SIR: Yesterday October 10, was World Mental Health Day. The Nigerian Survey of Mental Health and Wellbeing conducted between 2001 and 2003 found that about 12 percent of adults in the population have had at least one episode of mental illness in their lifetime, while about six percent have had it over the last one year. These are relatively low rates, reflecting the considerably high level of stigma-induced denial in these climes (The World Health Organization estimates that one in every four persons will be affected by a mental disorder at some stage of his or her life).
Nevertheless the reported 12 percent rate corresponds to a whopping 20million Nigerians, and among those of them who had seriously disabling illness, only about eight percent had received treatment in the preceding year. Given that the majority of mental disorders (77% in the Nigerian survey) occur in mild forms, most cases go undetected for years. Millions are burdened by distressing anxiety, obsessions, mood disorders, paranoia and other internal difficulties, and they must devote considerable mental energy toward maintaining a semblance of normalcy while trying to cope with the pressures of everyday living.
In a society like ours, “keeping it all together” becomes a compelling distraction on which affected persons must expend precious innate reserves of resilience, which insidiously takes its toll in the form of declining work performance, strained inter-personal relationships and compromised physical health.
Eventually, one final misfortune like loss of a job, a divorce or maybe an armed robbery attack – all traumatic events from which most healthy people will get over–tips over an already crumbling psyche. Before they tear their clothes and run out naked into the streets, these troubled minds have expended great effort concealing internal distress. And unlike most physical illnesses for which a relatively brief period of medical or surgical treatment could restore the individual to normal functioning, mental illnesses tend to be chronic and run a protracted course that takes enormous toll on the emotional and socioeconomic well being of the both the sufferers and the family members caring for them. It’s a suffering that might have been prevented by timely recognition and intervention in the early stages of illness, instead we end up paying a costly price for denial and wilful ignorance.
The federal government espouses a noble vision of Nigeria becoming one of the 20 leading global economies by the year 2020. Whether such a lofty target is achieved or not, continued economic growth will eventually see us make the transition to at least a middle income country. WHO estimates suggest that depressive illness will become the leading cause of disease burden at the time, exceeding Malaria, HIV/AIDS and the like. Already, mental illness is responsible for the most years of healthy living lost due to disease and premature mortality in the developed world.
We must begin to face up to the reality of an increasing burden of mental illness in the populace. It tends to occur in varying shades and degrees, and already is far more prevalent than is immediately apparent. The milder forms though ubiquitous mostly go unrecognized, yet constitute fault-lines of the mind which compromise personal productivity and social harmony. Those moderately affected live and work amongst us all, perpetually labouring under a defect of reason. Alarmingly, a good number make it into political office and their distorted cognition is a mist that beclouds sane judgment. Call this deformation professionelle or what you will, but the jeopardized ability to love and to work is the elephant in the room whose inevitable growth may choke our forward march as a nation.
• Dr. Walter Nzeakah
Neuro Psychiatric Hospital Aro, Abeokuta
