Psychiatric Expert, Dr. Olawale Olagunjoye, is the Executive Director of the first private psychiatric hospital in Nigeria and West Africa, The Retreat. In this interview with Martins Ifijeh and Ayodeji Ake, he highlights causes of mental disorders including alcohol, poverty, stress and prescription drugs. He also talked on why he is starting the health facility
Why do you have interest in mental health?
If you look at healthcare provision across Nigeria generally, you will discover the development and expansion in the sector, but it is much slower in the area of mental healthcare. This therefore highlights some of the societal challenges in terms of helping people to see mental illness when they see a mad man on the street. We all assume something has gone wrong with the mad man, but what we don't know is that there are a whole means of mental health conditions like noise pollution, stress, sitting in traffic, noise pollution from generators , poverty, stress, among others contributing to the disorder.
Those things can manifest into mental illness, and a key challenge is that most people don't know where to go to access healthcare timely. And I want to emphasise the word 'timely manner' because that is very important in mental healthcare delivery.
Timeliness is what we are after by providing quality psychological interventions alongside medical intervention. But what actually brought me into this is that I developed mental disorder when I was in my first year in medical school which is a bit unusual but at a time, and I recognised that the challenge faced was stigmatisation.
You mentioned some of the factors that can trigger mental illness, can you give us instance of how they can affect individuals?
Talking about environmental factors which have to do with the quality of an individual, I like to emphasise that as an individual what is more important is the relationship with the external world and the relationship in a work environment. For example, the sound of generators, noise population in particular, can affect the pattern of sleep, and the quality of sleep and that can impact an individual's mental health condition.
Lifestyle in cosmopolitan region like Lagos for example can be a factor. We wake up by 4a.m., go to work by 6a.m., getting to work by 8a.m., and then return home at about 10p.m. or 11p.m., which causes some of the stress that we are talking about.
You are establishing a private psychiatric hospital, and we know that mental health treatment is quite expensive, how will your services be affordable, of what impact will it be to the general public?
One of the things that you will discover is that while coming here, you can't hear noise and we got fresh air here, we purposely chose here because we were looking for a therapeutic environment that is serene where we can provide healthcare for patients in a dignified means that takes into account the emotional needs of the patient.
As regards the issue of affordability, we have what provides in the range of proximities. We provide the opportunities for all shades of individual, for instance, we have the open wards and we have the executive facilities. The key thing to remember is why this private hospital is purposely built, which is an important milestone when we look at the health standard across the country.
To a layman, can you tell some of the services you render in this place?
We provide a range of services. We offer screening for common mental condition, provide patient consultation assessment, provide treatment in terms of pharmacological support, that is provision of medication, and as well psychological support, which is the non pharmacological intervention, and it involves working with a therapist, psychologist and therapy assistance . Patients here are exposed to multitude of professionals.
We have other mental institutions around, do you have any partnership with any of them in terms of services collaboration?
We have a number of publicly run services, they are not adequate. We have a number of them, like that in Yaba, Aro, LASUTH , but we are here to compliment them and it is important to emphasise that the public services provide a good level of care for patients within the country and we also have a range of patients who require more than what they can get in the public sector.
Persons who want a bit more privacy, those who want to be placed in an appropriate setting, or want to be out of the general setting find their way here. That is something the public sector will not offer. We do work in collaboration with local psychiatrist and 98 per cent of our staff are locally based, they are trained in supporting our vision which is delivery of high quality evidence based therapeutic interventions which is part of our commitment.
How long have you been in operation?
We opened two months ago. When one is opening a new facility, part of what is to be done is training of staff, putting in place mechanism and system. So part of the initial opening is dedicated to induction of staff and providing packages and programmes for them and slowly, we have started to see that people will take advantage of the facility we got here.
How can we reduce stigma attached to mental health?
Stigmatisation is actually a big issue worldwide. I have been fortunate enough to work at local and international services. Stigma exists across all strata of the society. In tackling stigma, you cannot have one approach, it needs various tactics from colleagues, government taking a systemic approach to help people understand the issue, as well as and educate the public. Those are key milestones which have to be an ongoing campaign making people aware that people get better, recover and work normally.
With my years of experience, I have worked with professionals who are at the severe level of the spectrum. In terms of approaching stigmatisation, we need a collective system of approach. We are emphasising a therapeutic environment, psychological interventions treatment and recovery. These are the milestones that will contribute towards getting message on stigmatisation.
Nigerians often regard mad people on the streets as only those with mental disorder. Are there other types of mental disorders?
The commonest mental disorder is anxiety, depression and stress related conditions. They tend to be the commonest. But there are others. One is sleep disorder which people seem not aware of. The important thing is early identification and early treatment. We have got this big area that we have not talked about which is addictive disorders. That's an area I'm quite passionate about.
Over the years, we got this unmentioned mental illness which is like the elephant in the room. We have got a range of addictive disorders in the society that are not paid much attention to. Alcohol use, prescription drugs like codeine, cough mixtures, people talk about cannabis but yes it's a problem in the society, there are other substances like lexotan. When we talked about stress, people will take lexotan when they have headache, or probably husband and wife having issues and then they go take some alcohol. Often, it is not only the condition but the non intended consequences. That's one of those things we need to be aware of in the society about illness but that tends to be neglected. Such illnesses impact on the immediate family, relatives or the economic potential of the individual which will in turn impact the society. What we really want to do is to bring the provision of global standard of care in the area of mental health treatment. We hope to serve as an anchor.
In the area of mental healthcare, what stands you out?
Our vision is to provide personalised private and dignified care in a therapeutic and serene environment.
How affordable is the treatment here?
It is extremely affordable. We provide all services for our different patients.
Do you have programme to assist people of low class?
We are engage in the local communities. We will be seeking and working in collaboration with other organisations to do that. And importantly, we take issue of recovery seriously. When you look at recovery, I use the term recovery capital. For anyone with mental illness, what should be asking is how are patients able to manage and maintain treatment. Yes, we are located in Ikorodu Lagos but our services cut across Nigeria.
What is your message to Nigerians in terms of taking care of their mental health?
The key message to Nigerians is that mental health conditions are quite common, majority of the mental health conditions are treatable and people should seek help at appropriate and competent places.
If you are to describe your hospital, what would you say?
'The Retreat' is really a retreat. It's a retreat in the real sense of taking you into a therapeutic environment where you will be treated with dignity and compassion. Equally where you will meet with competent therapeutic experts. We use standardised therapeutic tools, and we use modern medication. Patients have access to our programmes. They have access to individual intervention, personalised treatment, and at the time of discharge they will have a discharge plan.
On security here, we have engaged local enforcement agents. We have a secure premises with a 24-hours security , and a CCTV coverage across the facilities.
Do you have partners you work with?
I have a partner Dr. Oluwafemi Oluwatayo, who is a colleague. He is a consultant in rehabilitation. What we do is to merge unique operation to provide a coloration intervention.