Against the background of the current economic recession, the number of Nigerians coming down with depression, anxiety and other forms of mental health challenges is on the rise. But affected persons do not receive treatment due to stigma and lack of empowerment of health workers. Journalist reports.
The peace in the home of the Cokers has been chattered. Since he lost his lucrative job in the banking industry, Mr.Babatunde Coker, the former Bank Manager with the defunct Society General Bank, had become a shadow of himself.
His wife of over 20 years, Lolade and his four children observed that their breadwinner had become the nagging father.
Their home in Ikorodu consequently became a battle ground due to frequent disagreement between Mr. and Mrs Coker.
The number of altercation and frequent brawl between the couple, were however linked to the anger and anxiety often displayed by Mr. Coker.Worried by the severe injury she sustained during some of the embarrassing brawl between her and her husband, Mrs Coker reported the case of domestic violence in her home to the nearest police station.
Following the intervention of the security agencies who later referred the Cokers to the General Hospital in Ikorodu, where Mr. Coker was observed and later diagnosed with depression and subsequently treated. Mr. Coker responded positively to medications, resulting in a turnaround in his health.
Not only that, peace and normalcy returned to his home. Most people feel sad or depressed at times. Feeling depressed can be a normal reaction to loss of job or other valuables, life’s struggles, or an injured self-esteem.
When feelings of intense sadness — including feeling helpless, hopeless, and worthless — last for many days to weeks and keep an individual from functioning normally, that depression may be something more than sadness. It may very well be clinical depression — a treatable medical condition.
Getting out of such depression to live normal healthy life again is a benefit that should extend to other members of the society that suffer depression but this is not always so in Nigeria.
According to a Professor of Psychiatry at the Lagos State University Teaching Hospital, LASUTH, Abiodun Adewuya, over 80 per cent of people who have mental health problems, including depression and anxiety in Nigeria, don’t receive treatment.
This development is worrisome as studies have shown that between 20 to 40 per cent of patients that attend the primary health care, PHC, centres and general hospitals have a form of common mental health disorder or the other.
Mental health disorders include a wide range of problems, including Bipolar disorder, Depression, Mood disorders, Personality disorders, Psychotic disorders, including schizophrenia Adewuya blamed the gap in treatment to stigma which discourages most patients from seeking health care, inability to recognise mental illness as a disease and lack of empowerment of health workers to recognise symptoms of mental health disorders in patients. He said, “Most patients in hospitals complain of having fever and headaches.
They don’t complain that they are sad and that is why they do not get treated.” Adewuya, however, pointed out that depression and other form of mental health disorders are not physical problems that one can see or things that simple laboratory tests can pick.”
Based on these, he reasoned that care workers need some probing and questioning to determine patients that suffer common mental health disorders.
Determined to address the treatment gaps with a view to refer severe cases to either secondary or tertiary facilities, the Lagos State Government recently trained some doctors, nurses, community health extension workers, CHEWS and others operating under PHCs and built their capacity to recognise the signs and symptoms in patients that come to PHCs with malaria, tuberculosis, diabetes and other health challenges.
Part of the strategy, Adewuya said is to treat the people that have already broken down, but the best way to tackle this problem is to prevent many cases from progressing further.
On what to look out for in the behaviour, attitude and actions of individuals that indicate red flags that require prompt medical attention, the professor of psychiatry listed the signs as someone feeling low, unhappy, exhibiting unusual sadness, crying without being prompted and it can actually progress to other things like someone losing interest in things that they usually like such as going to church, mosque, playing with friends, and definitely not interested in doing that again.
Similarly, other signs of mental health disorders that may need the attention of care givers include when someone who has no energy at all to do anything, when someone is always lying down, watching televi-sion and not demonstrating interest in doing anything, loss of appetite, not eating anything, having sleeping difficulties and waking up in the middle of the night and not being able to go back to sleep until around 5am.
Even when the fellow wakes up and feels so unimpressed that he wants to go back to sleep again. Adewuyi added, “Even if the fellow is a worker, he won’t be able to do what he normally does and then everybody will be complaining about him. “Although, people around him may think he is being lazy. No!
That person may be depressed,” he said, adding, “if you notice these in an individual, you can just ask the person to visit the nearest PHC in Lagos.”On the standard procedures to be adopted by the trainees, he said: “what we are trying to do is to set up a kind of procedure for them such that once someone who is probably very angry, very anxious and things like that, is brought to the hospital, the care workers will follow specific steps to detect patients suffering depression or other mental health challenges.
The professor of psychiatry said presently, the Lagos State Government was starting to address depression and anxiety. Thereafter, “we can add epilepsy and also teach the care givers how to recognise psychosis, which is the most severe form of mental disorder.
Highlighting the importance of offering needed treatment for persons who suffer mental disorders, a Director in the Lagos State Ministry of Health, Dr. Dolapo Fasawe said several studies have shown that people fail to identify with mental illness either due to stigma or due to fear.
“We have also seen that a lot of people who have mental illness are not even aware that they have mental illness.” On why Lagos State considers the training to be imperative, Fasawe said, “It is documented that a person with mental illness can function in the society if the person adheres to his medical advice and understands his condition. “Our message is that mental illness is like any other illness.
It can be taken care of. It can be treated and it can be managed. The key is identifying and offering adequate advice and help.” According to her, the plan of the government is to ensure that everyone that has mental illness in the state should have access to care. Fasawe said it is not the people suffering psychosis alone that have mental health disorder.
“Persons suffering depression, anxiety and other forms of mental health challenges also require treatment,” she affirmed, adding, “We want to reduce stigma; we want to educate the people.”