LAGOS, WORLD HEALTH DAY AND MENTAL HEALTH
Adeola Salako
The 2017 World Health Day, celebrated on April 7, has come and gone. But the talking point of the international day tagged: “Depression: Let’s Talk” would stay with us for a long time to come. Coming at a time when suicide is on the front burner in our nation, the theme could not be more apt and timely. The 2017 World Health Day was hence a clarion call and a rally-point for action on the mental disorder called depression.
As a mega city with over 21 million people, Lagos is not in any way exempted from the challenges associated with the rising incidences of depression and other mental health issues. Recently, the news mill has been agog with alarming incidences of successful and failed suicide attempts in the metropolis. The situation is further worsened by an economy in the throes of a galloping inflation and a country in the midst of its worst recession in its checkered history. With joblessness, homelessness and helplessness at an all-time high, mental health has understandably become a source of public health concern.
It is pertinent to note that mental health disorders impose an enormous disease burden on societies globally. Mental disorders also come with grave economic consequences. As a condition that cuts across race, age or sex bracket, depression affects an estimated 400 million persons worldwide. (That is more than the size of Africa’s three most populous countries -Nigeria, Egypt and South Africa)
Lack of support for people with mental disorders, coupled with a fear of stigma prevents many from accessing the treatment they need to live healthy, productive lives. Feelings of gloom and doom, loss of interest in life and living, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration are some of the symptoms that come with depression, which can be mild or severe. Globally, more than 300 million people of all ages suffer from depression. Though depression is not gender sensitive, more women are said to be affected by depression than men.
Depression, which can be long-lasting or recurrent, substantially impair an individual’s ability to function at work or school or cope with daily life and can have devastating consequences for families, friends, communities and workplaces. In its most severe form, depression can lead to suicide. The good thing is that, when minor, people can be treated without medicines but when depression is serious they may need medication and professional help.
As a government that prides itself in setting high standards to live up to the social contract with the citizenry, the Lagos State Government has not taken the matter lightly. The first course of action taken years ago was the establishment of a Mental Health Advisory/Stakeholders’ Group to conduct a situation analysis of Mental Health and available services in the state proffer innovative solutions and map out an implementation plan for reducing the burden of mental health problems in Lagos. This think tank is made up of academicians mainly from Department of Behavioral Science LASUCOM, policy makers, NGOs, researchers, clinicians and service users.
Not resting on it oars, Lagos State then launched its Mental Health Policy in 2012 to provide for the care of the mentally ill and provide the avenue for evidence based intervention that will be used to make care available to a huge portion of those in need. The Mental Health Policy has six policy streams that fill the current vacuum in Mental Healthcare, improve capacity of human resources and ensure collaboration and partnership with local and international stakeholders.
A Mental Health Desk Office has also been established and headed by Dr Dolapo Fasawe, a senior official of the State Ministry of Health as advocated by WHO. It is noteworthy that Lagos state is the first to do this in the entire Federation. Subsequently, the State hosted the first Livable City Conference with the theme: “Preparing for the Mental and Social Health Needs of the Lagos Mega City” which had participants from all walks of life. From this conference, a communiqué was developed, among other things, to serve as a guide in the development of State programs and interventions to address the Mental and Social Health needs of residents of the Centre of Excellence.
Following this, the Ministry of Health, in tandem with relevant MDAs of government began aggressively working on repealing and replacing the existing Mental Health Law to meet current global realities. This bill is presently at an advanced stage, and with renewed efforts, the law should be presented as an executive bill to the Lagos State House of Assembly soon.
Likewise, the Ministry of Health also commissioned a Mental Health Survey for Lagos State to generate data for planning mental health services. The Lagos State Mental Health Survey (LSMHS) was initiated to assess the types, patterns and severity of common mental health problems among citizens of Lagos State. With data collected from over 11,000 adult residents of Lagos, this study reveals a rate of clinically significant common mental disorders including anxiety, depression, suicidal ideation, alcohol and psychoactive substance use disorders and disability.
Recently, with the support of the Ministry of Health, the mental health experts from LASUCOM got funding from Grand Challenge Canada to activate the implementation of one of the streams of the Lagos State Mental Health Policy focusing on capacity building of Human Resources for Health to provide Mental Health Services. This policy stream specifically seeks to align with the WHO recommendation of integrating mental health into primary health care as the 9thcomponent of Primary Health Care.
The project is now in its Transition to Scale Phase, where the State is training about 800 health care workers from the 57 Flagship Primary Healthcare Centres to identify and manage common mental disorders like depression and anxiety. There is also ongoing training on dealing with psychiatric emergencies like aggression and suicide. The ongoing training of health workers in the PHC focuses on how to spot signs of suicidal ideation in patients and provide guidelines on what to do. The State Government is thus poised to ensure treatment of depression and other common mental disorders in all its 57 top PHCs.
More importantly, Lagos State has come up with help lines – 08058820777 and 09030000741 – through which Lagosians can ask questions, make enquiries and seek help from professionals early enough to allow for appropriate intervention.
The full import of the speech of Mr Jide Idris, Lagos state commissioner for Health at the press briefing to commemorate the World Health Day thus carries a deeper meaning when he said: “The vision of this administration is to build a State that works for all, where every citizen can excel, be productive, actualize their dreams without fear of danger, and live long healthy lives by encouraging healthy lifestyles and creating access to qualitative healthcare and ensuring universal health coverage. In the context of the right to health, this is a premium good that every responsive government must ensure in line with her social contract with the people.” Now that’s a vision worth living for.
