Grappling with stigma of mental illness in Nigeria

SIN the wake of the recent reports on suicides that have moved from an occasional blip to a very disturbing trend in our country, coupled with the greatly expanded data on mental illness, as well as the increasing development of evidence-based treatments with proven efficacy, it’s worrisome that the stigmatization of mental illness continues to be pervasive and persistent in the society. We’ve witnessed public figures like  Chimamanda Adichie, Halima Abubakar, Toyin Amaikwu, Waje, Dencia and many others, being outspoken about their struggles with mental health issues. But, despite the increasing openness of so many and the clear need for transparent discussion, the stigma surrounding mental health persists. As a matter of fact, Individuals with mental illness in Nigeria most especially continue to receive harsh stigmatization, resulting in decreased life opportunities and a loss of independent functioning over and above the impairments related to mental disorders themselves.

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And we are not talking about just a few people here.  The World Health Organization (WHO)  reported that an estimated 25 percent of the worldwide population is affected by a mental or behavioral disorder at some time during their lives. Of course, this can be debilitating, impacting  people’s ability to thrive at school, work,  with friends and in their life  generally. Specifically, an estimated 20%–30%, which implies that not less than 60 million of Nigeria population are believed to suffer from mental disorders. Simply put, three in every ten Nigerians suffer from one form of mental disorder or the other. Surely,  these numbers are alarming and seemingly only getting worse, then with the prevalence of smartphones, anxiety and depression are invariably increasing. The more connected young people are online, the more disconnected they’re actually in terms of organic feeling, the more judgmental they are about themselves, and the more challenging it is for them to feel confident in life.

With attention to the  aforementioned statistics, there’s no gainsaying that mental illness stigmatization has a huge, negative impact on not only a large number of our population, but their families, communities, and the nation at large. For one, the very symptoms and features of many forms of mental disorder involve pessimism, despair, and lowered self-worth. Hence, the nature of mental illness makes the internalization of negative social messages quite likely. More so, there are few possibilities for natural connections with or solidarity toward fellow individuals with mental disorders, given the historical isolation, invisibility, silence, and disenfranchisement of such individuals. It is for this reason, in fact, that self-help and advocacy movements for people with mental disorders are of such potential importance. Moreover, a history of mental disorder is usually concealable, and stigmatized conditions that can be hidden – as opposed to those that are visible – yield considerable anxiety and stress for those who have them. Put simply, higher levels of distress and lower levels of self-esteem is attributed to  individuals with concealable than visible stigmas.

The implication is that we have to be concerned with changing the conversation around mental health in Nigeria in order to have a better handle on the growing problem, and unless strategies for this change include altered laws and social policies and meaningful efforts to alter fundamental attitudes in members of society, the likelihood is that reform will be piecemeal and even counterproductive. Put differently,  there’s a need for revisions in policy, greater accuracy in media portrayals, enhancement of sensitivity and responsiveness in mental health workers and professionals, changed views on the part of the general public, increased involvement of family members, and greatly increased access to services and treatment for individuals with mental disorders—as well as increments in their ability to cope with discrimination and stigma, to enact important, multilevel change. In this case, primary care givers are often the unsung heroes in coping with both mental illness in their wards and relatives, in addition to  the stigma that attends to mental disorder. So, if the family and and accompanying caregivers  can get accurate information about the causes of and treatments for mental disorders, they will be able to recognize and discount outmoded, prejudiced beliefs from friends who think mental issues are spiritual or demonic, as well as flippancies from some half-baked professionals.

As for individuals with mental disorders themselves, procuring effective treatment is not only essential for relief of symptoms and distress but also for stigma reduction. That is, not only can pain and suffering be reduced, but engagement with friends, classmates, colleagues, and social observers in general can occur, with resultant benefits in terms of positive expectations and attitudes. Indeed, people with mental illness require rights, respect, and responsibility, even if they continue to show some forms of deviant behavior. In any case, young people appear to be looking for help in managing their mental health issues more effectively. It seems, though, that often they get shutdown or turned off to the idea because of the lack of support from society in general as mental health issues are frequently perceived as weakness, when in reality owning them and treating them shows great strength.

On the whole, stigmatisation is a form of social injustice, and solutions at the levels of social policy and reduction of discrimination are a major part of the equation. Hence, we need to change societal belief systems that mental illness is intractable and chronically disabling, and to  achieve that,  we have to  use our considerable knowledge base, that is accumulating continuing correct information about mental disorders, their treatments, and the stigma that surrounds mental illness to promote multilevel, integrated means of advancing evidence-based treatments, which can in turn produce improvement in symptoms and impairment, while simultaneously prioritizing reductions in discrimination, enhancement of empathy, and promotion of optimal social contact. Because mental illness is everywhere, with pervasively negative impact on individual, family, and society, it’s really time to change the conversation and end the dis-enabling stigma that further complicates its proper handling for good.

• Yakubu is of the Department of Mass Communication, Kogi State University, Anyigba, Nigeria.