The Federal Government has been urged to immediately implement the National Mental Health Act to address Nigeria’s widening mental healthcare gap and improve access to treatment for millions of people living with mental health conditions.
A Professor of Psychiatry at Ahmadu Bello University, Zaria, Prof. Taiwo Latif Sheikh, made the call during a Mental Health Leadership and Advocacy Programme (mhLAP) public lecture titled “Addressing Mental Health Systems Gap Through Policy and Legislation Reform.”
Sheikh warned that despite the enactment of the National Mental Health Act in December 2022, implementation has stalled because the government has yet to establish the Department of Mental Health in the Federal Ministry of Health, one of the law’s key provisions.
“We are calling on the Federal Government to implement the National Mental Health Act. The first objective of the law is the establishment of a Department of Mental Health in the Federal Ministry of Health, but that has not been done,” he said.
“Government officials swore an oath to uphold the laws of Nigeria. This law was passed by the National Assembly and signed by the President, yet it is not being implemented. We want the media to remind the government of its responsibility,” he added.
Addressing participants from several African countries, Sheikh described mental health as one of the world’s most neglected areas of healthcare, particularly in Africa, where investment in mental health services remains grossly inadequate despite the growing burden of mental disorders.
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He said between 85 and 90 per cent of Africans living with severe mental health conditions are unable to access treatment within a 12-month period.
“Only about five to 15 per cent of people who need mental healthcare can access it. That is a huge treatment gap that governments must urgently address,” he said.
According to the psychiatrist, most African countries channel their limited mental health resources into maintaining stand-alone psychiatric hospitals rather than strengthening community-based services. Much of the funding, he noted, goes towards salaries, utilities and administrative costs, leaving little support for patients and their families.
Sheikh argued that mental health should no longer be viewed solely as a health sector issue, noting that it also involves education, housing, finance, justice, agriculture, labour and social welfare.
“Mental health systems are not just about hospitals. They involve policies, legislation, financing, service delivery, human resources, research and access to medicines. More than 70 per cent of the social determinants of mental health lie outside the health sector,” he said.
He identified legislation, financing, service delivery, trained personnel, information systems and essential medicines as the six building blocks of an effective mental health system, warning that weakness in any of them would undermine service delivery.
The professor advocated integrating mental healthcare into primary healthcare and general hospitals instead of concentrating services in specialist psychiatric institutions, stating that integration would reduce stigma, improve access and bring care closer to communities.
With Nigeria having only about 300 psychiatrists serving a population of more than 200 million, Sheikh called for greater use of trained non-specialist health workers to provide basic mental healthcare under specialist supervision.
He also recommended training traditional and faith-based healers to recognise mental illnesses, respect patients’ rights and promptly refer complicated cases.
Sheikh described mental health as the foundation of a nation’s social capital, saying people with good mental health are better able to cope with daily stress, remain productive and contribute meaningfully to national development.
He urged African governments to prioritise community-based mental healthcare, strengthen legal protections for people living with mental health conditions, and adopt rights-based approaches that promote dignity, inclusion and recovery.
Also speaking, Emeritus Professor of Psychiatry at the University of Ibadan and Director of the WHO Collaborating Centre, Ibadan, Prof. Oye Gureje, said strong leadership and sustained advocacy are essential to addressing Nigeria’s mental healthcare challenges and driving reforms across Africa.
He explained that the Mental Health Leadership and Advocacy Programme, now in its 13th edition, was established to build leaders capable of influencing policy, mobilising stakeholders and championing improvements in mental health systems.
Gureje noted that there is now global recognition that “there is no health without mental health”, stressing that mental disorders remain common, underdiagnosed and inadequately treated despite their profound impact on individuals, families and national productivity.
He attributed the wide treatment gap to inadequate funding, weak political will and poor implementation of policies, arguing that trained leaders and advocates are needed to keep mental health on the policy agenda, raise public awareness and press governments to prioritise quality mental healthcare.
Head of the Division of Disease Control and Prevention at the Africa Centres for Disease Control and Prevention (Africa CDC), Dr Mohammed Abdulaziz, also stressed that strengthening leadership, reforming outdated mental health laws and adopting a public health approach are critical to closing Africa’s widening mental healthcare gap.
Abdulaziz said the Africa CDC Mental Health Leadership Programme was established to produce leaders capable of driving policy reforms and strengthening mental health systems across the continent.
He noted that the programme is built on four pillars: the Kofi Annan Fellowship, the Field Epidemiology Training Programme (FETP), short leadership and advocacy courses, and support for civil society organisations and people with lived experience of mental health conditions.
He added that the Africa CDC is supporting countries such as The Gambia and Sierra Leone in modernising their mental health laws while encouraging others to adopt rights-based legislation.
He urged African governments to replace archaic laws that stigmatise people living with mental health conditions, strengthen surveillance and research to generate evidence for policymaking, and adopt a whole-of-government and whole-of-society approach to mental health.
“We cannot continue to say mental health is underfunded without making deliberate efforts to change the narrative,” Abdulaziz said, reaffirming the Africa CDC’s commitment to supporting mental health reforms across the continent.
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