Using e-psychiatry to Scale up Mental Health Services in Nigeria

Abstract

A recent primary care study in Nigeria revealed that psychiatric disorders were common, with unexplained somatic complaints occurring in 57.5% of respondents, depression in 50%, anxiety disorders 49.3%, primary insomnia 45.3%, and alcohol use disorder 11.3% [1]. Other studies indicate that a broad range of psychiatric disorders are seen in Nigeria including mental retardation, epilepsy, conduct disorders, substance abuse psychosis, affective disorders, substance abuse, sexual dysfunction among others [2-8]. One of the major challenges in treating mental illness in Nigeria is the dearth of mental health care facilities and mental health care professionals [9] with the result that about 70% of mental health service provision in Nigeria is delivered through non-orthodox means such as religious organisations and traditional healers [10]. In spite of this high prevalence, primary care practitioners have constraints in identifying about one-third of patients with mental health problems [11], for various reasons where the patients are able to make it to the hospital. Thus, the task of identifying and treating patients with psychiatric disorders falls on the mental health professionals. In 2006, the world health organization conducted a study in Nigeria in which the mental health facilities were assessed in six states in the six geopolitical zones of the country [12]. The study showed that the number of human resources working in mental health facilities in the surveyed states was 3,105. The number of professionals available to the population per 100,000 is as follows: Psychiatrists 0.15, other medical doctors 0.49, Nurses 2.41, Psychologists 0.07, Social workers0.12, Occupational therapists 0.05, and other health or mental health workers 8.03. Obviously from the foregoing, the number of professionals available cannot meet the needs of the populace, meaning there is a need to scale up the extent of the available mental health services. A national Literacy Survey conducted by the National Bureau of Statistics in Nigeria estimates the adult literacy rate as 56.9 percent, though with significant differences between states (Lagos 92.0% and Borno only 14.5%), regions (urban 74.6% and rural 48.7%,) and gender (male 65.1% and female 48.6%) [13].