Abstract
Mental and neurological disorders are common in the primary health care settings. The organization of mental health services focuses on a vertical approach. The northeast as other low income regions has weak mental health services with potentially huge mental health burden. The manner of presentations and utilization of these services by the population may assist in determining treatment gap. We investigated the pattern and geographical distribution of presentations with mental disorders and explored the linkages with primary care in northeastern Nigeria over the last decade. A retrospective review of hospital-based records of all the available mental health service units in the region was conducted over a decade spanning between January 2001 and December 2011. A total of 47, 664 patients attended available mental health facilities within the past decade in the northeast. Overwhelming majority (83%, n = 39,800) attended the region's tertiary mental health facility. A substantial proportion (30%, n = 14,440) had primary physical illness, while 18%, n = 8606, had primary neurologic disorders. The commonest physical comorbidity was hypertension (4%) and diabetes (2%). A significant proportion of the populace with mental disorders appeared not to be accessing mental health care services, even when it is available. Meaningful efforts to improve access to mental health services in the northeast region of Nigeria will require successful integration of mental health into primary and general medical services.
Highlights
Mental, neurological, and substance use (MNS) disorders account for an estimated 14% of the global burden of disease [1, 2]
Evidence suggests that the burden of mental and neurological disorders predominates in the primary health care settings [4]
Mental disorders are known to appear with different somatic presentations in primary care settings with features of neurological disorders and contribute significantly to the hidden burden of mental diseases [5]. 25% of primary care patients have unrecognized mental health disorders
Summary
Neurological, and substance use (MNS) disorders account for an estimated 14% of the global burden of disease [1, 2]. These disorders result in direct economic costs of mental health care and indirect economic costs from lost productivity, impaired functioning, and premature death [3]. Mental disorders are known to appear with different somatic presentations in primary care settings with features of neurological disorders and contribute significantly to the hidden burden of mental diseases [5]. Scaling of mental and neurological health care services which is advocated especially in middle and low income countries to address the needs in primary care settings requires adequate specialist manpower [9]
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