In a Country where issues of mental health are not freely discussed and accepted without prejudice, persons with these challenges often face bias and stigma in an already challenging environment. Inequality in all strata of life and in most societies is staring us in the face, more so for those with mental health issues.
According to the World Health Organization (WHO) ‘mental health is a state of well-being in which every individual is able to realize his/her own potential, can cope with the normal stresses of life, work productively and make a contribution to his/her family and community’.
Mental health disorder is defined by psychiatric experts as a ‘clinically significant behavioral or psychological syndrome with sufficient personality, mind and/or emotional disorganization that seriously impairs individual and social function with an increased risk of suffering, death, pain, disability or loss of freedom’. Simply put, mental health is a dynamic state of internal equilibrium, which enables individuals to use their abilities in harmony with universal values of society. Basic cognitive and social skills; ability to recognize, express and modulate one’s own emotions, as well as empathize with others; flexibility and ability to cope with adverse life events and function in social roles; and harmonious relationship between body and mind represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium.
The inclusion of a harmonious relationship between body and mind is based on the concept that mind, brain, organism and environment are heavily interconnected, and the overall experience of being in the world cannot be separated from the way in which one’s body feels in its environment.
Disturbances of this interaction may result in psychotic experiences, eating disorders, self-harm, body dysmorphic disorder or poor physical health.The world is not an equal place. There exists a highly unequal distribution of incomes and assets within countries and between countries. While billions of people enjoy longevity and good health, more than one billion people live in abject poverty, struggling just to survive every day. This unequal distribution of income means millions of children run the risk of dying from easily treatable diseases, mental health problems inclusive. Each person’s experience is different with regards to human rights, opportunities, and quality of life. Some countries can boast of more resources and wealth than other countries, while some have a peaceful, stable government, and others don’t. Some countries are naturally safe (experiences less disasters) while some are dangerous. Some people are richer than other people. Some people have more social amenities like roads, hospitals, schools, while others don’t. Inequalities around the world can be linked to many causes.
MENTAL HEALTH AND DEVELOPING COUNTRIES.
Developing countries are facing the impact of mental health problems while confronted with limited resources and inequities in access to mental health care. There is a concerted effort by global health aid agencies to encourage and support national governments to move toward strengthening sustainable cost effective comprehensive integrated health care systems that includes full equity through universal coverage with strategies to strengthen the system through credible evidence and research.
The approach is experiencing varying degrees of success mainly due to a persistent lack of skilled human resources compounded by governance issues as most developing countries struggle with the extreme challenge of finding and retaining trained personnel for those health fields.
According to the psychiatric Times, some 450 million people worldwide currently suffer from some form of mental disease or brain condition, but almost half the countries in the world have no explicit mental health policy and nearly a third have no program for coping with the rising tide of brain-related disabilities. A statement by Gro Harlem Brundland, M.D., the former Director General of the World Health Organization (WHO) to corroborate these reports states that: mental health — neglected for far too long — is crucial to the overall well-being of individuals, societies and countries and must be universally regarded in a new light,” Former United Nations Secretary General, Kofi Annan added that “It is time for governments to make mental health a priority and to allocate the resources, develop the policies and implement the reforms needed to address this urgent problem. One in four people will suffer from mental illness at some time in life,”
The WHO (2000) also launched a worldwide effort called Project Atlas to catalogue mental health resources around the world. In its initial survey, the project found that, of the countries it surveyed:
41% have no mental health policy.
25% have no legislation on mental health.
28% have no separate budget for mental health.
41% do not have treatment facilities for severe mental disorders in primary health care.
37% have no community health care facilities.
About 65% of the beds for mental health care are in mental hospitals. Reports have shown that brain disorders are responsible for at least 27 percent of all years lived with disability in developing countries. When disability is taken into consideration along with death, brain disorders comprise nearly 15 percent of the burden of disease in developing countries. Furthermore, the stigma associated with many brain disorders, such as epilepsy, schizophrenia and mental retardation, prevents people in developing countries from seeking and receiving appropriate treatment. In addition, it may result in the loss of social and educational opportunities for both the sufferers and their families. Poverty can also be both a cause and a result of ill health and may contribute to brain disorders through poor nutrition, unhygienic living conditions and inadequate access to health care. According to reports, researches indicate that in many countries “poverty and several psychiatric disorders, such as depression, exacerbate each other.”
Mental Health problems in Nigeria Mental health professionals are few in Nigeria, as they are in many other developing nations. Nigeria being Africa’s most populous nation – a country of more than 200 million people – there are an estimated 150 practicing psychologists (25 Sept 2019).Taiwo Sheikh, president of the Association of Psychiatrists of Nigeria, revealed that the country only has 250 psychiatrists to serve a population of over 200 million people (29 Sept 2020)The prevalence of mental illness was 56.6%, which includes depression (20.8%), alcohol dependence (20.6%), substance dependence (20.1%), suicidality (19.8%) and antisocial personality disorder (18%). Depression is the most common illness that affects mental health. In a global survey, Nigeria ranked 15 in the number of suicides per year (1 Jul 2019). “Drug Abuse” is the most common cause of mental health disorder, and the rising drug use in Nigeria is alarming, with 14.3 million Nigerians aged between 15 and 64 years engaged in drug use. According to the report, instead of the expected 11 per cent increase in the global number of drug users by 2030, the projection is 40 per cent in Nigeria, and the whole of Africa.The Youth in Nigeria includes citizens of the Federal Republic of Nigeria aged 18–29 years according to the new youth policy (2019). However, the African youth charter recognizes youth as people between 15–35 years old. Nigeria is the sixth out of the 10 most populated countries in the world with 57 million young people after India (356 million), China (269 million), Indonesia (67 million), U.S.A (65 million), and Pakistan (59 million); while Youth Unemployment Rate in Nigeria increased to 53.40 percent in the fourth quarter of 2020 from 40.80 percent in the second quarter of 2020. ( National Bureau of Statistics, Nigeria.)
IMPACT OF COVID 19 ON MENTAL HEALTH IN DEVELOPING COUNTRIES.
Prior to the COVID-19 pandemic, there was a mental health crisis in many areas of the world. In 2017, Our World in Data reported that 970.81 million people had a mental health or substance use disorder. People living with mental health conditions have a 20-year reduction in life expectancy—two times greater than the estimated years lost from cigarette smoking. Despite the overwhelming global need for mental health services, up to 85% of individuals with mental health conditions in developing countries do not receive care due to lack of resources and investments. Unmet mental health needs bear a significant economic burden. The current pandemic presents an added burden to the existing mental health crisis due to complex and intersecting emotional challenges. “…mental health needs must be treated as a core element of our response to and recovery from the COVID-19 pandemic. A failure to take people’s emotional well-being seriously will lead to long-term social and economic costs to society.”–Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. Despite efforts to understand and address the mental health impact of COVID-19, the long-term mental health consequences are not known.
Current and longterm mental health consequences are accompanied by new challenges for mental health services. As COVID-19 continues to threaten the economic stability and health of developing countries, addressing mental health is essential. Prior work in underserved communities globally serves as a valuable blueprint for transforming the landscape of mental health to address preexisting challenges and consequences of the COVID-19 pandemic.