The fear of contracting coronavirus through hospital visit is understandable —Adetoun Faloye, psychiatrist and mental health advocate

Adetoun Faloye is a medical doctor with speciality in psychiatry; a senior registrar at the Department of Psychiatry of the University College Hospital, Ibadan and a mental health advocate. In this interview by Kingsley Alumona, she speaks about why she decided to specialise in psychiatry, general mental health and fear associated with the COVID-19 pandemic, domestic andsexual violence, and what she would do if she were the president of Nigeria in the face of the pandemic.

 

Briefly tell us what inspired you to study medicine, and your experience studying it in the university.

Very early in my life, my father identified my concern for the wellbeing of others as well as my grit for academic excellence. So, he encouraged me to study medicine. Medical school exposed me to the various extreme-health conditions that people suffer from and financial hardship that out-of-pocket payment for healthcare causes for patients and their families. I also learnt that ill-health is no respecter of age, tribe or socioeconomic status.

 

Why did you decide to specialise in psychiatry? And, how long have you been in the practice?

Psychiatry was one of my last clinical rotations in medical school. I realised it was very different from other medical specialties. A lot of time is taken to understand the patients and their journey from childhood to the point where they developed psychological challenges. Also, psychiatrists are non-judgemental and highly empathetic doctors who work closely with other healthcare providers with high level of camaraderie. Hence, my attraction to the specialty.

 

There is this belief that most Nigerians do not care about their mental health and that there is stigma associated with mental patients/treatment. What is your take on this?

This’s true. People don’t recognise the central role mental health plays in their lives. Some don’t even know the signs of deteriorations in their mental wellbeing. Many people assume that because they don’t have a mental disorder then it means they’re enjoying good mental health. When people understand the role mental health plays in realising their potential, their ability to cope with difficulties and challenges, their capacity to be productive at their jobs/ education and contribute meaningfully to the society, the attitude to their mental health will change.

It’s true that there is a lot of stigma associated with mental illnesses. This isn’t peculiar to Nigeria, but it’s worse in our country because of poor information as well as our cultural and religious indoctrinations that suggest that mental illnesses are as a result of voodoo or demonic attack. Also, the negative projections of mental illness in Nollywood as the aftermath of evil acts and money rituals have also compounded the problem.

 

With the COVID-19 pandemic, the lockdown and the challenges associated with them, how would you rate the general mental wellbeing of Nigerians?

Although I don’t have specific statistics, it’s expected that feelings of apprehension, anxiety, uncertainty, fear of the unknown, sleep difficulties, depression usually increase when people experience a major stressful event like this pandemic we are currently faced with. So, it’s expected that there will be high levels of emotional distress although this varies from person-to-person depending on individual capacity to cope, level of social support and other factors.

 

People are afraid of going to the hospital for treatment because of fear of contracting the coronavirus. Is this fear justifiable? Or the do you think there is a psychological deficit in this decision?

The fear of contracting the coronavirus through hospital visits is quite understandable. In fact, at the start of the pandemic in Nigeria, some hospitals recommended that only individuals with serious health challenges should come to the hospital. I don’t think there is a psychological deficit associated with people’s unwillingness to visit the hospital for other health issues at this time. We’re dealing with a highly contagious viral infection that can be easily transmitted by individuals who don’t even appear sick. So, being very cautious and avoiding hospital environments, except when necessary, is a wise thing to do.

 

Are you satisfied with the way the Ministry of Health and the Nigerian Centre for Disease Control (NCDC) are handling the COVID-19 pandemic? And, do you see the pandemic ending anytime soon?

I would say the MoH and NCDC are doing their best, although there are areas that should be improved on, especially with the issues of testing and rapidity of release of test result. The pandemic is projected to occur in waves—that is, there may be another surge at any time. However, I honestly hope it ends soon, so the hardship on many Nigerians, as a result of the pandemic, will reduce.

 

Members of the Nigerian Association of Resident Doctors (NARD) are threatening strike. Is this a wise decision in the face of this pandemic? How would you advice government in this regard?

When those who provide care are not provided adequate protective equipment and remuneration, it is better for them to ensure their own safety. Government should carefully consider the demands of NARD and come to suitable agreement that’ll work in the interest of the entire country.

 

Part of your work involves management of sexual abused and domestic-violence victims. These vices are on the rise during this pandemic. What do you think could be done to checkmate them?

Provision of hotlines that people can call and safe spaces for survivors by the government as well as interested not-for-profit organisations are extremely important interventions and are long overdue. Also, prompt response by law enforcement agents in accordance with the Violence Against Persons Prohibition Act (VAPPA) will also serve as deterrent to perpetrators.

 

If some walk into your office and tell you they were sexually abused, what would be your first reason? How would you advice the person?

I would believe the person, give them support, encourage them to seek medical help and also advise them to report at the police station. I’ll also stay in touch with them and help them through their journey of healing.

 

Early this March, you were in a conference panel that advocated for a sexual referral centre in Oyo State. Briefly tell us what the centre is about and how it would benefit the society.

Sexual assault referral centre, in my opinion, should be provided by government with support from civil society organisations. It would serve as first point of call for any individual who has experienced sexual violence. Such a centre should have hotlines that are easily accessible to citizens so they can call in when there are incidents of sexual assault and also transportation services for pick-up of survivors. It would be a safe place where survivors are believed and supported especially in the acute phase when there is usually intense confusion about what to do following an assault. Such a centre should be equipped to provide holistic care comprising legal, medical, psychological/emotional/counselling, residential vocational and social services.

 

If you were the president of Nigeria during this pandemic period, what would you do to better the lot of Nigerians?

I would see to widespread provision of food supplies and other basic needs for survival. I’ll ensure the provision of adequate protective equipment for healthcare workers and explore the use of scientifically tested home-grown treatments. Finally, I’ll regularly assure Nigerians to keep hope alive.

 

What is the greatest challenge you face as a doctor specialising in psychiatry, and how do you manage them?

My greatest challenge is poor engagement and compliance with treatment by clients and their families as a result of their poor understanding of the nature and causes of most mental illnesses. This leads to frequent relapses and worsening of the patients’ outcome. It can be discouraging. However, I encourage myself with the success stories of other patients who’re winning everyday against all odds.

 

What do you like doing at your leisure? If you were to make a wish on your next birthday, what would it be?

I love spending time with friends, chatting and having a good laugh. I also love reading books about courage and perseverance. I would wish to travel to at least five exciting places around the world.

 

What advice do you have for young people, especially the female ones, who are aspiring to be like you?

Have huge dreams. Believe you can achieve anything you set your mind to achieve, even in the face of challenges. Remain focused on your goals. Have a mentor(s) who guides you and holds your hands as you move ahead in life.

 

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