"Mental health is not a luxury, but a necessity. It is not a choice, but a right. It is not a matter of charity, but of justice." -- Dr Tedros Adhanom Ghebreyesus, Director General, World Health Organisation (WHO)
World Mental Health Day 2023: 'Mental Health as a Universal Human Right'
The theme for this year's World Mental Health Day -- 'Mental health is a universal human right' emphasises that everyone has a right to the highest attainable standard of mental health care. The World Federation for Mental Health, which chooses the theme every year, calls for urgent action to ensure that everyone can exercise their human rights by accessing quality mental health care, if the need arises. In Nigeria, one of the most important ways to achieve this goal is to integrate mental health care into primary health care (PHC), to ensure increased accessibility.
Suffering from a mental health issue should not be grounds for denying an individual their fundamental human rights or for excluding them from participating in decisions regarding their health. Globally, people with mental health disorders face various violations of their human rights, when they engage with society. They often face exclusion from their communities, experience discrimination, and encounter difficulties in accessing essential mental healthcare.
In some situations, their care may even infringe upon their human rights. Prior to its replacement, the Nigeria Lunacy Act of 1958 empowered medical practitioners to detain people suffering from mental illnesses and admit them into asylums without offering treatment. Fortunately, the National Mental Health Act 2021 was signed into law with the goal to "Promote and protect the fundamental human rights and freedom of all persons with mental health conditions and ensure that their rights are guaranteed," prioritising patient care.
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Integrating primary health care with mental health
Only approximately 15% of people with severe mental illnesses have access to mental health care in the country. While Nigeria's political commitment to improving mental health care is commendable, the true realisation of the objectives outlined in the National Mental Health Act 2021 can only be attained when people have equitable access to mental health services.
However, there is a significant gap in the country's current Mental Health Act, with no clear policy for integrating mental health care into PHCs nationwide. As a result, many people who require mental health services are unable to access them at the primary care level, and if they are referred to secondary or tertiary facilities, these are often far away, expensive or inadequate. In addition, health workers are not trained to provide mental health care or to identify and refer cases that require specialised care.
This gap must be addressed urgently if we want to ensure that mental health is a universal human right and a priority in PHC care in Nigeria.
Our Mental Health, Our Priority
We can ensure that everyone has access to mental health care services by integrating mental health care into PHC. It should not be limited to the privileged or unfortunate few who are presumed insane. To attain Universal Health Coverage, everyone in the country should be able to access high-quality mental health care services.
Nigeria is at a crossroads in its journey to improve mental health care for everybody. It is time to focus on eradicating stigma, increasing access to care, and empowering people to seek help when they need it.
