Mental illness, Expert advises urgent consultation once signs, symptoms are noticed

Dr Maymunah Kadiri is a Neuro-Psychiatrist & Mental Health Advocate. The multiple award winning health expert, in this intervie, points out the challenges of mental health and how Nigeria can get it right. Excerpts:

As a consultant, what solutions do you proffer to manage mental illnesses in society?

The importance of proper awareness cannot be over-emphasized in the management of mental illness. We must ensure that people understand the various causes of common mental illnesses which can then reduce stigma and discrimination. Stigma still plays a huge role in reducing the likelihood of health seeking behaviors and it also negatively impacts the quality of care being offered by health care workers and these have negative effects on the society in general. 

As soon as signs and symptoms are noticed, one should go see a physician who can then make appropriate referrals. Another key solution is in the keen diagnosis of these issues. Misdiagnosis play a role in the mismanagement of illnesses and this means that treatment is impeded because one is treating the wrong disorder. Likewise, there is a pressing need to increase the number of educated and qualified personnel such as psychiatrists, psychologists, psychotherapists and counsellors. People need therapy and medication. 

The World Health Organization has reported that Nigerias health system especially the mental health sector is morbidly understaffed and this means that despite the teeming number of individuals with mental health challenges, there is a dearth of professionals. 

We must also find ways to incorporate mental health first aid into our primary health care system to curb this bottleneck so they can take on the treatment of mild cases. Lastly, we must push for preventative mental health care wherein we focus on how we can equip members of society with assertive and resilience training, as well as encourage health-seeking behaviors to ensure that as much as possible, mental illnesses do not occur regularly. 

What kind of ways would you like the government to set up in handling cases of suicide?

A national suicide prevention strategy is recommended. This is important because it indicates a governments clear commitment to prioritizing and tackling suicide. The government needs to utilize a multi-agency approach which involves support from various stakeholders, advocacy from loved ones who have lost someone to suicide, links to wider global health policy. They can engage sectors such as different ministries, health administrations, nongovernmental and nonprofit organizations, universities, civil society at different levels (national, regional, state or provincial, and community) among others.

The government must focus on the ‘why’ and not the ‘how’. They must take steps to target the reasons which propel people to die by suicide. There is a pressing need to tackle issues such as problem drinking, especially through alcohol brief interventions delivered in primary care, accident and emergency services and antenatal care settings, and increased attention to the identification and treatment of depression in primary care. The biggest policy is for the government to pass the Mental Health bill into a Mental Health Act. This is important because currently our laws support the fact that when someone or a Nigeria tries to kill him/herself, it's better to die than to live. This is because if the individual survives, he /she will be charged and sentenced to jail which can take up to a year. This is cruel and totally inhumane for someone who may already be dealing with an emotional or mental illness. 

In what ways can reporting suicide cases be improved on?

Studies have shown that close to 800 000 people die due to suicide every year, which is one person every 40 seconds. Suicide is a global phenomenon and occurs throughout the lifespan. Effective and evidence-based interventions can be implemented at population, sub-population and individual levels to prevent suicide and suicide attempts. There are indications that for each adult who died by suicide there may have been more than 20 others attempting suicide. Also, for the fact that suicide remains a sensitive issue, it is very likely that it is under-reported due to stigma, criminalization and weak surveillance systems.

Some ways reporting suicide cases can be improved are, to encourage setting up National Suicide Prevention Hotlines so that individuals can reach out if they need help or can also seek assistance if a loved one is in dire need of attention. National Suicide Prevention Record for proper documentation, research to show the trend and this can help in the adequate planning for suicide prevention strategies. Laws can be enacted to ensure that individuals who attempt suicide are not prosecuted or penalized. This will encourage individuals to reach out and seek help without fear. 

Finally, there is a need to de-stigmatize suicide. As we increase awareness, we must consistently lead with our voices on the message that it can happen to anyone irrespective of age, gender or socio-economic status.

Are you satisfied with the way the society treats suicide attempt cases? Also, state your reasons? 

No. Suicide is often treated with banner of silence, like it does not exist or it does not happen. This narrative is false and must be expelled. It is necessary for us to continue to raise awareness of the etiology of suicide and talk about the ways in which we can prevent it. The stigma of isolation and discrimination is still ever present in the lives of the attempter, family members and loved ones. It is necessary that we embrace them, have empathy and continue to support them. We must reiterate that no one is to blame when someone attempts suicide and rather we must seek ways to tackle the individuals problems either through therapy or medication, increased social support and continuously reaching out to remind them that they are indeed loved and worthy. Again, to abolish the law that penalize or criminalize suicide those that have attempted suicide.

What activity or activities do you have for World Mental Health? 

The month is packed with activities and we are excited about the collaboration and support we have received so far.

We are organizing an online mental health virtual summit with theme: Suicide: Survive, Thrive & Advocate from 21st - 25th October, 2019. This will be done via a series of short videos in which we will be collaborating with influential individuals within the Nigerian community to speak on different topics regarding suicide and its prevention. A one day training on Saturday, 26th October, titled Mental health first Aid Training on Suicide Prevention will round up the week. 

In addition, there will be a focus on training stakeholders within the community to advocate for destigmatizing mental health and encouraging individuals to seek help when dealing with suicidal ideation. This will be done as we are partnering with other NGOs to strengthen our reach within the country and continue to push the message across.

We will also be organizing talks at the grass root levels with a suicide awareness talk with the traders and members of the general public. 

To mobilize a wider outreach, we plan to utilize our social media platforms such as Instagram and Twitter to put out regular posts and tweets over the course of the month. Also, are the various radio and television talk programs.

Already existing is the opportunity for individuals to engage with psychologists/psychotherapists in the Little Drops of Happy Hub every Friday, which is a free walk-in counseling program that is focused on enlightening the society and allowing those in need receive free counseling from experts.

 We also use this medium to implore Nigerians to support this MOVEMENT because so many people need help, but don't have the finances. We need support from concerned Nigerians and corporate bodies so we can pay our dedicated therapists helping us, subsidize the prices for subsequent sessions and their medications for those in need.

What are your general tips for staying mentally healthy?

If its not broke dont fix itright? No! One of the best methods of mental health recovery is to maintain an environment prone to mental health and mental illness recovery. Staying mentally healthy is a way of life, not something you do when things start to go wrong. Keep reading for your top 10 tips to staying mentally healthy! Remember sometimes, the best treatment is prevention.