Friday, 1st July 2022
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Urgently needed: A new Mental Health Act

During colonial times, the then British Imperialists enacted the Lunacy Ordinance in 1916. Shortly before independence in 1958, the Lunacy Ordinance

Sir: During the colonial times, the then British Imperialists enacted the Lunacy Ordinance in 1916.

Shortly before independence in 1958, the Lunacy Ordinance was revised and empowered mental health practitioners and magistrates to detain mentally challenged people who if in their opinion constituted a danger to themselves and society.

In 2003, the National Assembly introduced the mental health bill, which held an initial promise to greatly reform the mental health practice in the country. Unfortunately, it was thrown out six years later and Nigeria was back to Square One.

In 2013, another bill was sponsored in the National Assembly, which had as its ethos the creation of a Foundation to cater for the needs of people with mental health foundations and substance abuse addicts. Tragically again, it hit a brick wall as our legislators tossed it aside when it failed to garner massive support for it.

We need a mental health act to adequately protect the interests of the mentally challenged in Nigeria. For instance, the act will adequately protect them from stigmatisation and discrimination, especially in the workplace. It will protect them from being summarily dismissed by their employers and will give them good grounds for litigation if their dismissal is deemed to be unfair.

Since 2006, HIV antiretroviral drugs have been free in most parts of Nigeria, the mental health act will guarantee the massive opening up of the space for international health donors to replicate the same in the mental health sector by giving them free medication, which will greatly ameliorate the economic hardship of the patients – many of them are economically disadvantaged and go through hell and high water to regularly purchase their medication.

Nigeria has a huge crisis in its hands. It has millions of patients domiciled in the country with less than 400 psychiatrists to attend to them. Most of these doctors are residents in the urban centres and work for government-owned hospitals.

Outpatients have to battle long queues and extreme stress to see their doctors on their appointment days in government-owned hospitals. The stress involved makes some of them not bother keeping up with their regular appointments, which in most cases leads to relapse with the vicious cycle never-ending.

Our annual health budget is less than the 15 per cent WHO recommended figure with the health sector being heavily dependent on foreign health partners. Mental health is the least prestigious in the field of health with few health practitioners being attracted to it. To make matters worse, the few ones being locally trained are fleeing the country in droves because of the harsh working conditions and scandalously minuscule remuneration.

It is high time that the stakeholders in the mental health sector closed ranks and came together for the purpose of acting as a sturdy pressure group to pile pressure on the National Assembly to enact a mental health act to be in the best interest of the patients, who need a potent law to protect them as they are vulnerable.

In sane countries, the law protects the weak but sadly not so in Nigeria, which prides herself as the ‘Giant of Africa’ – life here especially for the mentally challenged is akin to an archetypal description of the Thomas Hobbes definition of the State of Nature.
Mentally challenged persons have the right to live normal and independent lives under the eagle-eyed supervision of their doctors and so there is the need for a sturdy legal framework to back and advance their interests.

What stops the Minister of Health from using his influence to push for a mental health bill in the National Assembly instead of spewing gaffes on a daily basis?
Mental Health NGOs should galvanise and collectively draft a bill to be sponsored by a public-spirited legislator and have the patience to stay with it as most of our so-called lawmakers are only interested in ‘stomach infrastructure,’ apologies to former Ekiti State Governor, Ayo Fayose, and have no desire to leave lasting legacies.
Health is wealth and when health is lost, something is lost, goes an old cliché and so it is imperative for Nigeria to have a mental health act so that we would stop being the laughing stock among the comity of nations even in Africa as smaller countries like South Africa, Ghana and Uganda have long recognised mental health as an essential element of primary health care.

The time to act is now before we lose more lives, especially to suicide
• Tony Ademiluyi