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The burden of mental disorders is increasing worldwide, thus, affecting society and healthcare systems. Mental health issues are now at the forefront of global public health discourse. In this regard, the 2019 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) explored some mental health conditions that were considered paramount in this discourse. These included depressive disorders, anxiety disorders, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, eating disorders, and idiopathic developmental intellectual disability.
Another study on the mental health burden within the same period, 2019, examined the epidemiological and economic impact of the global burden of mental disorders in terms of the impacts on human health and losses to societal welfare. The researchers estimated that 418 million disability-adjusted life years (DALYs) which is equivalent to 16% of the estimated global DALYs in 2019 was attributable to mental disorders; this was a more than three-fold increase compared to conventional estimates. The economic value associated with this burden is estimated at about USD 5 trillion.
Mental health issues need to be appraised and addressed both at the macro and micro levels. At the macro level, the systems approach needs to be adopted. Ultimately, serious mental health problem would require the expertise of qualified mental health professionals in diagnosing the condition and providing the appropriate therapy where needed. At the micro-level a decentralized mental health delivery system is needed. Unfortunately for Nigeria, the treatment of mental health conditions has been centralized and restricted more or less to the few psychiatric hospitals dotted across the country.
This brings to the fore the fact that many people living in the rural or semi-urban areas of the country with mental health conditions are to a large extent disenfranchised from accessing mental health care and services by reason of their geographic location. Considering the high costs of building and adequately equipping mental health facilities in low and middle-income countries such as Nigeria, as well as staffing these facilities with the requisite numbers and cadres of mental health caregivers for country with a large population such as Nigeria, it has been argued that mental health services should be decentralized.
To this end there has been calls for the integration of mental health into primary care in Nigeria thereby leveraging the primary health care system to deliver mental health services at the community level5 It should be commended that the government of Nigeria adopted this policy however its implementation has been flawed.
We at MEDELA are in full of this decentralization policy for mental health as a veritable strategy for bringing mental health services to those who really need the services but are constrained by financial or geographic access. However, to translate policy into action there Should be a deliberate commitment by the government to seek collaboration with local NGOs and CBOs that work at the grassroots with communities to drive this initiative.
MEDELA, as part of contribution in the global fight against this emerging public health problem that has been largely overlooked for decades, has set up a mental health help portal covering the following mental health issues: depressive disorders, anxiety disorders, bipolar disorder, schizophrenia, autism spectrum disorders, attention-deficit hyperactivity disorder, eating disorders, compulsive disorders, and dementia.
Our mental programme includes a fee-online mental-risk assessment for the 10 priority mental health conditions and a referral pathway to health provider for counseling and treatment where necessary. The mental health portal can be accessed by anyone simply by logging in to our website: www.medela-ng.org, to take the risk assessment test. Depending on the risk score, the individual can then be advised to see a health care provider for follow up care. The Medela website also has a repository of reference material on mental health literacy and health education on how to prevent or avoid triggers of mental issues such as depression, anxiety, substance use etc. as well as mental health promotion.
In addition to the on line service, MEDELA is also exploring the option of collaborating with other NGOs working on mental health issues in Nigeria to promote advocacy for increased government support for mental health promotion as well as community engagements to create awareness and address mental health challenges including myths, taboos and stigma about mental health issues at the grassroots level.
It is worth noting that that extensive research has been done to demonstrate the success and cost-effectiveness of various pharmacological and psychosocial treatments for mental disorders. In this regard, the focus for MEDELA is on how to support efforts at translating these evidences into policy and practice by giving impetus to the creation and strengthening of the enabling environments for improving the uptake of these treatment and preventive services through our advocacy and community engagement intervention strategies within the population so as to slow down the tide of this epidemic of mental health disorders.
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