“Most young people who self harm do so in response to intense emotional pain or a sense of being overwhelmed by negative feelings thoughts or memories”
Lawani Ambrose
The World Health Organization (WHO) in its constitution defined health as follows; “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. WHO further defines mental health as a “State of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. From the foregoing it is obvious that there can be no health without good mental health. The 1999 Nigerian Constitution as amended guarantees the right to health for its citizens.
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The theme for the October 10, 2018 World Mental Health Day is “Young people and mental health in a changing world”. The United Nations defines the youth as persons between the ages of 15 and 24 years. The Young Persons Act of Nigeria states that childhood ends at 14 years. The Webster’s dictionary defines the word youth as the time of life between childhood and maturity. An adolescent is an individual within the age bracket of 10 and 19 years. About 23% of Nigeria’s population is made of persons aged 10 to 24 years.
According to WHO, “half of all mental illness begins by the age of 14, but most cases go undetected and untreated”. The primary aim of the 2018, World Mental Health Day theme is to improve the awareness of the public about emerging issues that can have negative impact on the mental health of young persons.
Life events such as job loss, bereavement, change of schools, communal strife and conflict, incarceration, and illegal migration e.t.c negatively impacts the mental health of young persons. Drug abuse and the wide spread inappropriate use of technological devices also negatively impacts the mental health of young persons. Illicit drug use among young person leads to risky behaviours such as unsafe sex, dangerous driving, suicide, e.t.c. According to WHO, suicide is the second leading cause of death among 15-29 year-olds and 78% of global suicide occurs in low and middle income countries. Rohan Borschmann et al, in their article on self-harm and suicide in young people define “self harm” as any intentional behavior that causes damage, mutilation or destruction of the body without suicidal intent. They also report that “most young people who self harm do so in response to intense emotional pain or a sense of being overwhelmed by negative feelings thoughts or memories”.
Each historical period in Nigeria has been reported to be associated with peculiar patterns of drug abuse among young persons. The pattern of the 1960’s and 1970’s were mainly characterized by the use of Cigarettes and Alcohol. Young persons in Nigeria currently abuse Cannabis and other extremely potent dependence producing substances like Cocaine, Heroin, Tramadol, Codeine e.t.c. The recent ban on the importation of some of these psychoactive substances can only be a short term solution as the possibility of purchasing some of these substances online cannot be ruled out. Some household products are currently been abused by young persons in Nigeria because of the feeling of euphoria (“high”) that they derive from the use of such substances. In the light of the foregoing a holistic strategy must be conceptualized to combat the menace of drug abuse amongst young persons in Nigeria.
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The widespread inappropriate use of technological devices in Nigeria brings to the fore the emerging phenomenon of cyberbullying and its adverse effects on the mental health of young persons. Young persons in Nigeria should be armed with basic information on how to prevent cyber bullying especially as regards what they post online (photographs and messages e.t.c), who they communicate with online and how they ensure the integrity of the password to their social media accounts especially while using public technological devices.
Early intervention services for young persons who develop mental illness should be made accessible. Seamless linkage with services should also be provided as they become adults. Majority of the institutions that provide professional mental health care services in Nigeria are located in the urban areas and young persons with mental illness residing in rural areas have to overcome some logistic challenge before they present in such institutions for treatment. For the records payment for mental health care services in Nigeria is still largely by direct out of pocket payment. Only very few Non Governmental Organizations (NGO’s) exists to crusade for improved care of mentally ill young persons in Nigeria.
Another unsavory report is the poor budgetary allocation to mental health care in Nigeria. WHO posits that low income countries like Nigeria invest less than 1% of their health budget on mental healthcare. Giving effect to the spirit and letter of Primary Health Care that incorporates mental health as its ninth component will improve access to mental health care for all and reduce the stigma associated with the illness. Lagos State and few other States in Nigeria are blazing the trail by making mental health care services available at the Primary Health Care level. Other States should take a cue from them. Government needs to exercise the political will to ensure that the Mental Health bill is enacted. WHO avers that Mental Health Legislation serves as a key component of good governance, especially concerning issues related to protection of the human rights of the mentally ill, involuntary admission, professional training for mental health workers and the framework for service delivery.
The Federal Ministry of Health should conceptualize culturally appropriate and evidence based strategies for identification of issues that constitute a challenge to the mental health of young persons in Nigeria. Such strategies should be multidisciplinary and multisectoral. The teacher training curricula in Nigeria should be redesigned to enable Teachers to identify early signs of mental illness in students who are young persons.
In conclusion Government, Non Governmental Organizations, Community Based Organizations and Religious Organizations have a role to play in ensuring that the population of young person’s ready to take over as leaders at different levels and tiers of government in Nigeria is not compromised by the burden of mental illness amongst young persons in Nigeria. Only mentally stable young persons in Nigeria can be beneficiaries of the recently enacted Not Too Young To Run Bill.
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Ambrose, a Psychiatrist writes in from Benin City Edo State via [email protected]