they see it as a taboo.

You do not want to be described like that. People would rather lock up their children who they know have mental health issues, knock them off or tell them that something else happened to them. Do you know that people are dying by suicide? And do you know what families are saying is the cause of their death? They say the person died suddenly, but we know the person died by suicide. This is because of the stigma attached to the fact that somebody has died by suicide in the family or mental health.

Our culture is another massive barrier for people seeking help and talking about it. Because we just want to keep quiet, we don’t want anybody to point to you the negative finger or point to your family and say “that house have a mad person living in it”. We need to bring that thing down. Some mental illnesses are genetic that you don’t have any control of. It is the chromosomes in the gene that you picked up.

We need to change the narrative. The negative use of language that we use is also a factor. People don’t want to be described negatively so they keep quiet. There are quite a lot of other factors, but those ones, I can pick straight away are some of the major barriers we have had and I don’t see people seeking for help early.

Of course, even when people know the situation, the fact is economics, finances. For you to go to Neropsychiatric hospital Yaba, they are going to give you medication and how much is it? A lot of those people we see on the street with mental issues believed that there is just one tablet for medication everyday and they would be normal. The same way someone who has diabetes takes insulin everyday, why can’t someone that has mental health issues have access to a medication that will keep them all right the same way. Mental health illness is as important as physical illness.

Mental health is not listed in the National Health Insurance Scheme to ensure those who can’t afford the treatment access it. How do we intend to solve this issue of access to funds for mental health?
If organisations like ours don’t rise up to say there is a problem – pointing that the government has done the National Health Insurance Scheme and mental health is not mentioned – For as long as we keep quiet, they would not look towards that side and that is what we need to keep pushing to eradicate the barriers that are so many.

There is institutionalised barrier and system barrier; it will not be pushed until we speak and we will continue speaking. Things have to change because we are losing our bright minds to drugs, substance misuse, abuse, suicide and mental health issues and we need to recognise that this is a challenge.

This older generation will go, they are not going to be here forever. It is a challenge if we do not recognise the fact that we need to start talking about metal wellbeing of the nation. In the next 20 to 30 years, definitely, we will not be as productive as we are now.

These entire developed nation we praise was because they thought ahead and I am saying in next 10 to 15 years, we are going to have major problems with dementia and mental illness if we don’t deal with it now.

You organised a national conference with other foundations on mental health, focusing on suicide as a challenge to developing nation, what prompted it?
It is in partnership with three organisations, what we did was bringing stakeholders together. We are had the judiciary, the legislative, and the executive – the three arms of government present. We also brought other stakeholders from primary and secondary schools, universities, the teachers, directors of organisations and institutions. It was a stakeholders meeting to bring everyone together.

We talked about the challenges of suicide to developing nations, especially Nigeria. One of the key session that I always make sure we have was the panel session, which is what I call an ‘open mic session’ where you allow people to ask questions and then they are given guided answers because a lot of people do not know about mental health issues.

It is when you are in such an environment that you can get the right answers from the experts who are there. That is what the conference was all about. We are looking at how we need to work together, focusing on pushing for decriminalising suicide attempts in Nigeria and also pushing for the passage of the Mental Health Act.

There is a gap and I believe such stakeholders meeting that we had on Saturday can cover that gap. It was about opening the government’s eye to the Lunacy Act 1957 that we still have. The Act states that once a person fails on an attempted suicide, the person is charged to court because it is a criminal offence.

We want that taken out, we want changes, which is why we want to have a Mental Health Act. At the moment, being the most populous black nation in the world, we do not have a Mental Health Act. So what happens if the person is mentally ill? How would you take care of the person? What would the government do? What is the national mental health strategy?

We have the national strategy for maternal and other health issues, why don’t we want to have in mental health, which is a state that we all have.

We have the national strategy for physical health; we should compulsorily fight for metal health as well. With all of the activities that we are having and the conferences, it helps to open people’s eyes to the gaps, both the public and private sector and also our community and then we can gradually start to close it up. The conference is a practical session where questions were asked and guided answers given to drive solutions to mental health issues.

With the conference having recorded success with huge attendance and representatives from the three arms of government, what next should Nigerians expect?
We want to achieve decriminalised suicide society. We are backing and pushing this to the floor of the house and move for the repealing of the Lunacy Act of 1957.

Do you know that the lawyers that I spoke to are not even aware that suicide attempt is a criminal offence? People are jailed for it and people are not aware. One of the outcomes expected of the conference is decriminalising suicide attempt and to move for National Strategy on Suicide Prevention, and the need to put training in place for key agencies, institutions to train officers and teachers on suicide prevention

The action plan is mainly for the stakeholders to come together and resolve this problem

Would there be any communiqué drafted that would be sent to the presidency?
Yes, there would be and we would be sending it to the National Assembly to begin plans to address this mental health issues.

I am doing all of this because of the passion I have for my great country. There are so many people that probably would have given up on Nigeria and all of that, but I haven’t, because this is where am from.

What is your advice to Nigerians in addressing mental health issues?
Why is mental health on the back burner? There is an adage that says, “It is the child that lifts up his hands that you would carry”. We see the matter as very critical.

We need to work together to prevent suicide we can’t just keep quite about it. Until we as a nation and as a continent actually do say we need mental health brought to the forefront, because there is no physical health without mental health.

Let us talk about both of them at par to put enough information out there. For example, Nigeria is rated as the fifth highest for suicide and I query that statistics. Where do they get that the statistics? We don’t have it. Do the police record how many people they picked up? Do we have coroners that record people who died by suicide? We don’t have a system in place that store statistics.

These are some of the things that we need to stop and we need to do. If we are saying that we want mental health to be at the forefront of the sustainable development goals, we need to be saying to our government that we need to put a strategy in place that will capture how we pick up figures so that government can respond appropriately to the problem that has been noted in the community.

The system and environment makes it so difficult for people. My message will be about the fact that we should remove the stigma around mental illness first of all.

Seek help when you notice, seek for knowledge when you know things are not all right. One of the major factors triggering suicide is relationship breakdown. Where two people in love suddenly break up, this leaves them heartbroken or you have a job you like and suddenly you get sacked with children at home.

Another is a major physical health issue where a person is diagnosed with Human Immunodeficiency Virus and thinks life has ended.

My advice is that what appears to be a big mountain today is a molehill by the time you look at it tomorrow. Don’t allow your present circumstance to dictate your future.

The younger generation should have the ability to hold on to hope. There is need to self-care by making sure you take care of your mind. You need to understand what your mind needs.