by Rachel Ogbu

The country is generally short of physicians and, with a population of over 120 million, has less than 100 psychiatrists.

The bulk of psychiatric service is provided by the eight regional psychiatric hospitals and the departments of psychiatry in 12 medical schools. A number of general hospitals also provide psychiatric services. Despite these facilities, mental health care remains inadequate, with the ratio of psychiatric beds being about 0.4 to 10 000 persons, while that for both psychologists and social workers is 0.02 to 100 000 persons (World Health Organization, 2001).

As part of our #IssueofTheWeek, here is a list of registered mental health centres in Nigeria.

The Federal Neuropsychiatric Hospital, Kaduna.

The hospital is reputed for parading facilities and sophisticated equipment rated as best in Nigeria.

The Federal Neuro-Psychiatric Hospital (FNPH), Maiduguri was established in 1995 along with four (4) other new Federal Neuro-psychiatric Hospitals in accordance with the National Mental Health Policy of the Federal Government of Nigeria. Our services took off in September 1999; hitherto, under the supervision of the University of Maiduguri Teaching Hospital, Maiduguri.

Over the years we witnessed remarkable transformation that has since elevated FNPH-Maiduguri, one of which is the accreditations by the West African College of Physicians and the National Postgraduate Medical College of Nigeria in 2001; to train resident doctors in psychiatry. Another accreditation also was granted the hospital by the Nursing and Midwifery Council of Nigeria in 2002 to train psychiatric nurses.

Federal Neuro-Psychiatric Hospital, Uselu

In 1964, the old Iyekuselu Districk Council Maternity/Dispensary located in Uselu was acquired by the Mid-Western regional government and the Psychiatric Unit was moved in and named Nervous Disease Clinic, Uselu.The Nervous Disease Clinic started with the acquired three dilapidated buildings giving accommodation to eight (8) in-patients and rendering out-patients services for both psychiatric and physical ailments.The hospital which became popularly known as Uselu Clinic took off on Monday, 7th December, 1964, under the supervision of dr. N. O. Azinge, a specialist physician in the absence of any psychiatrist.

This was the only psychiatric hospital in the mid-western region (later Bendel State and now Edo State).In October, 1975, the Federal Military Government took over the hospital from the then Bendel State Government. An interim Management Board for Neuro-psychiatric Hospitals under the Federal Ministry of Health was inaugurated in 1977 and the name Nervous Disease Clinic, Uselu was changed to Neuro-Psychiatric Hospital, Uselu, Benin City.

The name was again changed to Psychiatric Hospital, Uselu, Benin City, by Decree No.42 of 1979 which established the Psychiatric Hospitals Management Board.

The Board was dissolved in 1994 during the military regime and remained so unitl the current civilian regime. The incumbent Medical Director is Dr. (Mrs) Olabisi. F. Ihenyen, who assumed office in October 2003.

Neuro Psychiatric Hospital Yaba

Psychiatric Hospital, Yaba came into existence on October 31, 1907 when the hospital was set up as an asylum under the British Colonial rule. The first batch of 48 inmates were admitted in a disused Nigeria Railway Building in Yaba.
Over the years, the hospital has witnessed four developmental stages. The first stage, (1907  1950) was purely asylum state. The function of the hospital was custodial i.e. keeping the mentally ill away from the society. During this period, there were padded cells and drugs such as paraldehyde, mist alba etc were prescribed by the doctors and administered by the asylum attendants. There were no nurses, no beds and beddings, no uniform and no form of psychiatric treatment. However, medical doctors from the Ministry of Health paid occasional visits to give minimal treatment.. The buildings were dilapidated and the inmates lived in appalling sanitary conditions. It was truly an asylum and its name at that time was the Yaba Lunatic Asylum.

The second stage (1951  71) witnessed the arrival of qualified psychiatrists, nurses and pharmacist. There was an outpatient department and it also marked the beginning of Occupational Therapy in the hospital. The name of the institution was changed from asylum to Yaba Mental Hospital. This stage marked the beginning of the progressive development of the hospital as emphasis shifted to therapy in which apart from tranquilizers, EOT and deep Insulin therapy were used. During this period,

The third stage saw the introduction of qualified psychiatrist. At this time, although buildings were still substandard, treatment then was the best and the name changed from mental hospital to Psychiatric Hospital. During this stage more professionals like nurses and pharmacists started working in the hospital. The Out Patient department was established and Occupational therapy was well developed.

The fourth stage marked the coming of the first female psychiatrist in Nigeria as the medical director of the hospital. It witnessed the beginning of improvement in the infrastructure and treatment in the hospital. Postgraduate training for resident doctors in Psychiatry also began during this period

The Neuropsychiatric hospital, Aro, Abeokuta

designated by the World Health Organization in 1979 as the WHO Collaborating Centre in Research and Training in Mental Health and Neuroscience, selected by the Federal Government of Nigeria as one of the 7 specialty hospitals in Nigeria to be rehabilitated and equipped to a 5-star status, categorized as a 3-star service provider in 2008 by SERVICOM for acceptable quality service delivery, awarded a National Honour as the best Specialty Hospital in 2007 by the National Council on Health, one of the twenty resource centres in the world for the UNODC/TREATNET project, a complex institution situated in two locations, Aro and Lantoro.

The hospital at ARO occupies a landmass of 274.75 acres and has 226 beds distributed over 5 Wards; while Lantoro annex sits on 69 acres and has 300 beds distributed over 9 Wards.

Given the limited number of these hospitals, their catchment areas often go beyond their immediate location in terms of city or even state.

Other Mental health hospitals and centres include; the Federal Psychiatric Hospital, Calabar Road, Calabar, Federal Neuro-Psychiatric Hospital, Chime Avenue, New Haven, Enugu, Federal Neuro-Psychiatric Centre, Kware, Synapse Services: Centre for Psychological Medicine, Abuja, and the Lagos State Psychiatric Hospital, Yaba.

Nigeria’s mental health policy was first formulated in 1991 and includes the following; components: advocacy, promotion, prevention, treatment, and rehabilitation. These components are addressed in the following manner:

• Persons with mental, neurological and psychosocial disorders having the same rights to treatment as individuals with physical illnesses.

• Integration of mental health into general health care services at all levels of healthcare

• Ensuring comprehensive coverage through delivery of mental health services through primary health care.

• Appropriate training of mental healthcare personnel

• Intersectoral collaboration to be fostered with the aim of improvement quality of life

• Promotion of healthy attitudes and positive socio-cultural attributes particularly among youths

• Elimination of stigma through the promotion of positive attitudes towards the mentally ill in the general population

• Use of appropriate preventive therapeutic and rehabilitative measures to reduce the problems of alcohol and drug abuse

• Special care to be provided to different disadvantaged minority groups in the community

• Encouragement of NGOs in the promotion, preventive and rehabilitative aspects of mental health services

• Collaboration with appropriate international organizations with relevant objectives

• Periodic review of legislation governing the care of the mentally ill.

• Encouragement and funding of mental health related research