‘Over 450 million people suffer mental illnesses globally, 14.9% of doctors diagnosed with mental disorders’

Baba Awoye Issa is a professor of Psychiatry and the pioneer Medical Director of the Federal Neuro-Psychiatric Hospital, Budo-Egba, Kwara State. In this interview with SIKIRAT SHEHU, he shares his experiences and insights on mental health disorders, their causes, and available treatments. Issa revealed that there is a high prevalence of mental and behavioral disorders globally, with over 450 million people suffering from mental illnesses. He also revealed that the prevalence of psychiatric morbidity among doctors stands at 14.9%, underscoring the need for urgent intervention. He emphasized that Nigeria requires a comprehensive and integrated approach that removes existing barriers, promotes mental health awareness, and strengthens access to care. Excerpts:

Can you tell us about your life journey so far?

I am from Ogbondoroko in Asa Local Government Area, of Kwara where I completed my primary education. I then attended Community Secondary School, Ballah, and Government Secondary School, Afon. I pursued my medical education at the University of Ilorin, followed by postgraduate qualifications from the West African College of Physicians and the National Postgraduate Medical College of Nigeria.

In 2005, I joined the University of Ilorin as a Lecturer Grade I and served as an Honorary Consultant Psychiatrist at the University of Ilorin Teaching Hospital. I became a professor of psychiatry in 2017.

In 2022, I was seconded to help establish the Federal Neuro-Psychiatric Hospital in Budo-Egba, becoming its first Medical Director in 2023. I am married with children.

What inspired you to specialize in psychiatry?

I was drawn to psychiatry by chance. Initially, I aspired to be a gynecologist and then an internist. However, the influence of a senior psychiatrist, Professor Abdullah Dasliva Yussuf, who is also the Chief Medical Director of a Federal Tertiary Hospital in Ilorin, led me to psychiatry.

This field is inspiring because it sits at the intersection of science, humanity, and storytelling. Unlike other medical specialties that focus on the body, psychiatry delves into the mind our thoughts, emotions, and behaviors. I wanted to understand what drives people, what challenges them, and what aids their healing.

Every patient brings a unique narrative, and being trusted to help rewrite those stories is both humbling and rewarding. Witnessing a person recover from their lowest mental health points and return to their daily life is one of the most fulfilling aspects of practicing psychiatry.

Psychiatrists often discuss how the field allows exploration of the complexities of human experience trauma, resilience, identity, and relationships. Some are inspired by personal experiences, others by an interest in neuroscience or psychology, and many are motivated by the urgent need to destigmatize mental illness and enhance access to care.

How has your journey in psychiatry shaped your perception of mental health?

My experience in psychiatry has significantly transformed my understanding of mental health as a dynamic and holistic spectrum, intricately connected to physical and social well-being, cultural influences, trauma, relationships, and resilience. It involves more than diagnosing disorders; it is about comprehensively understanding the human condition. Through patient interactions, I’ve realized that healing is non-linear and that empathy often surpasses expertise. Listening beyond words and recognizing vulnerability as a strength are crucial, as societal factors like stigma, inequality, and access impact mental health equally as biological factors do. Psychiatry has instilled a sense of humility in me, reminding me of the mind’s complexity and the need for compassion, curiosity, and care in addressing mental health. Nevertheless, psychiatry remains heavily stigmatized, and mental health is inadequately funded by governments.

What do you find most rewarding and most challenging about being a psychiatrist?

The greatest satisfaction in psychiatry comes from observing patients’ transformations. Watching them transition from hopelessness to optimism and from loneliness to engagement is profoundly gratifying. These changes are not always overt; they might be as simple as a change in self-perception or a moment of laughter in therapy. The opportunity to engage with someone’s innermost thoughts and aid in their path to self-empowerment is an honor. Additionally, the intellectual stimulation psychiatry offers, by integrating neuroscience, psychology, and philosophy, is unmatched in any other discipline.

Challenging is the fact that understanding that healing is a gradual process and that progress can be slow or setbacks may occur is challenging. The emotional burden of the work, such as dealing with trauma, crises, and risk management, can be exhausting. Additionally, systemic issues like limited resources, stigma, and unequal access to care present further challenges. There is a frequent desire to accomplish more, more quickly, and for a greater number of individuals.

How has psychiatry evolved over the past two decades?

Over the past 20 years, psychiatry has experienced significant changes due to scientific advancements, evolving societal views, and innovative treatment methods. New medications with fewer or tolerable side effects have been developed across various mental health disorders. The focus has shifted from custodial asylum care to community-based treatment, with an increased emphasis on psychotherapy and counseling over medication. Electroconvulsive therapy and neuromodulation techniques have become more effective. Advances in non-invasive diagnostic technologies like CT and MRI have been notable, alongside the widespread adoption of Electronic Medical Records in psychiatry. Anti-stigma campaigns have also gained momentum. Despite all these the rise in the use of synthetic and potent psychoactive substances remains a concern.

What misconceptions about psychiatry do you encounter most often?

These misconceptions are what we mostly referred to as myths about psychiatry. Some of the most common misconceptions about psychiatry include: The prevailing misconception that psychiatric care is reserved solely for individuals diagnosed with severe mental illnesses, such as schizophrenia or psychosis, warrants critical examination. In reality, psychiatry addresses a diverse array of mental health concerns, including but not limited to anxiety disorders, major depressive episodes, substance use disorders, sleep disturbances, chronic stress, and burnout.

These issues can affect individuals regardless of their background or life circumstances, underscoring the importance of a holistic understanding of mental health. As such, it is imperative to recognise that effective psychiatric care is not limited to acute conditions but is essential for the well-being of those grappling with a broad spectrum of psychological challenges. This paradigm shift in perception will foster greater acceptance and accessibility of mental health services, ultimately benefiting society at large.

The prevailing misconception that mental health disorders signify weakness or personal failure undermines the complex nature of these conditions. Such a viewpoint inaccurately frames individuals as lacking willpower, perpetuating stigma and creating barriers to seeking essential support and treatment. This narrative not only diminishes the serious impact of mental health issues but also exacerbates the challenges faced by those affected. A more informed perspective is necessary, one that recognizes mental health disorders as multifaceted and influenced by a range of genetic, environmental, and psychological factors. Promoting a culture of understanding and support is imperative in dismantling stigma, encouraging individuals to seek the help they need without fear of judgement.

The prevalent misconception that psychiatrists are solely focused on prescribing medication fails to acknowledge the comprehensive nature of psychiatric care. In reality, psychiatric treatment is characterised by a multidisciplinary approach that encompasses not only pharmacotherapy but also psychotherapy, counselling, and various holistic methods. This integrative framework is crucial, as it allows for the tailoring of interventions to address the unique and multifaceted needs of each patient. Such a personalised strategy enhances treatment efficacy and fosters better overall mental health outcomes. Thus, it is imperative to recognise the vital role that therapeutic modalities play alongside medication in the field of psychiatry.

Mental illnesses aren’t real illnesses: Some believe that mental health conditions are ‘made up’ or not as serious as physical illnesses. However, conditions like depression or anxiety are as real and impactful as diseases like diabetes or heart conditions, with biological, psychological, and environmental factors playing a role. In our own clime here, as in many developing countries, the etiology of mental disorders are still at the primitive stage attributing mental disorders to demons, Ginns, malevolence of other, etc. such beliefs make appropriate help seeking awkward enabling illnesses to go to chronicity thus rendering treatment ineffective.

Once you start psychiatric treatment, you’re on medication for life: There is a fear that psychiatric medications are lifelong commitments. While some conditions may require long-term medication, many people use them temporarily to stabilize and improve their mental health.

Talking to family or friends is enough: While social support is important, professional psychiatric care provides expertise and therapeutic strategies that go beyond casual conversations, especially for complex or severe conditions.

Psychiatric treatments are outdated or ineffective: Psychiatry has evolved significantly, with advances in medications, therapies, and brain research. Modern treatments are evidence-based and continue to improve patient outcomes.
Psychiatrists can read your mind: A frequent myth is that psychiatrists have an almost psychic ability to understand people’s thoughts instantly. Instead, psychiatrists rely on communication, observation, assessments, and diagnostic tools to understand a patient’s mental health needs.

Mental illness isn’t common, so it’s not a priority: Mental health conditions are far more prevalent than many realize. According to global statistics, one in four people will experience a mental health issue in their lifetime.
Mental health is separate from physical health: People often fail to understand that mental and physical health are deeply interconnected. Untreated mental health conditions can lead to physical illnesses and vice versa.
These myths/misconceptions can be addressed through education, advocacy, contact, openness and increased awareness towards reducing stigma and improving care.

In your opinion, what role does psychiatry play in bridging the gap between mental and physical health?

The World Health Organization (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Therefore, there’s no health without mental health. Psychiatry plays a pivotal role in dissolving the artificial boundary between mental and physical health. Here are some of the ways:
Psychiatry recognizes that health outcomes are influenced by an intricate interplay of biological, psychological, and social determinants. This comprehensive perspective is encapsulated in the Biopsychosocial Model, which advocates for a holistic approach to patient care. The emphasis on treating the whole person aligns with contemporary trends in personalized medicine and patient-centered care, emphasizing the importance of understanding each individual’s unique context and needs.

Psychiatric research has significantly advanced our understanding of the intricate relationship between mental states and physical health. Chronic stress, for instance, has been linked to various adverse health outcomes, including hypertension, immune system suppression, and metabolic disturbances. Conversely, the presence of physical illnesses such as diabetes or cancer can often precipitate psychological conditions like depression and anxiety. This dynamic interplay between mental and physical health is commonly referred to as Mind-Body Interactions, highlighting the importance of integrated approaches in medical and psychological treatment strategies.

Somatic Symptom Recognition in Psychiatric Practice. Psychiatrists possess specialized training to accurately identify instances where physical symptoms, such as fatigue, pain, or gastrointestinal disturbances, are primarily attributable to psychological factors. This expertise is crucial in preventing misdiagnosis, which can lead to inappropriate treatments or unnecessary medical procedures. By distinguishing between somatic symptoms of psychological origin and those stemming from physical health issues, mental health professionals ensure that patients receive appropriate and targeted care, thereby improving treatment outcomes and reducing healthcare costs. The ability to recognize somatic symptoms effectively also enhances interdisciplinary collaboration, facilitating comprehensive patient management that integrates both psychological and physical health considerations.

Treatment Synergy: Psychiatric medications, including antidepressants and antipsychotics, play a crucial role in enhancing overall health outcomes. These medications not only address mental health symptoms but also contribute to physical health improvements by mitigating behaviors that can exacerbate medical conditions. Such behaviors include inadequate sleep, substance misuse, and neglect of routine medical care. The integrated approach of combining psychiatric treatment with physical health management underscores the importance of a comprehensive healthcare strategy, ultimately leading to better patient outcomes and improved quality of life.

Collaborative Care in Modern Psychiatry. Contemporary psychiatric practice emphasizes a multidisciplinary approach, integrating collaboration with primary care providers, neurologists, endocrinologists, and other medical specialists. This integrated model aims to enhance patient outcomes through comprehensive management of complex cases. For instance, addressing depression in patients with cardiac conditions not only facilitates improved mental health but also contributes to better physical recovery and a reduction in mortality rates. Such collaborative strategies are essential in delivering holistic patient care, ensuring that treatment plans are tailored to the multifaceted needs of individuals with comorbid conditions.

Stigma Reduction in Mental Health: Recognising mental illness as a legitimate medical condition plays a crucial role in reducing societal stigma. Psychiatry’s efforts to validate mental health issues contribute to normalising the act of seeking professional help, akin to consulting a healthcare provider for physical ailments such as fractures or hypertension. This approach fosters an environment where individuals feel more comfortable pursuing treatment, thereby promoting early intervention and improved health outcomes. Emphasising the medical legitimacy of mental health conditions helps dismantle misconceptions and encourages a more compassionate and understanding societal attitude towards those affected.

In summary, psychiatry fundamentally challenges traditional distinctions by examining whether the conceptual gap between mental and physical health should persist. Recognising the profound interconnectedness of the mind and body, this discipline consistently emphasises an integrated approach to understanding human health, thereby fostering a more holistic perspective within medical practice.

What are some of the most pressing mental health challenges in Nigeria or globally today?

The mental health sector in Nigeria faces numerous challenges that hinder effective service delivery and support for individuals with mental health conditions. These challenges are multifaceted, involving workforce shortages, infrastructural deficiencies, societal attitudes, and policy implementation issues.
Nigeria has an alarmingly low number of mental health practitioners, with fewer than 150 psychiatrists serving a population of over 200 million.

This scarcity results in limited access to specialized mental health care, especially in rural and underserved areas. The shortage is compounded by the uneven distribution of professionals, with most concentrated in urban centers, leaving rural populations with minimal or no access to mental health services.
The treatment gap in Nigeria is significant, with less than 10% of individuals suffering from mental health conditions receiving adequate care. This gap is attributed to factors such as limited healthcare infrastructure, lack of awareness, and cultural stigmatization. Many individuals do not seek help due to fear of discrimination or lack of knowledge about mental health issues, leading to untreated conditions that can worsen over time.

Stigma surrounding mental illness remains a major obstacle to care. In Nigerian society, mental health issues are often misunderstood, and individuals with such conditions are frequently labeled as “mad” or weak. This societal perception discourages affected individuals from seeking help and hampers community-based support systems. Cultural beliefs and traditional practices also influence how mental health is perceived and managed, sometimes leading to reliance on spiritual or traditional healers instead of medical professionals.

The infrastructure for mental health care in Nigeria is inadequate. There are few neuropsychiatric hospitals, and mental health services are poorly integrated into primary healthcare systems. This lack of infrastructure limits the capacity to provide comprehensive care, especially in rural areas where healthcare facilities are already scarce. Improving infrastructure and integrating mental health services into primary care are essential steps toward addressing these gaps.

Many trained mental health professionals leave Nigeria in search of better opportunities abroad, a phenomenon known as brain drain or in recent time-Japa. This migration exacerbates the shortage of qualified personnel and hampers efforts to develop sustainable mental health services. Retaining professionals and creating incentives for them to work within Nigeria are critical for strengthening the sector.

Despite the above, research on mental health in Nigeria is limited and fragmented, making it difficult to develop evidence-based policies. Although the National Mental Health Act of 2021 was enacted to improve mental health services, its implementation is still in the early stages. Effective policy execution, increased research funding, and data collection are necessary to inform strategies and improve mental health outcomes across the country.

Globally, there is a high prevalence of mental and behavioural disorders, with over 450 million people worldwide suffering from mental illnesses. Anxiety and depression are the most common, affecting nearly 1 in 8 people. Substance use disorders have remained a global challenge of utmost significance.

Recently, you disclosed that 14.9% doctors had diagnosable mental disorder, this is worrisome and how will you react to this?

Analysis of the Study on Mental Health of Doctors in Nigeria (Issa et al, 2014): The referenced research, published in the Pan African Medical Journal in 2014, provides significant insights into the mental health challenges faced by doctors working in tertiary hospitals in Nigeria.

The study highlights a point prevalence of psychiatric morbidity among doctors at 14.9%, assessed using the General Health Questionnaire-12 (GHQ-12). This indicates that nearly one in seven doctors experienced mental health issues at that time. The study identified key factors associated with psychiatric morbidity, including non-participation in social activities and perceiving workload as “heavy.” These factors suggest that social isolation and perceived work stress are critical contributors to mental health problems among medical professionals.

Furthermore, the study emphasizes that the prevalence of psychiatric morbidity among doctors was higher than that observed in the general population, underscoring the unique stressors faced by healthcare workers. The authors advocate for measures to mitigate these issues, such as providing recreational facilities within hospitals and encouraging doctors to participate in social activities, aiming to improve their mental well-being.

Progress and Challenges Since 2014. Over the past eleven years, the situation has reportedly worsened. The number of doctors in Nigerian hospitals has decreased, leading to increased workload and burnout among remaining staff. This decline in medical personnel exacerbates stress levels and negatively impacts mental health. Additionally, economic factors play a role; wages that were relatively better in 2014 have since declined when adjusted for international currencies, further contributing to financial stress and job dissatisfaction among doctors.

The cumulative effect of these factors reduced workforce, increased workload, and diminished wages has likely intensified mental health issues among healthcare professionals. The situation underscores the urgent need for systemic interventions to address these challenges.

Government and Stakeholder Interventions. In response to these ongoing issues, the Nigerian government, led by the Ministers of Health and Social Welfare, have initiated efforts to improve conditions for health workers. These initiatives include ensuring that healthcare workers receive their due compensation and increasing manpower training programs to address the shortage of medical personnel. Such measures aim to reduce workload, improve job satisfaction, and ultimately enhance the mental health of doctors.

While these efforts are steps in the right direction, sustained and comprehensive strategies are necessary to effectively address the complex factors affecting doctors’ mental health. This includes not only workforce expansion and economic improvements but also ongoing support systems, mental health services, and workplace reforms to foster a healthier working environment for medical professionals in Nigeria.

How do cultural beliefs and stigma affect the acceptance of psychiatric treatment?

Understanding the influence of cultural beliefs and stigma on the acceptance of psychiatric treatment is essential for developing effective mental health interventions and promoting patient engagement. Cultural beliefs encompass the shared values, norms, and perceptions within a community that shape individuals’ understanding of mental health and illness. These beliefs can significantly impact how individuals perceive psychiatric conditions, their causes, and appropriate responses.

In many cultures, mental health issues are often associated with spiritual or supernatural causes, such as possession, curses, or divine punishment. Such perceptions may lead individuals to seek help from traditional healers, religious figures, or spiritual practices rather than medical professionals. Consequently, this can delay or prevent access to evidence-based psychiatric treatment, potentially worsening the condition.

Stigma related to mental health is another critical barrier. It involves negative stereotypes, discrimination, and social exclusion directed toward individuals with psychiatric conditions. Stigma can be internalized, leading to feelings of shame and low self-esteem, which discourage individuals from seeking help. External stigma from family, peers, or the community can also result in social isolation and reluctance to pursue treatment due to fear of judgment or rejection.

The combined effect of cultural beliefs and stigma often results in a reluctance to acknowledge mental health issues openly. Patients may prefer to conceal their symptoms or avoid treatment altogether, fearing social repercussions. This avoidance can lead to untreated mental illnesses, increased severity of symptoms, and a higher risk of comorbidities.

Addressing these barriers requires culturally sensitive approaches that respect local beliefs while providing accurate information about mental health. Community education programs, involving local leaders and traditional healers, can help bridge the gap between cultural perceptions and medical treatment. Anti-stigma campaigns are also vital in changing negative attitudes and promoting acceptance. Healthcare providers should be trained to understand cultural contexts and communicate effectively with diverse populations to improve treatment acceptance and adherence.

In conclusion, cultural beliefs and stigma play a significant role in shaping attitudes toward psychiatric treatment. Overcoming these barriers involves a multifaceted approach that combines education, community engagement, and culturally competent care to enhance acceptance and improve mental health outcomes across different populations.

Could you explain the balance between psychotherapy and medication in patient care?

The balance between psychotherapy and medication in patient care is a critical aspect of mental health treatment, often requiring a nuanced approach tailored to individual needs. Both modalities have their unique strengths and limitations, and their effective integration can significantly enhance treatment outcomes.

Psychotherapy, also known as talk therapy, involves structured sessions with a mental health professional aimed at addressing emotional, behavioral, and psychological issues. Common forms include cognitive-behavioral therapy (CBT), psychodynamic therapy, and humanistic approaches. Psychotherapy helps patients develop coping skills, gain insight into their behaviors, and modify maladaptive thought patterns. It is particularly effective for conditions such as depression, anxiety disorders, post-traumatic stress disorder (PTSD), and personality disorders.

Medication, on the other hand, involves the use of pharmacological agents to manage symptoms. Psychotropic drugs such as antidepressants, antipsychotics, mood stabilizers, and anxiolytics can provide rapid symptom relief and stabilize mood or thought processes. Medication is often essential in severe cases, such as major depressive disorder or schizophrenia, where symptoms can be debilitating and require immediate intervention.

The balance between psychotherapy and medication is a dynamic and individualised decision. An integrated approach often yields the best outcomes, combining the immediate relief provided by medication with the enduring benefits of psychotherapy.

What recent research breakthroughs in psychiatry excite you the most?

Recent advancements in psychiatry have significantly expanded our understanding of mental health disorders and opened new avenues for treatment. Among these breakthroughs, several stand out due to their potential to transform clinical practice and improve patient outcomes.
Genetic and Neurobiological Insights
Innovations in Pharmacotherapy
Biomarkers and Early Detection
Neuroimaging
These recent research breakthroughs in psychiatry are exciting because they move us closer to personalized, effective, and accessible mental health care. As our understanding of the biological and psychological aspects of mental disorders deepens, the potential for innovative treatments and improved patient quality of life continues to grow.

What advice would you give to medical students considering a career in psychiatry?

Choosing a career in psychiatry is a significant decision for medical students, as it involves a commitment to understanding complex human behaviors, mental health disorders, and the intricacies of the mind. For students contemplating this specialty, several pieces of advice can help guide their decision-making process and prepare them for a successful career in psychiatry. A career in psychiatry can be highly rewarding for those interested in mental health, human behavior, and holistic patient care. It requires a combination of intellectual curiosity, emotional resilience, and a compassionate approach. By gaining relevant experience, developing essential skills, and seeking mentorship, medical students can make an informed decision about pursuing psychiatry as a specialty and prepare themselves for a fulfilling career dedicated to improving mental health and well-being.

How can universities better prepare students for the realities of mental health care?

Universities play a crucial role in shaping students’ understanding and preparedness for the realities of mental health care. As mental health issues among young adults continue to rise, educational institutions must adopt comprehensive strategies to equip students with the necessary knowledge, skills, and resources.

Integrating Mental Health Education into Curriculum: One of the foundational steps is embedding mental health education into the academic curriculum across disciplines. Courses on psychology, health sciences, and social work can provide students with a solid understanding of mental health disorders, treatment options, and the importance of destigmatization. Additionally, incorporating modules on self-care, resilience, and stress management can empower students to maintain their mental well-being and recognize early signs of mental health issues in themselves and others.

For example, the university of Ilorin, Nigeria has one of the best curriculum for psychiatry and behavioral sciences. Students are introduced to it early as part of the Integrated Paper through 200 level and 300 level taught with other basic sciences like medical microbiology, pharmacology, community health, etc.

Beyond theoretical knowledge, universities should offer practical training sessions and workshops. These can include role-playing scenarios, crisis intervention techniques, and peer support training. Such activities help students develop empathy, communication skills, and confidence in addressing mental health concerns, whether in professional settings or personal life.

Accessible mental health services are vital. Universities should ensure that counseling centers are well-staffed, approachable, and equipped to handle diverse issues. Promoting awareness about available resources through orientation programs, digital platforms, and peer networks encourages students to seek help when needed. Confidentiality and cultural sensitivity should be prioritized to foster trust and inclusivity.

Creating a campus culture that prioritizes mental health involves training faculty and staff to recognize signs of distress and respond appropriately. Peer support programs, mental health ambassadors, and student-led initiatives can cultivate a community where open dialogue about mental health is normalized. Reducing stigma and promoting acceptance are essential for encouraging students to seek help without fear of judgment.

Partnerships with external mental health organisations can expand the scope of support and resources available to students. Universities can facilitate internships, workshops, and awareness campaigns in collaboration with these organisations, providing students with real-world insights into mental health care and advocacy.

Therefore, by integrating mental health education into curricula, offering practical training, ensuring accessible resources, fostering a supportive environment, and collaborating with external organizations, universities can significantly enhance students’ preparedness for the realities of mental health care. These initiatives not only benefit individual students but also contribute to the development of a more understanding and resilient campus community, ultimately promoting overall well-being and academic success.

What skills do you think every young psychiatrist must develop to succeed in the field?

In the rapidly evolving field of psychiatry, young professionals must cultivate a diverse set of skills to ensure success and provide effective patient care. These skills encompass clinical expertise, communication, emotional intelligence, and adaptability, among others. Below is a detailed overview of essential skills for aspiring psychiatrists. The success of young psychiatrists depends on their ability to develop a comprehensive skill set that combines clinical expertise, interpersonal abilities, emotional intelligence, and a commitment to lifelong learning.

Cultivating these skills will enable them to adapt to the dynamic nature of mental health care and provide the highest quality of patient-centered treatment.

How do you see technology e.g., AI, shaping the future of psychiatry?

Looking ahead, the synergy between technology and psychiatry is expected to foster a more proactive, accessible, and effective mental health care system. As AI continues to evolve, it will likely facilitate early intervention, reduce stigma by normalising mental health discussions, and support clinicians in making data-driven decisions.
Collaboration among technologists, clinicians, and policymakers will be crucial to harness the full potential of AI while safeguarding ethical standards and ensuring equitable access for all individuals seeking mental health support.

What policies or reforms would you recommend to improve access to psychiatric care?

Improving access to psychiatric care in Nigeria requires a comprehensive approach that addresses existing barriers and promotes mental health awareness. The following policies and reforms are recommended to enhance psychiatric care access across the country:

Strengthening Mental Health Legislation: Developing and implementing robust mental health laws that protect the rights of individuals with mental health conditions is essential. Such legislation should focus on ensuring equitable access to care, safeguarding against discrimination, and establishing standards for mental health services.

The Mental Health Act 2021, a act of the parliament and a Nigerian law has not been implemented since its enactment. The major recommendation of the Act that would make other components functional is the establishment of the Department of Mental Health in the Federal Ministry of Health and Social Welfare. That has not been established since then.

Increasing Funding and Resources: Allocating more government funding towards mental health services is crucial. This includes investing in infrastructure, training healthcare professionals, and providing essential medications. Adequate funding can facilitate the expansion of psychiatric facilities, especially in underserved rural areas.

Expanding Mental Health Workforce: Training and deploying more mental health specialists, including psychiatrists, psychologists, psychiatric nurses, and social workers, is vital. Incorporating mental health training into general medical education can also improve early detection and referral processes.

Integrating Mental Health into Primary Healthcare: Embedding mental health services within primary healthcare settings can improve accessibility, especially in remote regions. This integration allows for early diagnosis, treatment, and referral, reducing the stigma associated with specialized psychiatric facilities.

Public Awareness and Education Campaigns: Launching nationwide awareness campaigns can help reduce stigma and misconceptions about mental health. Educating the public about the importance of mental health and available services encourages individuals to seek help without fear of discrimination.

Community-Based Mental Health Programs: Developing community-based mental health programs ensures culturally sensitive care and supports social reintegration. These programs can include outreach services, support groups, and rehabilitation initiatives tailored to local needs.

Leveraging Technology: Utilizing telepsychiatry and digital health platforms can bridge the gap in mental health service delivery, especially in rural and underserved areas. Technology can facilitate remote consultations, follow-ups, and mental health education.

Establishing Partnerships and International Collaboration: Collaborating with international organizations and NGOs can provide technical assistance, funding, and best practices to improve mental health infrastructure and services in Nigeria.

The multi-faceted strategy involving legislative reform, resource allocation, workforce development, community engagement, and technological innovation is essential to improve access to psychiatric care in Nigeria. These reforms can contribute to a more inclusive, effective, and sustainable mental health system that meets the needs of the population.

In your view, what will be the biggest thing in mental health issues of the next generation?

In considering the future landscape of mental health issues among the next generation, several key factors are likely to shape the predominant challenges. As society continues to evolve rapidly, driven by technological advancements, social changes, and environmental pressures, the mental health landscape will inevitably reflect these transformations.

Technological Impact and Digital Dependency: One of the most significant influences on future mental health issues will be the pervasive role of technology. The increasing integration of digital devices, social media, and virtual environments into daily life has already begun to affect mental well-being. Future generations may face heightened risks of anxiety, depression, and social isolation due to excessive screen time, cyberbullying, and the pressure to maintain curated online personas. The phenomenon of digital dependency could lead to difficulties in establishing real-world social connections and managing emotional health effectively.

Social and Environmental Stressors: Next-generation individuals are likely to encounter intensified social and environmental stressors. Climate change, economic instability, and geopolitical conflicts are expected to contribute to a sense of uncertainty and insecurity. These stressors can exacerbate feelings of helplessness, anxiety, and trauma, especially among youth who are more vulnerable to environmental and societal upheavals. The ongoing climate crisis, in particular, may lead to eco-anxiety, a condition characterized by chronic fear about environmental doom.

Changing Societal Norms and Mental Health Awareness: On a positive note, increased awareness and destigmatization of mental health issues are expected to promote early intervention and support. Future generations may be more open to discussing mental health openly, seeking help without fear of judgment. However, the challenge will be ensuring equitable access to mental health resources across different socio-economic and cultural groups, preventing disparities in care.

Emerging mental health challenges may include new forms of anxiety related to technological dependence, identity, and privacy concerns. The rise of artificial intelligence and virtual realities could introduce novel psychological challenges, such as identity fragmentation or detachment from reality. Additionally, the pressure to succeed in a highly competitive digital economy may contribute to burnout and chronic stress among young people.

Overall, the most significant mental health issue for the next generation will likely be a complex interplay of technological, environmental, and societal factors. Addressing these challenges will require innovative approaches in mental health care, policy development, and community support systems to foster resilience and well-being in an increasingly interconnected world.