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Practicing As A Mental Health Professional in Nigeria

The Nigerian society's dismissive nature towards mental health issues makes mental healthcare inaccessible to those in need. For Mental Health Awareness Week 2021, we talked to Ibifubara Davies, a Psychologist and Research Analyst living & working in Lagos, Nigeria, about the state of mental healthcare in Nigeria and what progress can be made to undo this grave situation.

It is no secret that for a healthy and well-functioning life, the health of both mind and body is imperative. However, despite the wealth of knowledge available to us, a large section of Nigerian society actively shuns conversations on and around mental health. This, in turn, makes mental healthcare inaccessible as those in need are either restricted by religious and cultural barriers or cannot obtain such help due to a shortage or lack of qualified professionals.

This apathy towards mental health care is worrisome when you consider that a significant percentage of the population has suffered or is suffering from mental health-related problems. According to a 2016 study published in the Annals of Nigerian Medicine (ANM), approximately 20-30% of the Nigerian population suffer from mental disorders. In 2017, the World Health Organisation (WHO) put the number at about 50 million, roughly a quarter of the population. In addition, the growing insecurity, financial uncertainties due to a failing economy and the Covid-19 pandemic have exacerbated this problem by putting further strain on the minds of Nigerians.

Ibifubara Davies is a Psychologist and Research Analyst living and working in Lagos, Nigeria. She has worked with organisations that focus on helping survivors of sexual trauma and PTSD get back on their feet. She is dedicated to providing good mental health care to young Nigerians and is looking forward to getting a doctorate in Physiological Psychology in a few years. For Mental Health Awareness Week 2021, she talked to B.Side about mental healthcare in Nigeria, the highs and lows of being a mental health professional in Nigeria and what she thinks we can do to save an increasingly grave situation.

Hello Ibifubara, thank you for talking to us. For starters, what do you enjoy most about your job?

I really enjoy the moment when people that were closed off start to open up. Sometimes the clients themselves don’t know that this is happening yet, but right there, the healing process begins, and it’s so refreshing to watch.

And what do you dislike about it?

I give so much of myself, my expertise, my knowledge in therapy sessions. Often in real life, I have no energy left to feel anything. My job can be so overwhelming and draining.

What mental health or mental health problems do you usually face? Do you have a stereotypical type of patient? Or do you get people with varying issues?

Depression, anxiety, Post Traumatic Stress Disorder (PTSD), ADHD are the issues I focus on for now as they are what my clients face. There is no stereotypical type of client. Believe me when I say no two clients are the same. Everyone’s case is unique, and that’s one of the things that makes my job exciting. Clients can be diagnosed with the same disorder. For example, two people can be diagnosed with depression with symptoms that can be almost identical, but how it presents itself usually differs.

What are the challenges you face as a mental health professional in Nigeria?

Nigeria on its own is a problem. A lot of things do not work in your client’s favour. From scattered government systems to traumatising family institutions and lack of opportunities to be their best selves. You help your client get through a particular situation. At the end of the day, the one thing they need to reach their goals during treatment is almost impossible because of the environment they find themselves in, and you’re going in circles trying to figure out an alternative for them. Being a psychologist in Nigeria is pretty tasking; you have to develop unique culturally sensitive treatment plans to help your client. Suppose the government is not trying to undo the job you’ve done. In that case, the physical or mental health institution is not working effectively with you because they are unable to. So, I would say broken systems are the challenges I face. From family, religion, education to the government, everything is set in place for your client not to do well, and it is your job to help them figure out a way to push through.

How do you deal with false perceptions of mental health as a taboo in a place like this?

It’s frustrating. I have this mental health practitioners friendship group, and anytime issues online or offline come up that involve people with false perceptions of mental health issues or the talk of therapy being a taboo in this country comes up, it can be demoralising and sometimes feels like we haven’t gone anywhere with awareness or sometimes it feels like people are undoing the little work we have done. So, what we promised ourselves to do is show up, keep our heads high and most importantly, keep doing the work.

How do I deal? I change the narrative one client, one tweet, one post, one webinar, and one session at a time by showing up and doing the work.

What actions do you think would be effective in educating and changing such attitudes?

We need to integrate mental health education in school curriculums – just like what has been done for physical health education – to form a generation of mental health-conscious citizens. And for informal settings, mobilise community leaders to help in the education of people, especially in urban slums or rural areas, on the effects of everyday life on mental health and ways they can take care of

themselves. The government should improve mental health-related vulnerability assessment through population and health data. Also, without testimonies of good mental health care, many people are going to rely on the information they have about the present state of mental health facilities. Hence, the government has to make sure there is appropriate funding of the mental health facilities and workers should be vetted thoroughly and paid well.

Do you think we have made any progress regarding the societal acceptance of people with mental health issues in Nigeria?

Yes, I believe progress has been made, but we still have a long way to go. Though more people are coming out to talk about the mental health issues and their good and bad experiences with mental health care institutions, there is still a knowledge and action gap to be filled. Society still needs to learn a lot. From the correct mental health language to use to places where people can get help, more has to be done, especially outside the social media bubble.

Do you think that mental health problems are at an all-time high?

Yes, they are. First of all, this is due to demographic changes. There is also more exposure to things like social media. There is also an increase amongst millennials which I call “generation tired” because they are constantly overworking. This generation was taught that hard work would get them ahead, which results in them ignoring the signs of mental health issues. Also, because there is an increase in mental health awareness, more people are open with what they are dealing with. Hence, the increase in statistics. With that comes an increase in numbers. The more the world gets older, the more we are exposed to new things that can potentially affect our mental health in different ways.

There is a growing suspicion that this growth of mental health problems is linked to growing access to technology. Do you think this is true? Is technology is a major contributing factor to mental health issues in Nigeria?

Technology contributes to mental health issues in Nigeria in different ways, but this usually happens when it becomes overused. Many people feel very isolated while focusing more on online engagements than physical ones, but things like setting time limits for social apps can help reduce those feelings of isolation. Technology exposes people to negative social interactions and social comparison, leading to anxiety and depression, sleep deprivation, inability to complete essential tasks. You also can seldom control everything you see online, and that can prompt one’s psychological triggers.

On the other hand, however, technology has given us things like virtual therapy (teletherapy); this was especially useful during the height of the COVID- 19 pandemic and lockdowns when we couldn’t see clients physically.

Finally, it is Mental Health Awareness Week; what progress would you like to see in Nigeria regarding mental health?

Nigeria’s outdated mental health laws being reformed, starting from the Nigerian Lunacy Act (1958). I would also like to see more people practice psychology. Often, people talk about their bad experiences with therapy and their inability to find another therapist because of the shortage in the country. If more people practised, at least that problem would be half-solved. Ultimately, the aim is to make sure people get good mental health care.

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