Renamed the Lunacy Act of 1958, these laws have not been amended since.
Again, facing scant support, it has yet to become law. In the absence of a dedicated authority to assess compliance or support legislation, the effect of this policy on the quality of care and life for people living with mental health problems in Nigeria remains negligible.
With fewer than 300 psychiatrists for a population of more than 200 million, most of whom are based in urban areas, and in view of poor knowledge of mental disorders at the primary health-care level, caring for people with mental illness is typically left to family members.
A paucity of community-based and primary health-care services means that access to care is restricted to the most severe cases, usually in the form of psychiatric inpatient care or makeshift institutions. The result is a chronically and dangerously under-resourced mental health system catering to the needs of an estimated one in eight Nigerian people who suffer from mental illness,
poor awareness of the causes of mental health, widespread stigma and discrimination, poorly equipped services, and abuse of people with mental health problems. A reform of the mental health law that is in keeping with international standards is urgently needed to drive change.
aims for 50% of countries to have developed or updated their law in line with international and regional human rights instruments by 2020. In 2017, only 40% of WHO member states had updated their legislation in the previous 5 years (ie, since 2013).
Africa had the lowest rate at 21%, although this rate had doubled since 2014. On Feb 19, 2020, the Nigerian Senate held a public hearing for the Mental Health and Substance Abuse Bill. If passed, the Bill would allow for much needed budgetary allocations for mental health facilities and mental health providers.
Widespread consultation with key stakeholders, including the Association of Psychiatrists of Nigeria and community representatives, is currently in process. In strong support of this Bill, we further put forward several considerations.
and the African Charter on Human and Peoples’ Rights.
Third, we call for mental health services to be a covered mandate in the national health insurance scheme to ensure accessibility and affordability of care. Fourth, and in line with best practice, we urge additional support for outpatient, primary, and community care services for people with mental illness. Finally, and in view of the severe dearth of human resources for mental health, we call for the integration of mental health training, responses, and psychoeducation within primary care settings, as contained in the National Mental Health Service Delivery Policy of Nigeria. Legislation that works for all is important to help improve the health of the nation and to safeguard the care of all Nigerian people, today and for the future.