Dr. Olawale Lagundoye is a consultant psychiatrist and Executive Director of the foremost private psychiatric hospital in Nigeria and West Africa, The Retreat: Therapy Redefined, located in Ikorodu, Lagos State. Lagundoye in a chat with journalists said noise pollution, stress, sitting in traffic, generators, poverty and other social vices are fueling mental disorders in Nigeria. He, however, recommended early identification and timely treatment by providing quality psychological and medical interventions in a specialized mental care facility. CHUKWUMA MUANYA (Assistant Editor) was there.
Who is mentally ill? Or rather when can one be described having mental problem?
The commonest mental disorder is anxiety, depression and stress related conditions. Those tend to be the commonest. Another 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 is an area I am 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 societies that are not paid attention to. Alcohol uses, prescription drugs like codeine, cough mixtures, people talk about cannabis but yes it is 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 also the non-intended consequences. That is one of those things we need to be aware if in the society about illness but that tends to be neglected because it will impact on the immediate family, relatives or the economic potential of the individual, which will impact on 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.
Why has mental health become a big issue now? Why did you major in mental health?
If you look at healthcare provision across Nigeria generally, you will discover the development and expansion but it is slower in the mental healthcare. And that highlight some of the societal challenges in terms of helping people to see mental illness when we see a madman on the street and then we realize something has gone wrong with him but what we know is that there are a whole means of mental health condition like noise pollution, stress, sitting in traffic, generators, poverty and other means. Those things can manifest into mental illness. The key challenges are those mentioned are either not identified or when identified, people do not know where to go to access healthcare timely. And I want to emphasize the word ' timely manner' because that's very important in mental healthcare delivery. Timely is what we are after by providing quality psychological interventions alongside medical intervention. My interest in psychiatry started early in my career whilst a medical student.
You mentioned some of the factors that can trigger mental illness, can you give us instance if how they can affect individual?
Talking about environmental factors which have to do with the quality of an individual, like I emphasize that as an individual what is more important is the relationship with the external world and the relationship in a work environment. And what we discover is that individual getting drawn into one aspect or the others regard themselves. The fact that making provisions for themselves. Like the sound of generators, noise population in particular, that can affect the pattern of sleep, and the quality of sleep and that can impact in an individual mental health condition. Lifestyle in cosmopolitan region like Lagos for example, we wake by 4am, go to work by 6am, and returning home at about 10, 11pm in the night, which causes some of the stresses that we are talking about.
Mental treatment is quite expensive. Do you have plans to make your services affordable? What impact is it to the general public and why is that it is located in Ikorodu axis of Lagos state?
One of the things that you will discover is that while coming here, you cannot 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. As regards cost, we have what provides in the range of proximity. We provide the opportunities for individual like we have the open wards and we have the executive facilities. We provide a whole range of treatment. The key thing to remember that it is a purposely-built private, which is an important milestone when we look at the health standard across the country.
How affordable is the treatment here?
It is extremely affordable. We provide all services for our different patients.
How about indigent people? Do you have any plans to assist people of low class to access mental care?
We engage in the local communities. We will be seeking and working in collaboration with other organization to do that. And importantly I will talk about recovery. When you look at recovery, I use the term recovery capital. For anyone with mental illness, what should be asked is, what is it for anyone that has received treatment to be able to maintain the treatment, which includes engaging the wider community. Yes we are located in Ikorodu Lagos but our service is across Nigeria.
What makes this centre different? What novel services do you render in this place?
Our vision is to provide personalize private and dignified care in a therapeutic and serene environment. We provide a range of service. We offer screening for common mental condition, we provide patient consultation, assessment, we provide treatment in terms of pharmacological that's medication and as well psychological non pharmacological intervention which involves working with a therapist, psychologist and we have a range of therapy assistance. A patient is exposed to multitude of professionals.
'The Retreat' is really a retreat. It is 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.
What kind of equipment edge do you have here?
We use standardize therapeutic tools, and we uses modern medication. Patients will have access to our programmes. They will have in individual intervention, patients will have personalised treatment and at the time of discharge, they will have a discharge plan.
Security is a very big issue now in Nigeria. Can patients here be assured of their safety?
We are engage in the local enforcement agents. We have secure premises with a 24 hours security; we have Closed-circuit television (CCTV) coverage across the facilities.
Are you into any kind of partnership with any centre?
We have a number of them, like that in Yaba in Lagos; Aro in Abeokuta, Ogun State; and Lagos State Teaching Hospital, but we are here to compliment them and it is important to emphasize 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. Those who want a bit more privacy, they want to be placed in an appropriate setting, they want to be out of the general setting. We do work in collaboration with local psychiatrist and 98 percent of our staffs 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.
Stigmatisation has been a big issue as regards to mental health. Anybody with any kind of mental disorder or have visited a psychiatrist centre is often stigmatized. 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 and educating the public. Those are key milestones, which has 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 emphasizing a therapeutic environment, psychological interventions treatment and recovery, as a key milestone will contribute towards getting message on stigmatization.
How best can an average Nigerian take care of his or her mental health issues?
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 individual to assist them using the forum that is in existence.
How long have you been in operation?
We opened two months ago. So far, when one is opening a new facility, part of what is to be done is training of staffs, putting in place mechanism and system. So part of the initial opening is dedicated to induction of staffs and providing packages and programs for them and slowly, we have started to see that people will take advantage of the facility we got here.
Do you have partners you work with?
Dr. Oluwafemi Oluwatayo is my colleague and partner. He is a consultant in rehabilitation. What we do is a merge of unique operation to provide a coloration intervention.
Do services here meet international standard?
Different countries have different standards, there is what we call nationalise standards. That is aim at delivery services to a particular standard across the spectrum conditions. From our perspective, that is what we are aspiring like having a comprehensive assessment, physical examination, physical and social means of individuals then taking into account what happens beyond our hospital which is actually makes us a unique opportunity in providing that that level of care in the therapeutic environment.
We use standardize therapeutic tools, and we uses modern medication. Patients will have access to our programs. They will have in individual intervention, patients will have personalize treatment and at the time of discharge, they will have a discharge plan.