On World Mental Health Day on 10 October 2019, Qatar-headquartered news organisation Al Jazeera focused on Nigeria.
In an online report with the headline ‘Nigeria includes a mental health problem’, the broadcaster made several claims. In July 2019, Al Jazeera also reported that will Nigeria had a “mental health crisis”.
In an effort to improve the accuracy of public debate on mental health in Nigeria, often an under-reported topic, we checked the accuracy of several claims made inside most recent report.
One in four Nigerians are suffering coming from some sort of mental illness.
Al Jazeera attributed This specific statistic to the entire world Health Organization, estimating the share at “some 50 million people”.
Africa Check contacted Al Jazeera for the source of the report’s claims, along with were told that will the item was against Al Jazeera’s policy “to provide external organisations detailed breakdowns of its public along with proprietary sources”.
“The information can be factually correct, along with you are welcome to independently verify the item,” the report’s author said. We turned to the WHO, which also raises awareness on mental health internationally.
What can be mental illness?
Mental illness, sometimes referred to as mental disorders, “comprise a broad range of problems, with different symptoms,” the WHO says. nevertheless they are generally characterised by some combination of abnormal thoughts, emotions, behaviour, along with relationships with others.
Examples include depression, schizophrenia, intellectual disabilities, along with disorders due to drug use. Most of these disorders can be treated, the international health agency says.
For data on Nigeria, Dr Mark van Ommeren, the mental health coordinator at the global health agency, referred us to the WHO Collaborating Centre for Research along with Training in Mental Health, Neurosciences & Drug & Alcohol Abuse at the University of Ibadan.
Prof Oye Gureje, who can be the director of the centre, told Africa Check that will the largest nationally representative study on mental health in Nigeria was published in 2004.
Titled Prevalence, Severity, along with Unmet Need for Treatment of Mental Disorders inside entire world Health Organization World Mental Health Surveys, the item was carried out in several of Nigeria’s six geopolitical zones in 2002.
In a sample of 6,667 people aged over 18, the item was found that will one in eight Nigerians had had a mental illness in their lifetime. The most common were depression along with anxiety disorders.
There can be no newer data coming from the WHO to show that will one in four Nigerians have suffered coming from a mental illness.
There are only eight neuropsychiatric hospitals in Nigeria.
We were unsuccessful in finding an official definition of a neuropsychiatric hospital. Peter Ajiboye, professor of psychiatry at the University of Ilorin Teaching Hospital, told Africa Check that will a neuropsychiatric hospital can manage both behavioural along with some nervous disorders, such as epilepsy.
“More psychiatric hospitals are right now using the name neuropsychiatric hospitals. This specific can be a way of fighting the stigma that will comes with the word psychiatric hospital,” he said.
There are eight federal neuropsychiatric hospitals in Nigeria, according to the health ministry. This specific number can be accurate, Emeka Akpa, the administrative head of the Nigerian Medical Association, told Africa Check.
nevertheless there are three different state-run neuropsychiatric hospitals in Nigeria, Dr Joyce Omoaregba, a senior consultant at Edo state’s Federal Neuropsychiatric Hospital along with secretary-general of the Association of Psychiatrists in Nigeria, told Africa Check.
These are in Port Harcourt, Ondo state along with Anambra state.
Nigeria has Africa’s highest rate of depression.
Al Jazeera said This specific was according to the WHO. Country-level estimates on depression rates can be found inside health agency’s 2016 Global Health Estimates. The most recent data can be coming from 2015, Allison Brunier, a WHO spokesperson, told Africa Check.
For depressive disorders, Nigeria does hold the continent’s highest number of cases, at 7,079,815. nevertheless as a share of the population, at least 24 different countries in Africa have a higher rate of depression than Nigeria’s 3.9%.
The top several are Cape Verde (4.9%), Lesotho (4.8%), Botswana (4.7%), Ethiopia (4.7%) along with South Africa (4.6%). Some 47 African countries are covered by the data.
Nigeria ranks fifth inside entire world inside frequency of suicide.
The frequency of suicide can be the number of suicide cases in a year along with can be measured per 100,000 of the population, Dr Joyce Omoaregba, a senior consultant at Edo state’s Federal Neuropsychiatric Hospital told Africa Check.
The WHO has previously told Africa Check that will for comparisons between countries, age-standardised rates are the most appropriate. (Note: The organisation does not Discharge rankings along with cautions against This specific partly due to concerns over data accuracy.) The health agency’s most recent data shows that will Nigeria’s age-standardised suicide death rate was 17.3 suicides per 100,000 people in 2016. This specific places the country 15th inside entire world.
The South American country Guyana has the highest frequency of suicide inside entire world, at 30.2 suicides per 100,000 people.
There are less than 150 psychiatrists in This specific country of 0 million.
In a 2013 national policy document on mental health services, Nigeria’s health ministry also made This specific claim.
According to the Association of Psychiatrists in Nigeria, there are 250 psychiatrists registered to the item, along with 0 psychiatry trainees. All psychiatrists working in Nigeria must also be listed with the association, secretary-general Joyce Omoaregba told Africa Check. Despite some Nigerian psychiatrists moving to different countries, their estimate still holds, he said.
Mental health professionals in Nigeria face several challenges leading many to leave the country, according to Gabriel Onyeama, an associate professor of psychiatry at the University of Nigeria.
These include poor physical environments along with weak conditions of service. In addition to improving these, the government should train more professionals, Onyeama said.
WHO estimates that will fewer than 10% of mentally ill Nigerians have access to the care they need.
This specific estimate can be coming from a WHO survey, Prof Oye Gureje told Africa Check. He can be director of the WHO Collaborating Centre for Research along with Training in Mental Health, Neurosciences & Drug & Alcohol Abuse at the University of Ibadan.
the item was coming from a study on mental health published in 2004. “the item can be a finding showing that will those with severe forms of anxiety along with depression along with substance abuse rarely get any treatment for their conditions,” Gureje said.
“different studies show that will probably a higher proportion of those with psychosis get treatment, nevertheless mainly coming from traditional along with faith healers – along with that will the treatment can be often inappropriate along with inhumane.”
In a November 2019 report international advocacy organisation Human Rights Watch highlighted the mistreatment of people with mental health conditions in Nigeria.
Yaba Psychiatric Hospital had a 2018 budget of N133 million (US$372,000) – nevertheless only N13 million ($36,000), or less than 10% of that will amount, was released by the federal government.
According to the 2018 appropriation bill released by the national assembly, Yaba Psychiatric Hospital in Lagos was allocated N3.3 billion, or $10.7 million at the official exchange rate. (Note: The hospital can be also known as the Federal Neuropsychiatric Hospital.)
Another N134 million was set aside for ongoing construction along with different projects.
There can be however no detail inside 2018 budget implementation report coming from the national budget office on how much eventually reached the hospital. The hospital’s management also declined to share This specific information when contacted.
By 2018, Nigeria had allocated just 3.95% of its budget to funding its ministry of health.
In Nigeria’s approved 2018 budget of N9.12 trillion, some N356.45 billion was allocated to the health ministry.
This specific works out to 3.91% of the allocated budget, according to documents coming from the country’s budget office.
In previous years the budget share was higher. In 2015, the health share was 4.24% of the budget, in 2016 the item was 4.1% along with in 2017 4.17% – or N304 billion.
Every week, at least 12 doctors leave Nigeria to seek employment inside UK.
Drawing attention to the number of doctors coming from Nigeria leaving for different countries, Al Jazeera said the country was losing at least 12 doctors every week to the United Kingdom, citing data coming from the UK’s General Medical Council.
The General Medical Council can be responsible for registering doctors along with setting professional standards for all doctors working or training inside UK. Its registry does not make explicit whether doctors are coming from a country different than the UK or when they arrived inside UK, nevertheless does record the “place they were awarded their main medical degree”.
On 7 November 2019, there were 310,527 doctors inside register, a 10.9% increase coming from the 280,000 doctors listed when we last checked on 25 April 2018.
The number of doctors whose primary medical qualifications were obtained coming from Nigeria rose by 1,742 – coming from 5,250 to 6,974 in those 18 months. This specific means that will on average 22 Nigeria-trained doctors were added to the doctors’ registry every week, higher than Al Jazeera’s figure.
Nigeria has an estimated physician-patient ratio of one doctor to every 4,000 to 5,000 patients.
The physician-to-patient ratio can be a “flawed metric” due to the difficulty of approximating the number of patients at any given time, Prof Lukoye Atwoli told Africa Check in June 2018. At the time, he was dean of the School of Medicine at Kenya’s Moi University. Due to This specific difficulty, most reports will use the doctor-population ratio as a proxy for coverage.
The Medical along with Dental Council of Nigeria regulates the practice of medicine, dentistry along with alternative medicine in Nigeria. For over a year, Africa Check has unsuccessfully requested data on the number of doctors in its register.
Nigeria’s population can be also controversial, with the last published official estimate showing a population of 193 million in 2016. The UN’s population division estimates the population as 0.9 million as at 1 July 2019.
In April 2019, the president of the Nigeria Medical Association, Dr Adedayo Faduyile, was widely quoted as saying “40,000 doctors were taking care of 0 million people”.
Fayudile told Africa Check that will every doctor in Nigeria can be a member of the organisation. Using his figure, the doctor-to-population ratio can be between 1:4,800 along with 1:5,000, depending on which of the two population estimates can be used.
… [This specific can be] six times smaller than the physician-patient ratio (one physician to every 0 doctors) recommended by WHO.
Nigeria’s doctor-to-population ratio can be widely cited, along with can be often compared to the WHO’s “recommended ratio”. As we explained in May 2019, This specific “recommended” ratio can be nonexistent.
Dr Mathieu Boniol, a WHO statistician, has previously told Africa Check that will the agency has not prescribed any ideal ratio of any kind of healthcare worker to a population.
The WHO might have published some estimates for research along with comparison purposes, nevertheless “a country’s number of healthcare workers should be adapted to its needs along with the characteristics of its national health labour market”, Boniol said.