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Tag: mental

  • Dealing with mental, economic depression

    Dealing with mental, economic depression

    Mental stress, often regarded as a silent global epidemic has negatively impacted the well-being of many individuals. While it may not be as visible as physical ailments, the consequences of unmanaged mental stress can be devastating, reports AMBROSE NNAJI

    Mental stress is fast becoming a worrisome global health issue that should not be ignored. Whether it’s as a result of the demands of work, family responsibilities, financial pressures or the constant stream of information and expectations, many find themselves wrestling with the burden of mental stress. While stress is a natural response to challenges, chronic and unmanaged stress can have severe consequences for people’s mental and physical well-being. Mental stress, simply referred to as “stress,” is the body’s response to a perceived threat or demand. Medical experts say it’s a natural survival mechanism that triggers the release of stress hormones such as cortisol and adrenaline, preparing the body for a “fight or flight” response. They stated that while this response is crucial in life-threatening situations, however, chronic activation of the stress response can be harmful.

     They clarified that cortisol, a steroid hormone, is manufactured by the adrenal glands atop each kidney. During periods of stress, cortisol levels surge in the bloodstream. Maintaining an optimal cortisol balance is crucial for overall health, as an excess or deficiency of this hormone can lead to various health issues.

     In contrast, adrenaline, another hormone, aids rapid reactions in moments of excitement, stress or danger. This response is commonly referred to as the ‘fight-or-flight’ reaction.

     They also observe that Nigeria’s current economic and security situations are increasingly impacting the mental well-being of many. They warn that without prompt and appropriate measures to improve the situation, it may lead to a widespread mental breakdown.

     According to authorities, chronic stress can worsen pre-existing health problems and may increase the use of alcohol, tobacco and other substances. Stress, according to them, tends to be widespread during events such as major economic crises which the country is currently undergoing, disease outbreaks, natural disasters; war and community violence.

     A surgeon at the Lagos University Teaching Hospital (LUTH) Dr Chukwuemeka Ogbonna Nwogu emphasised that mental stress is a fundamental factor contributing to various stress-related illnesses such as high blood pressure, psychiatric disorders, depression, diabetes and more.

     Highlighting the psychological impact of mental stress on human health, and underscoring its significance during challenging times, Dr Nwogu said mental stress also has repercussions during significant life stages such as menopause, pregnancy and similar phases.

     He, therefore, advised that individuals should maintain a relaxed approach and avoid overburdening their mental faculties. He recommended not dwelling excessively on aspects beyond one’s control. He cited examples such as the unchangeable cost of goods in Nigeria without good governance and the inability to rectify societal practices without effective governance.

     The medical practitioner urged people to understand that certain things are beyond their control, encouraging them not to dwell on those matters and avoid subjecting themselves to unnecessary stress.

     Regarding the impact of mental stress on health, Dr Nwogu shared an incident from a recent blood transfusion, where individuals with previously normal blood pressure now experienced elevated levels due to heightened mental stress. He emphasised that widespread mental stress, combined with inadequate nutrition, is a breeding ground for various diseases.

     Emphasising the healing power of love during some challenging times, Dr Nwogu stated that love is important in individuals’ lives; re-echoing Christ’s teachings to love others as you love yourself.  He emphasised the need to express love, especially during trying times when the circumstances are exceedingly challenging.

    Read Also: Time to focus on mental health

     The surgeon, who also noted that excessive consumption of preservatives is a significant contributor to deteriorating health, emphasised the necessity for individuals to recognise the importance of reducing or avoiding the intake of foods preserved in various forms as a means of promoting a longer and healthier life. He highlighted preservatives as predisposing factors for various health issues such as cancer, diabetes, hypertension and other uncommon ailments that are now prevalent in society.

    Dr Nwogu argued that many of the frozen foods consumed could potentially be preserved using formalin due to their questionable sourcing, often involving unsanitary smuggling practices. He said formalin, being dissolved in water, is utilised as an industrial disinfectant and a preservative in funeral homes, medical laboratories, certain foods and various products such as antiseptics, medications and cosmetics.

     He encouraged the consumption of fruits and vegetables to counteract the effects of preservatives. However, he cautioned that some extremely hazardous preservatives might not be effectively neutralised by the natural organic agents found in these foods. Underscoring the importance of health, he urged individuals to prioritise their well-being for a prosperous future.

     Dr Nwogu urged individuals to minimise the intake of preservatives, which he said are commonly present in canned and packaged foods such as tomatoes, Maggi, frozen chicken, fish, semovita, and wheat. He recommended making an option for natural, preservative-free foods such as gari, fufu and unripe plantains.

     Also, Dr Edison Chukwudi Okorie, MD, JP acknowledged there is a recent surge in illness among people, a situation he attributed to the economic state of the country. He opined that this increase in illnesses may be attributed to inadequate treatment or under-treatment, resulting in conditions that become resistant to medication, which can ultimately be linked to poverty.

     Furthermore, Dr. Okorie underscored the fact that some individuals resort to using traditional remedies that could potentially harm their kidneys or liver.

     He added: “In general, people are experiencing heightened levels of stress. Concerns about their livelihoods, insecurity, insurgency, and various other worries have made many individuals irritable, leading to the displacement of their stress onto others. This collective stress is causing a great nuisance to their mental and physical health, with many developing stress-related ulcers, leading to epigastric pain and alterations in their eating habits.”

     According to Dr. Okorie, the ongoing situation can lead to high blood pressure, which can have far-reaching effects on various body systems. It also increases the risk of experiencing the “three attacks man,” which includes a stroke, heart attack and pulmonary embolism.

    The medic said happiness is a choice, even in the face of hardship. He noted that stress levels vary among individuals, as stress is based on how one interprets their circumstances. He encouraged people to embrace happiness and advised them to undergo regular check-ups, engage in regular exercise and practice forgiveness. Furthermore, he stressed the importance of learning how to control physiological and emotional responses to stress, as well as adapting to or ignoring situations that cannot be changed, to move forward in life.

     A Psychologist at the University of Lagos and the Head of the Department of Guidance and Counseling in the Faculty of Education, Professor Ngozi Osarere affirmed the initiative taken by the Catholic Men Organisation to educate their members on achieving a stress-free life and maintaining good mental health.

     Osarere, who spoke on “Management of Stress and Attitude”, held that attitude has a lot to do in the management of stress. She said it is important to adopt a positive mindset and alter one’s attitude to alleviate stress.

     Highlighting the foundational role of women in family and society, Prof. Osarere acknowledged the tendency for some men to lose sight of their spouse’s contributions as they progress in life. She noted that both partners have significant roles to play in sustaining a marriage, even as she urged men to recognise and appreciate the sacrifices their spouses make.

     While expressing her aversion to divorce, Prof. Osarere acknowledged that in extreme cases where staying together poses a threat to the life of either of the spouses, separation might be the best option. She maintained that taking care of one’s well-being is essential. If a marriage becomes a hindrance to personal health and safety, it is crucial to prioritise one’s journey of life.

    The challenging economic circumstances and persecution in the land have also incited concern within the Church. The Catholic Church of Isolo Deanery in the Lagos Archdiocese, exercising wisdom, deemed it necessary to arrange a programme for its members and communities on how to navigate this difficult situation.

     Spearheaded by the Catholic Men Organisation (CMO), the programme focused on managing the situation without risking a complete breakdown. The programme was organised in conjunction with the Christian Women Organisation (CWO).

    Reverend Father Patrick Osuntoyinbo, the Chaplain of Isolo Deanery of the CMO acknowledged that many people are enduring exceedingly tough times due to Nigeria’s economic turmoil. This plight is exacerbated by soaring fuel prices and a high exchange rate, causing food prices to skyrocket beyond the means of the average individual.

    Fr. Osuntoyinbo expressed concern that men are particularly burdened by these harsh circumstances, given the responsibilities entrusted to them to care for their families. He also noted that many individuals are grappling with mental stress due to the hostile situation.

     He stated that the Church initiated the programme as a means to guide its members and communities on facing the harsh realities of this period, aiming to prevent mental breakdowns. Fr. Osuntoyinbo emphasised that while certain circumstances are beyond one’s control and cannot be altered, one can control their reactions, approach, and responses to these situations.

     On the grim circumstances in the country, he said: “This is our way of addressing the situation in the country: there are certain things you cannot change, but you can change your reaction, your approach, and how you react to those circumstances. If they are circumstances beyond your control, you cannot change them, but you can change your attitude and how you respond to the situation.”

     Preaching a message of hope, Fr. Osuntoyinbo said: “If we despair now, we won’t be alive to witness when things will improve. So, we need to be mentally and psychologically strong, so that physically we can be resilient and navigate the challenging circumstances we are experiencing at the moment.”

     The President of the Christian Women Organisation (CWO) at Holy Rosary Catholic Church in Arida, Lagos State, Mrs Eze Grace shared her insights into the training session, describing it as impactful.

     Mrs Grace stated that several health assessments, including blood pressure (BP) and sugar level checks, were conducted after consulting with a medical doctor to explain individual health conditions and statuses.

     Reflecting on the training, Grace expressed gratitude to the health workers and pharmaceutical companies that participated. She highlighted their contributions, not only in providing medications but also in educating attendees about their usage and effectiveness in managing health conditions.

     She expressed her satisfaction with the training, saying the practical advice provided on managing stress and maintaining a positive attitude in dealing with life’s challenges is praiseworthy.

  • Don’t discriminate against people with mental illness, say psychiatrists

    Nigerians and reporters have been advised not to discriminate against people suffering from mental illness.

    They spoke at a workshop for reporters and members of the Suicide Research and Prevention Initiative (SURPIN) of Lagos University Teaching Hospital (LUTH), Idi Araba.

    They said the workshop was aimed at reducing the rising rate of suicide across the country.

    The experts, which included Dr Babatunde Fadipe, Dr Bola Ola, Dr Peters Nubi, Dr Raphael E. Ogbolu and Dr Oladipo A. Adepoju, Dr Alero and Miss Titi Tade of LUTH’s Socia Welfare Unit praised LUTH’s SURPIN, saying it is the first of its kind.

    Stigma, the experts said, makes sufferers of mental illness to be maltreated by friends, relatives, neighbours and employers.

    It has aggravated their rejection, loneliness and depression among those with the illness, they said. They also said those with the condition are often denied participation in family life, normal social networks and productive employment.

    According to the psychiatrists, stigma can be defined as a mark of shame, disgrace or disapproval, which results in an individual being shunned or rejected by others.

    The stigma associated with mental illness is strong, but increases more if an individual’s behaviour differs from that of the ‘norm’, they added.

    Stigma, especially the one associated with mental illness, they said, has a negative effect on any mentally ill person’s recovery, ability to access services, the type of treatment and level of support received and acceptance in the community. Rejection of people with mental illness, they said, also affects the family and caretakers of the mentally ill person and leads to isolation and humiliation.

    Major causes of stigma, according to them, are myths, misconceptions and negative stereotypes about mental illness.

    They said the number one factor, which drives suicide or mental illness, is stigma, and that it could be reduced by  talking about mental illness in the community. It could also be reduced by providing accurate information on the causes, prevalence, course and effects of mental illness and countering the negative stereotypes and misconceptions surrounding mental illness.

    Providing support and treatment services, which enable sufferers to participate in community activities and ensuring the existence of a legislation to reduce discrimination in the workplace, access to health and social community services, is another way of reduce the stigma.

    The experts pointed out that mental illness have both economic and diminishing effects on the society. This, according to them, is because it affects the thinking of the individual and diminishes his or her social role and productivity.

    Also, they said mental illnesses could disable one and last for many years, as they take could reduce the emotional and socio-economic capabilities of relatives, who care for sufferers, especially when the health system is unable to offer treatment and support at an early stage.

    The experts listed some of the  costs to include lost production from premature deaths caused by suicide (which most times are under reported, hence, generally equals to and greater than deaths from road accidents); loss of production from people with mental illness, who are unable to work; loss of productivity from family members caring for the mentally-ill person, reduced productivity from people who are ill while at work and cost of accidents by people who are psychologically disturbed, especially dangerous in people like train drivers, airline pilots and factory workers.

    Also, supporting dependants of the mentally ill persons, financial costs for families caring for the mentally-ill persons, unemployment, alienation, and crime in young people whose childhood problems, e.g., depression, behaviour disorder, were not sufficiently well addressed  to benefit from the education available, poor cognitive development in the children of mentally ill parents, and the emotional burden and diminished quality of life for family members.

  • LASUTH to screen staff for mental health

    LASUTH to screen staff for mental health

    The Lagos State University Teaching Hospital (LASUTH), Ikeja workers will soon undergo mental health assessment screening/test. According to the Chief Medical Director (CMD), Prof Wale Oke, the step is necessary to enable the hospital pick in time any of its staff from breaking down or slipping into depression, traceable to workload.

    Prof Oke made this known at this year’s World Mental Health Day  observed by the hospital’s Psychiatry Department. The theme was:  Mental health in the work place.

    According to Prof Oke, if there is anybody that needs to undergo mental health assessment screening/test in the hospital, it is him because, “the work here at LASUTH is much, and when one needs to take decisions but cannot due to procedural demands in the system, and the answers are not coming, such creates anxiety. One cannot but wonder how one copes in such situation. In addition, I listen to all the complaints”.­­

    He said most times people walk into his office and accuse him of inefficiency, not realising that everything is not under his control but that he needs directive from the parent body of the hospital, “that alone can give one psychosis and neurosis. However, I have developed mechanism to adjust. Anybody that walks into my office and gives me stress, I ensure such leave with measured laughter or hope.”

    He said worldwide doctors, nurses and hospital workers account for largest part of the statistics that made up suicide because they are faced with a lot of frustrations and things they cannot control, “so we have resolved that anybody coming into the employment of  LASUTH will be subjected to mental health assessment screening/test. That will also extend to gradual and progressive levels. The results will be noted and once the personnel want to cross the border, we can easily pick same.”

    Prof Oke told the staff not to panic over the mental health assessment screening/test policy that is about to start, or fear being labeled ‘mad’, “but the policy is to assist us know the level of stress of each worker, and how it has affected your capacity, so as to prevent it from escalating to a level where it becomes so bad that hospitalisation is inevitable,” said Prof Oke.

  • ‘Reccession affecting workers’mental health’

    ‘Reccession affecting workers’mental health’

    Many Nigerians, especially those in employment, have been victims of recession and it is affecting their mental health, the Medical Director of Neuro-Pscychiatry Hositpal, Yaba, Lagos, Dr Oluyemi Ogun, has said.

    She said this during the  World Mental Health Day and the hospital’s 110th anniversary.

    The hospital was established  as an asylum on October 30, 1907 at Nigerian Railway in Yaba, where its first 48 inmates were admitted.

    The theme was: Mental health in the workplace.

    Mrs Ogun said: “The choice of the theme could not have come at a more appropriate time than now when the twin forces of economic global melt down and uncertain political climates have led to non-performance of most organisations and the resultant effect includes poor organisational policy framework to protect the right and privileges of employees.

    “This has led to employee exploitation, bullying and poor welfare packages as the employees are made to bear the brunt of the economic reality and it is therefore a common place to find cases of mental challenges on the increase in the work place.”

    Mrs Ogun, who advocated that mental health should be subsidised, if not made free, said more than 300 million people globally suffer from depression and anxiety and a recent World Health Organisation (WHO) study reveals that both cost a total  US$1 trillion yearly.

    Mrs Ogun also advocated the importance of employers to put in place arrangements that promote mental health and support people with mental disorders as the mental status of employees has a direct impact on organisational performance and productivity.

    A consultant psychiatric and a health service provider Dr Femi Olugbile highlighted the major causes of mental health in the work place and way forward.

    Olugbile said mental health’s major causes need to be understood,  saying:  “A significant number of people in the work place are experiencing mental health issues at some point in their life and because we spend most time of our life time in our work place, we experience such health issues there. In addition to that, part of the issues has always been that despite our focus on it, there is little recognition in tackling it. Very negative prevalent attitude among the employer and employee themselves are major causes of  lots of stigma attached to the very mental illness, leading to a lot of denials in the work place.”

    Continuing , he said: “Modern approach is actually to shift the focus in promoting wellness, so the gain of what we are celebrating today, is strategic in a way of strategising people in the existence of mental illness both in and out of the work place, the fact that the work place is the critical aspect in the life of individuals.

    “We need to understand that we can’t run away from the mental health, we need to shift focus to promoting wellness and every organisation in promoting mental wellness are making services available to treatment of illness should know that they are doing it to improve their bottom line. The gain of what we are celebrating today is making the awareness, the responsibility of the employer to the employee and making structure for employee to function well.”

    That is why we are advocating for – Employee assistant program, which is a concept that talks about the responsibility of the employer not only to treat illness of employee but to help to promote the wellness both psychologically and socially, that is where we should all be heading to develop mental wellness in the society. Getting it right in work place we will definitely get it right in the society at large.

    “So the way forward is awareness and focusing on wellness and start giving resources in critically improving the wellness the emotional and social wellness of their employees not as a philanthropic activity but as a necessity to improve the economy,” Olugbile explained.

    A consultant psychiatric, Dr Steven Olamide Oluwaniyi, spoke on: ‘Factors that improve or affect employee mental health in the work place’, said: “The environment where you work  if it is hostile, threatening or unfriendly, or gives excessive work load can generate stress in an individual.Where you feel your employer is a bully, you don’t feel save, you wake up in the morning and you are afraid because you don’t know what will happen, all these things constitute stress. And we know that when stress is high and it is persistent, everybody at one point will break down. But a situation whereby you are challenged positively, you wake up and feel happy to go to your working place where you spend more than 50 percent of your day, whereby you are looking forward to see your happy colleagues, that individual will feel very happy and motivated, so these are the issues that we are talking about, that is an aspect at the place of work.

    “So, when people now have problem in the other part of their lives, they are withdrawn to themselves, thinking about the problem and nobody seems to care, the productivity of that individual that used to be very productive has now gone down and despite that the boss is shouting at him for not getting things done, all these becomes a problem. So the employer needs to get training in the ‘Employee assistant programme.”

    But if an employee finds himself in an environment where the superior notices that something is wrong and call to either counsel and ask what is bothering the individual, in that circumstance the person is likely to open up and the advice given at that moment can help the mental health issue the individual might be going through. So I will advise the employees to know that making their employers happy is for their own and for the organisation greatness, vice versa.

    ‘’Having a healthy mental work force will improve productivity. And also, for everyone to come together to create policy, such that someone with a mental health issue can also be more productive and not be stigmatised- ensuring open culture in the society will minimise mental issues,” said Oluwaniyi.

  • Hospital to offer free mental health screening

    What is the mental health of your  workers and how do you determine a sane level of healthy mental health?

    These and more  will  be on focus at the retreat on mental health/awareness, being organised by The Retreat, a private mental hospital in Ikorodu, Lagos.

    The evnt will hold on Tuesday, ….. at 10 am.

    According to the hospital’s Chief Executive, Dr Olufemi Oluwatayo, the theme of this year’s World Mental Health Day focuses on “Mental health at the work place as professionals in psychiatry know that many employers and organisations do not see issues of mental health at the workplace as a priority and many employees may be suffering in silence.

    ‘’We, therefore, feel that this is an opportunity to help screen people for common mental disorders such as anxiety and depression and advise on treatment pathways if necessary. We are offering free screening services; skilled doctors will be on call both on the phone and at the Retreat campus in Ikorodu to offer confidential help.”

    This will be backd up by The Retreat’s psychiatrists, mental health nurses, therapist assistants, an occupational therapist and a top clinical psychologist in Ikorodu.

    Oluwatayo said the screening would be coordinated by him. “I am a former Health Advisor to the Lagos State Government, and a World Health Organisaton (WHO) scholar, writer, and a mental health advocate. I am also a Welcome Research Fellow and lecturer at the University of Manchester, United Kingdom.

    “In line with the WHO objectives, The Retreat, through the mental awareness and free screening, aims to add value to mental services across board, including education and raising awareness about mental issues in Nigeria ,” Oluwatayo added.

  • Experts seek NOA’s assistance on mental health

    Experts seek NOA’s assistance on mental health

    Experts have called for better synergy between the health sector and the National Orientation Agency (NOA) to increase awareness for mental health.

    Speaking at the 14th Annual Scientific Conference on mental health held at the Faculty of Clinical Sciences, College of Medicine, University of Lagos, the experts pointed out that many people were still ignorant of mental health and that the situation had been compounded by the recession in the country.

    The conference, which had as its theme ’’Mental health in a recessed economy’’, was attended by experts from all walks of life.

    Faculty Conference Committee chairperson, Prof Adeola Onakoya, said everyone has a role to play in mental health promotion because, “we all have mental health needs even in the absence of diagnosis of mental illness. The concept of mental health promotion is a potent tool for guiding policy makers, public officials, civil society, and employers of labour and medical professionals in the behavioral health needs of the society. Nigeria can do better in mental health”.

    A Professor of Psychiatry, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu,  Jude Ohaeri, who underscored the need for the NOA to be more involved, maintained that paying more attention to mental health was one way of arresting the sickness.

    She said: “Encouragement of mental health does not have to involve multi-million naira projects. Taking a cue from the World Health Organisation (WHO) that says mental health is not merely an absence of metal disorders.

    ”Everything we learnt in the medical school is about the disease part of it whereas people who have mental health disease are not really the problem of this country, the problem of this country is not that we have psychiatric patients aspiring to be a senator, it is that people who are deficient in aspect of humanity seized this power and they rule us at whatever level, whether they are class teacher or whatever, that is the problem, so we are not able to ‘catch’ them. Those are the people who are deficient in humanity and are in charge of our daily lives.

    She continued: “Mental health promotion is not only aimed at preventing the condition or depression, but to make up for  deficiency in peoples’ character, emotion, those things that make for the fact that while we are not depressed we are not optimistic, we don’t love our neighbours  as ourselves. Those are things affecting our mental health.

    “In this situation of a severely depressed national economy, promotion of mental health is a cost-effective strategy for national development, spanning many facets of societal functioning that has the potential to engender citizens’ resilience, optimism and the other positive emotions and character traits that build the human foundation for the flourishing society.”

    Ohaeri said the NOA should collaborate with experts in the field, “to articulate a mental health promotion campaign, what will engender internal locus of control, positive emotions and traits, as a means to heal our national divisions by fostering right human relations and bring peace to our nation’’.

    Nordical Fertility Centre Madical Director, Dr Ajayi who bagged Icon of Health Promotion Award from the Faculty, said infertile people too face stresses which lead to depression, a mental health issue.

    “People who don’t have children feel something is missing,’’he said, advising such people to seek medical attention and counselling because there are medical answers for it, including IVF (In vitro Fertilisation).”

    Ajayi said the award was a wakeup call for him to do more in promoting mental health, especially infertility.

  • Tips on mental disorders for healers, by don

    Tips on mental disorders for healers, by don

    A professor of Psychiatry   at the Lagos State University College of Medicine, Lagos State University (LASU), Abiodun Adewuya, has advised mentally ill-people healers to treat them with care.

    He gave the advice in an interview with The Nation.

    He said the role of traditional healers in psychiatry could not be overemphasised.

    “We, as professionals, take due recognition of these trado-medicine healers as complementary, but then, they have their limitations, hence they must know when to refer appropriately.

    “Aside that, one problem in the sector is the poor quality of care   given the sick. Stigma and discrimination can result in a lack of access to health and social services. The human body isn’t a simple machine with an easy solution for problems, especially those involving mood and mental health,” he said.

    Relying on the World Health Organisation (WHO) statistics, the notable medic said health systems had not been adequately being provided.

    As a result, the gap between the need for treatment and its provision is wide all over the world, he said.

    In low- and middle-income countries, he said, between 76 and 85 percent of people with mental disorders do not get treatment for their disorders. But not so in high-income countries, where those who have no access is between 35 and 50 percent.

    ‘’And that is the gap traditional healers in psychiatry have filled over the years,’’ he added.

    Adewuya, an Honorary Consultant Psychiatrist at the Lagos University Teaching Hospital (LASUTH) Department of Behavioural Medicine, pointed out that some plants are good for treating mental disorders. He listed these herbs to include Rauwolfia Vomitoria, Asofeyeje (Yoruba) akanta (Igbo language) and Wada (Hausa), an hypnotic that is good for reducing blood pressure.

    “Rauwolfia is also good for treating insanity, anti-anxiety agent and is a good stimulant for the nervous system. This has been documented by Lambo J. O. (1975) Management of Hypertension in Traditional Medicine; in Sofowora A (ed) Antihypertensive Agents from Natural Sources: Ile-Ife, University of Ife Press, where it is reported that Asofeyeje has effect on the brain and will restore mental activities to normal.

    ‘’It should, however, be moderately used as it sometimes weakens the patient. Notable side effects of Rauwolfia alkaloids are depression and parkinsonia syndrome. according to Okpako D.T. ‘Principles of Pharmacology: A Tropical Approach: New York, Cambridge University Press (1991). Odugbemi T. in: ‘A Textbook of Medicinal Plants from Nigeria: Lagos, University of Lagos Press (2008) and Adodo Anselm in ‘Nature Power: Benin, Generation Press’.

    Adewuya continued: “As good as this plant and others are, they have their limitations and I will encourage healers to update themselves on their practice and treat patients accordingly. Every drug is plant- based, so as professionals we are not throwing away the traditional art of healing mentally sick but we are rather asking that the healers should identify their limitations, and refer when necessary.”

    He said the era of beating, starving or even chaining mentally ill people had gone, urging practitioners to improve on their practice.

    “The healers have their plus. And they are commended for that. But they should just know that the archaic way of maltreating people with mental illness is phasing out. The healers should not chain them to bed, shackle or punish them for being ill. They should know when to refer. Most of the healers inherited the art from their fathers or forefathers but it is high time they introduced civility into their skill.

    ‘’When they do the referral, it does not dent their image; nobody will laugh at them or allege that they are not good at their trade. It does not translate to their not knowing their salt either. It is not an admission of failure on their part.  Rather, they would have done professionally well, and praised. The place where they treat should also be hygienic. When they do not refer to the appropriate hospital promptly, some serious damages would have been done to the patient and they come in, highly damaged. Trado healers should see us as working together because of the patient involved and not as rivals,” Adewuya added.

    He noted that there are various forms of mental disorders, that required various treatments but it has been observed that healers apply the same format in handling their patients.

    “There are different mental disorders, with different presentations. They are generally characterised by a combination of abnormal thoughts, perceptions, emotions, behaviour and relationships with others.

    “Mental disorders include depression, bipolar affective disorder, schizophrenia and other psychoses, dementia, intellectual disabilities and developmental disorders including autism. There are effective strategies for preventing mental disorders such as depression. There are effective treatments for mental disorders and ways to alleviate the suffering caused by them. Access to health care and social services capable of providing treatment and social support is important,” he explained.

    Adewuya said he had analysed  the herbal plants and other ingredients used by the healers. He said he could only advise on regulation of the dosage to avoid more damage being done. ‘’As scientists we are promoting what we have around here, we are not throwing out the bath water with the baby,’’ he added.

    He described schizophrenia as a severe mental disorder, affecting about 21 million people worldwide. Psychoses, including schizophrenia, are characterised by distortions in thinking, perception, emotions, language, sense of self and behaviour. Common psychotic experiences include hallucinations i.e. hearing, seeing or feeling things that are not there and delusions fixed false beliefs or suspicions that are firmly held even when there is evidence to the contrary. The disorder can make it difficult for people affected to work or study normally.

    “Stigma and discrimination can result in a lack of access to health and social services. Furthermore, people with psychosis are at high risk of exposure to human rights violations, such as long term confinement in institutions.

    ‘’Schizophrenia typically begins in late adolescence or early adulthood. Treatment with medicines and psychosocial support is effective. With appropriate treatment and social support, affected people can lead a productive life, be integrated in society. Facilitation of assisted living, supported housing and supported employment can act as a base from which people with severe mental disorders, including schizophrenia, can achieve numerous recovery goals as they often face difficulty in obtaining or retaining normal employment or housing opportunities,” Adewuya added.

  • Mental malady

    Mental malady

    Way out is improvement in socio-economic conditions 

    If there is a connection between recession and depression, leading to increased cases of suicide, then there is cause for concern as Nigerians battle biting recession. For instance, it was alarming that the Nigeria Police Force (NPF), during an interactive session in Yenagoa, Bayelsa State, expressed concern over the rising cases of suicide among its officers.

    Against this background, the insightful picture by a psychiatrist at the Federal Neuro-Psychiatric Hospital, Yaba (FNPHY), Lagos, Dr. Bolanle Ajayi, deserves attention: “The high cases of depressive illnesses are no doubt as a result of the economic recession and a lot of people are being affected. Even in our hospital wards now, we see a lot of people coming down with depressive illness, suicide, and depression, deliberate self-harm and by the time we look at the primary cause of these illnesses, it was actually this recession going on.” Ajayi was quoted as saying that many Nigerians are psychologically, socially and emotionally affected by the recession.

    Statistically speaking, the figures indeed suggest that more Nigerians are experiencing mental challenges that may not be unconnected with the country’s unfavourable economic situation. For example, FNPHY recorded 59 per cent increase in the number of new patients in the first 11 months of 2016.  Between January and November 2016, patient attendance at the health institution reportedly reached 53, 287 compared with 25,267 for the same period in 2015.

    A report said: “More women than men appeared to be seeking help for psychiatric illnesses because during the period in question, the number of female patients increased 135 per cent from 13,730 to 32,261, compared with an increase of 82 per cent from 11,537 to 21,026, for male patients.”

    It continued: “The number of new patients in the hospital increased from 2,531 to 4,031. Of the new patients, 2,001 were male representing 53 per cent increase over the 1,306 recorded last year, while 2,030 were female, a 66 per cent increase over the previous year. In absolute figures, there was an overall 46 per cent increase in number of admissions in 2016 (867) compared with 594 in 2015, while the community clinic attendance went up from 1,793 to 3,510, a 95 per cent increase.”

    More disturbing is the information that more children were also mentally challenged in the period under focus: “Even children were not spared as there was a 144 per cent increase in the number of child/adolescent clinic attendance from 1,375 to 3,355. This comprised a 141 per cent increase of girls from 2,311 to 5,581, and 138 per cent increase for boys, from 936 to 2,226. Also, the number of follow-up patients increased 74 per cent from 19,889 (9,076 male and 10,813 female) to 34,536 (11,608 male and 22,928 female).”

    The increased psychiatric consultations and hospitalisations reportedly  resulting from the country’s worsening economic crisis have been attributed to significant stressors, including loss of livelihood, depleted financial income, reduced purchasing power and lack of savings which are putting a strain on  individual, familial and group relationships. It is said that the effect of the recession is more pronounced in low-income families, making them increasingly unable to meet their basic needs such as food, security, transportation, healthcare and shelter. This leads to problems of anxiety, lowered self-esteem and other emotional/behavioural difficulties, which may further lead to suicidal thoughts and suicidal action.

    Research has shown a nexus between poverty and mental breakdown, which must not be ignored, considering the lamentable enabling conditions created by the country’s recession. Dr. Ajayi was quoted as saying that depressive disorder, an extreme form of sadness, could result in loss of sleep and inability to function properly. She said: “People suffering this form of mental disorder do not have interest in previous pleasurable exercise. Sometimes, they may even want to commit suicide or write suicide notes.”

     She added: “Virtually all kinds of pressures lead to one sickness or another. When someone has mental illness, and wants to buy medication and he/she cannot afford it, he gets home and somebody provokes him, things like that affect people in the long run. Take for instance in our hospital now, many of our patients on treatment are no longer coming either due to money for transportation or they are not able to pay for their treatment. Some new patients now find it difficult to pay for their files. All these contribute to the increase in mental cases.”

    It is bad enough that the country is going through hard times; it is terrible that more and more people are breaking down with psychiatric illness and going through suicide-provoking situations as a result.

    Collapsing social values and weakened social structures may well further complicate the complication, but the reality is that people need pro-life and pro-sanity environments to cope in recession.

    Rethinking mental illness in this context shows that, in the final analysis, improved socio-economic conditions are the ultimate remedy for recession-induced psychological problems.

  • Lagos repositions mental health desks

    Lagos repositions mental health desks

    The government of Lagos State is set to activate  mental health desks in all the primary health centres (PHCs) across the state.

    To ensure their seamless take off, the Head of Department of Psychiatry, Lagos State University Teaching Hospital (LASUTH), Ikeja,  Prof Abiodun Adewuya, the desk officer in-charge of Mental Health, Ministry of Health Alausa, Ikeja, Dr Dolapo Fasawe and experts in the field, have held a training for officers drawn from the PHCs in the state. The event held at Ikeja and was well attended.

    Adewuya said the government decided to do this because it noted the importance of mental health in the state.

    “Frightening enough, though the state has three institutions with mental health facilities, the human capacity required to detect, treat and manage cases is not able to cope with the surging figures. And so engaging that healthcare givers from PHCs, which is the first place of call in healthcare delivery system. It is a systematic way for early detection of cases and possibly management, thereby halting larger scale of patients’ admission at tertiary institutions,” he said.

    Nigeria has no fewer than 300 psychiatrists. Out of this number, about 32 are in Lagos hospitals.

    Adewuya listed symptoms to watch out for, which people can report to PHCs. He said: “When you notice that people are losing interest in things that once interest them, it is time to check their mental wholeness. For experiencing one or more of the following feelings or behaviours can be an early warning sign of a problem. Eating or sleeping too much or too little, pulling away from people and usual activities, having low or no energy, feeling numb or like nothing matters, having unexplained aches and pains, feeling helpless or hopeless, smoking, drinking, or using drugs more than usual or feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared.

    “Others are yelling or fighting with family and friends, experiencing severe mood swings that cause problems in relationships, having persistent thoughts and memories you can’t get out of your head, hearing voices or believing things that are not true, thinking of harming yourself or others or inability to perform daily tasks like taking care of your kids or getting to work or school.’’

    According to Fasawe: “Mental health include our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood. Over the course of life, if you experience mental health problems, your thinking, mood, and behavior could be affected.’’

    She added: ‘’Many factors contribute to mental health problems, including: Biological factors, such as genes or brain chemistry, Life experiences, such as trauma or abuse, and family history of mental health problems.”

    She added that doctors, nurses and other health care workers at the PHCs are being trained to identify and treat depression, epilepsy and psychosis (DEP) so that there would be increased access to evidenced-based intervention and improved health outcome in clients with DEP.

    According to Fasawe, quoting the World Health Organisation (WHO), the knowledge of what to do about the escalating burden of mental disorders has improved over the past decade. “There is a growing body of evidence demonstrating both the efficacy and cost-effectiveness of key interventions for priority mental disorders in countries at different levels of economic development.

    ‘’Examples of interventions that are cost-effective, feasible, and affordable include: treatment of epilepsy with anti-epileptic medicines; treatment of depression with psychological treatment and, for moderate to severe cases, (generically produced) anti-depressant medicines; treatment of psychosis with older antipsychotic medicines and psychosocial support; and taxation of alcoholic beverages and restriction of their availability and marketing,” she said, adding that the challenges facing people with mental health problems are principally  stigma and funding.

  • Mental gridlock

    World Bank’s intervention at the Apapa Ports may well prove that what the perennial gridlock needs is thinking  

    It could be said that Nigeria’s major sea ports in Apapa are metaphors for the state of the nation. For over a decade, the ports and their precincts have been associated with daily crippling gridlock.

    The Apapa and Tin Can Island ports as well as the numerous jetties in that axis of Lagos once made up the maritime hub of the West Coast of Africa. They also served as entrepots for adjoining land-locked countries like Mali and Niger Republic. Not anymore.

    In the last decade or more, the ports of Apapa have become hellish cul-de-sac of sorts where routine businesses are transacted with sorrow and anguish. It manifests in the form of traffic congestion that lasts for many hours daily.

    The problem has been blamed on the usually large number of tankers and trucks plying the ports’ vicinities, and waiting to pick up cargo, especially petroleum products.

    With the rail tracks servicing the ports long in disuse, every item of cargo going in or emanating from the ports has to be hauled with one form of truck or the other. What this means is that there is always congestion in the entire port areas occasioned by large number of vehicular movements.

    Apart from the matter of the disused rail tracks, the roads leading in and out of the ports have failed almost irretrievably for more than 10 years. Several attempts to revamp them or completely modernise them have been to no avail.

    Successive governments since 1999 have failed to find a lasting answer to this critical problem, and the issue of tankers clogging the precincts has remained intractable. There are probably no busier roads in the country, and none are more economically strategic or even more viable.

    It is a positive development that the World Bank is poised to spend N12.2 billion ($40m) to clear the Apapa gridlock. Working in collaboration with the Nigerian Shipping Council (NSC), Nigerian Ports Authority (NPA), and the National Freight Information and Transport Hub (NAFITH), the World Bank will provide the funding for setting up an electronic passage and for rehabilitating some of the roads around the ports.

    According to the Executive Secretary of the NSC, Mr. Hassan Bello, “The fund is meant to improve logistics around the Apapa, Tincan and Orile areas. For every time there are over 5000 trucks on the axis… but what we need at any point in time is not more than 1500 trucks in that Apapa vicinity… what are the extra 3500 trucks doing there?” The electronic passage device to be installed will ensure that a truck is in Apapa only when it is needed.

    There is no doubt that this scheme, when completed, would give a new lease of life to the ports of Lagos. But while we are at it, we urge the Federal Government and all the stakeholders to consider building modern trailer and tanker parks around the areas to absorb the trucks in waiting.

    There is also an urgent need to repair the pipelines at Mosimi and Ejigbo depots so that tankers would have less need to go to the ports for petroleum products.

    Lastly, the need for a rail track crisscrossing the ports cannot be overstated. It would appear that the gridlocks at our most important ports are man-made as this intervention of the World Bank may soon prove.