Mental Health is the state of well-being of an individual and the individual’s mental health impact on the Community. It is an interplay between an individual and the community. A negotiation based on the make-up of the individual and the conduciveness of the environment in the individual is found.

A transaction between nature and nurture. A conducive atmosphere is a prerequisite for an individual to thrive and attain potential. A level of resilience and coping methods are also desirable in an individual to navigate through the expected challenges (described as ‘normal’) and the goals set by him or her to be able to be productive and give back to the community.

The World Health Organization (WHO), affirms that Mental Health is attained when an individual can actualize his/ her potential, cope with normal stresses of life, work productively/fruitfully and contribute to the community (WHO).

From the foregoing, the four criteria prescribed would suggest that the individual has a role to play and the community, in which he/ she finds himself/ herself, also has responsibilities. For this mutual or symbiotic relationship to be effective, there are responsibilities implicit in it. The mental health of a society (just like the general health) is a major indicator of the prosperity of that nation.

The Mental Health of every individual is not in a static, unitary position. It is always in an oscillating motion, moving from one end with optimum level to another end with lower levels. This depends on the stresses and distress faced. Individuals may manifest some symptoms occasionally due to the distress but can bounce back following his/ her resilience and the right application of the developed coping methods.

If the distress persists and the individual is unable to cope further, he/ she may break down and develop mental health conditions. A lot of us are in the “distress position” and that is why we have one symptom or the other occasionally. Many visit some make-shift clinics repeatedly and are diagnosed with “malignant malaria”, “high-level typhoid” etc. Approximately 50% of all outpatient medical visits are related to somatic concerns, of which at least one-third to one-half are medically unexplained (Kroenke K, 2003).

Intrauterine environment, ante-natal/perinatal care, early childhood environment, availability of school health program, clean/conducive/health-promoting environment, available/affordable/accessible mental health care which is well-integrated into the Primary Health Care, employment opportunities and a community devoid of stigma/discrimination/non-inclusion among many other things are expected to be made available for an individual to be mentally healthy.

If an individual falls ill, the person should be able to access quality care at an affordable and accessible facility with minimal stress.

According to the Nigeria National Mental Health Survey, conducted about two decades ago in Nigeria, about 12% or one in eight Nigerians have had or were experiencing one form of mental health condition or the other; with Anxiety Disorders being the most common.

With the increasing incidences of violence like banditry, kidnapping, communal/ farmer-herder’s clashes; unemployment/underemployment; deteriorating health indices; prevailing and pervading poverty; poor budgetary allocation to health and education and stigma/discrimination, the figure must have doubled by now.

In recent times, the petroleum subsidy removal, deregulatory monetary policy and other policies have thrown many into a state of distress. Many have developed mental illnesses and many more are on the verge of decompensating.

Also, with the increasing number of migrating trained medical and mental health practitioners to foreign countries, the available personnel are very few, overstretched and underpaid.

The available Mental Health Practitioners including Psychiatrists are very few. As we speak, we have less than three hundred (<300) Psychiatrists sub-serving a population of over two hundred million (200M) Nigerians with more and more eager to leave the system (the “japa syndrome).

The “push and pull” theory described factors discouraging practitioners from staying and those factors attracting them to the countries seen as greener pastures respectively. It is also noteworthy to say that the few available mental health practitioners are largely located in the urban, metropolitan or city centres where mental health facilities are principally located.

What are the responsibilities or roles nature assigned to us to play to maintain our mental health?

As individuals, it is our responsibility to aspire to remain in good mental health by engaging in acts that promote mental health. Individuals need to:

• Imbibe good sleep hygiene
• Eat healthy
• Have realistic expectations
• Exercise the body and the mind
• Engage in leisure activities
• Be well-connected to society
• Avoid the use of psychoactive substances and
• Seek appropriate help early when ill.

Society should be primed to take care of the weak and the vulnerable. Our responsibility is to ensure that:

• Every individual should be his/her brother’s keeper and avoid stigmatisation or discrimination against the mentally ill.
• Full integration of mental health care into the Primary Health Care and making access to mental health care available, accessible and affordable to all especially those in the rural areas where more than 60% of the populace live.
• Increase budgetary allocation to health and by extension, mental health care.
• Provision of Psychosocial support to the populace by reducing the poverty rate.
• Implementation of policies that promote good mental health e.g. implementing the Mental Health Act 2021 as gazetted fully and urgently, 2023 Mental Health Policy, decriminalization of suicide etc.

Life cannot be lived in isolation.

We know that government cannot do it alone. Non-governmental organisations, Corporate organisations, Civil Society Organisations, philanthropists and all well-meaning Nigerians need to stand up to be counted.

Can we plough into the Mental Health Fund meant to be established under the Mental Health Act 2021?

Is it not possible to subsidise the cost of drugs for the mentally ill as it is being done for people with cancer?

Would it be out of place for some industries and organisations to endow wards at Teaching Hospitals as their corporate social responsibility to the community?

We all need to take a cue from the Intersect Consortium which is contributing her quota and impacting lives.

If we all play our role, the present poor state of things can be rectified.

Professor Taiwo James OBINDO M.B.Ch.B.(Ife); FWACP (Psychiatry) is a Professor of Psychiatry Honorary Consultant and the President, of the Association of Psychiatrists in Nigeria.

Advancing Mental Health in Nigeria:

In our commitment to pushing the boundaries for mental health in Nigeria, Intersect Consortium stands at the forefront.
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