We often say that although Nigeria comes up with good plans, their implementation is poor. I do not know how we came about this conclusion, but I think it is very wrong. No human being succeeds anywhere in the world without putting in place workable and achievable.
I want to believe that ineffective policy formulation is one of the means by which Nigeria has been brutally and recklessly raped and her resources plundered. There is no basis for separating the formulation of policy from its implementation. Too much money is spent on understudying other countries to learn how they formulate polices, but this is done without regard for our peculiar circumstances, feedbacks from stakeholders and our culture.
Our policy statements appear to have been copied from foreign countries and they are meant to be implemented unprocessed in this country.
The members of the elite leveraging our cultural software to implement their campaign of looting and plundering by adopting policy frameworks that are not easily adaptable as a deliberate strategy for personal enrichment to the detriment of the society at large.
A sound policy is a deliberate system of principles to guide decision and achieve rational outcomes. Policies are generally adopted by the highest decision-making body in an organisation or government, whereas procedures or protocols emanating from policies are developed by the middle level officers.
Polices assist in subjective and objective decision making in such a way that results can be objectively assessed. Policy differs from the rules or law. While law can compel or prohibit behavior, policy merely guides actions toward those that are most likely to achieve a desired outcome. Policies can, therefore, be understood as political, management, financial and administrative mechanisms arranged to reach explicit goals.
A mental health policy, in context, defines the vision for the future of the people’s mental health and specifies the framework that will be put in place to manage and prevent mental and neurological disorders. When clearly conceptualised, a mental health policy can coordinate essential services and activities to ensure that care is delivered to those in need, while at the same time preventing inefficiencies in the health system according to a WHO document.
A mental health plan is a pre-formulated and detailed scheme to implement the vision and objectives defined in the policy. The plan should include concrete strategies that will be implemented to tackle mental disorders and associated disability, as well as specifying the targets to be achieved by the government. It should also clarify the roles of the different stakeholders in implementing the plan. It is therefore not a private document.
Our nation still operates by the ordinance of the pre-colonial years, yet with so much mental health burden. The Nigeria population is exploding with potent factors that impact negatively on our mental health. Our experience of terrorism, which has left many people homeless and traumatised, prescribes that mental health should assume a status of full-fledged department rather than a desk in all tiers of government. On this page, we have raised several issues beyond the narrow clinical paradigm of mental illness and mental health.
Developed countries are adopting concepts of mental capital development where mental well-being is viewed as a prime resource for national development. Unemployment, homelessness, dysfunctional family, terrorism, socioeconomic challenges, education, reproductive health, gender issues, culture, religion, political instability, stigma, alternative practitioners and many more are crucial issues that a strong mental health policy should address.
The mental health situational analysis and needs assessment must be broad enough to explore these issues. There should be a facilitation of inputs from the stakeholders rather than just consulting the experts.
Effort should be directed at improving the capacity of metal health systems and services to ensure their effective utilisation. The current paradigm of viewing health as a crucial component of development agenda holds that development is not only infrastructural but crafting of programmes and strategies that enhance the utilisation of available effective services such that the people can take ownership.
Intervening between the teeming population and the services is our culture, which must be thoroughly interrogated and adapted as vehicle for policy formulation and implementation.
Also, embedded in our culture are certain liabilities that can frustrate the western orthodox approaches but paradoxically offers unique opportunities for intervention. Policy should construct pathways of care based on synergy worked out by the major stakeholders. It is disturbing that our National Health Insurance Scheme has not made a very generous accommodation for the care of the mentally ill, which is a violation of a major principle of setting up the scheme designed to get the rich to pay for the health care of the vulnerable poor. The state governments have not done fairly well in developing sound policies for mental health, despite the fact that they interface with the real burden of mental health directly.
Source: Medical World Nigeria