Illegal and inhumane treatment centres: After the rescue, what next?

THE news cycle has been aflush with gory details of the hundreds of citizens who were recently rescued from illegal spiritual rehabilitation centres across the country; from the north (Kaduna) to the south (Ibadan).

Several of these individuals were young men and women, including young children, who had been taken to these places on account of behavioural problems, mental disorders or addiction to psychoactive substance use.

Furthermore, the recent report by the Human Rights Watch vividly depicted the very inhumane circumstances in which persons with mental disorders are being taken care of across various sectors – but especially in traditional and spiritual healing homes.

The majority of the inmates, similar to what was found in the recently closed illegal homes, were chained and exposed to other forms of inhumane living conditions.

It is imperative that the government and all relevant stakeholders are awake to the current challenges and realities with respect to mental health.

It is therefore gratifying to note the Press Release by the Association of Psychiatrists in Nigeria (APN) as well as the responses from Civil Society Organisations such as the Asido Foundation and Mandate Health Empowerment Initiative (MHEI) to these discoveries….while it is still topical.

The task of ensuring that all citizens enjoy not just physical health but also mental and social wellbeing, is a task for all. Mental illness should not be a basis for exposure to gross human rights violations and treatments.

But the focus of today’s article is more on the aftermath of the widely publicised police raids and rescue of the hundreds of citizens from these horrible centres.

After the rescue, press briefings and statements; when the cameras stop rolling and have left the scene, what should be next for the affected individuals and their families?

Should they simply be allowed home to their families?

What plans should be in place for their rehabilitation? How about psychosocial support and counselling? Ongoing treatment for those with mental disorders?

This is often, where we lose the plot, as attention shifts away and we all get lured into complacency…until the next saga. For instance, this is not the first and will certainly not be the last. The Soka incident in Ibadan, for instance, was just a few years ago.

What rehabilitation efforts should be in place?

Affected individuals should be afforded medical, psychological as well as social treatment and rehabilitation.

• Medical treatment and rehabilitation: Affected individuals need to have comprehensive medical evaluations as some of them looked very malnourished, and may have skin lesions, chest infections as well as a host of other conditions that may have been exacerbated by the squalid living conditions they had to put up with.
• Psychological treatment and rehabilitation: Those with background mental health problems would require an assessment as well as adequate treatment plan to ensure they get well and remain well.

Families need to be psycho-educated as a window of opportunity to change minds about the treatability of mental disorders in hospitals. Furthermore, the dangers of human rights abuses, including risk of death should be emphasised. Those who may have been traumatised and may be suffering from anxiety and post traumatic stress disorders will also require intervention.

• Social rehabilitation: This is where the majority of the work is required, with the pivotal role of the Ministry of Women Affairs and Social Welfare taking the lead role. Experienced social workers are also needed in high numbers.
• Work: To be productive and meaningfully engaged has significant beneficial effect on mental wellness. Thus, the released individuals can best be helped through vocational assistance.

Furthermore, the social workers can assist in finding and maintaining employment of the patient through development of vocational skills and connecting the patients to employment services in the community without causing undue stigma.

• Housing: This involves connecting the patients to safe, affordable and appropriate housing. These may include options, on where the patient would live either independently or in a family home. Sometimes it is better for a patient to reside in group homes, residential care service centre and apartments.
• Relationships: Social skills and interpersonal functioning are important parts of social rehabilitation. Skills training may focus on helping people function in their social worlds, including family, work, school, friendships, and romance.

This is achieved by teaching skills related to emotional understanding, interpersonal problem-solving, verbal and conversational abilities, and nonverbal communication.

• Community Functioning: This is a strategic goal of social rehabilitation – to help those with mental illness become better integrated within their community. For this reason, social workers may be required to work with the released individuals in community settings and locations. Practicing social and life skills allows clients to gain experience and to rehearse interactions they might face as part of daily life.