|Posted on:||Thursday, 11th May, 2017|
Mental health conditions are a leading cause of disability, yet CBM is one of very few development organisations prioritising them. Philip Ode, the Project Coordinator at the Comprehensive Community Mental Health Programme (CCMHP) for Benue State, Nigeria describes the effective and collaborative solutions that CBM are supporting to address this serious need.
Stigma, neglect and abuse
“Most people with psychosocial disabilities in Nigeria have difficulty living with their conditions in society. There are human rights abuses like keeping them under lock and key by their families so they won’t associate with others in the community. Children with intellectual disabilities are not sent to school and employment opportunities are often denied to adults. Worse is the growing sexual abuse of women and girls with psychosocial disabilities, and yet no action is taken to address these issues. They aren’t recognised as a vulnerable group by the government and other development partners.
People with mental illnesses lose hope about the future and are living life one day at a time.
The negative attitude of communities is one of the main challenges to overcome. Mental health and psychosocial disabilities are generally perceived as spiritual, and often seen as a punishment for wrong-doing. That’s why most people showing signs of mental illness, especially in rural communities, will be taken first to a traditional healer, or religious leader.
If someone with a condition like schizophrenia behaves in destructive or aggressive ways, then holding them against their will is considered normal. Harsh treatments can follow like beating, burning, cutting, and ostracising in the name of curbing their excesses. Many people with severe mental illness end up in prison, if their families haven’t coped with their behaviour because treatment hasn't been available.
A nationwide need
There is a real lack of professionals to help- just one psychiatrist to 1 million people in Nigeria. That's a huge gap between those who need treatment and those who can get it . The few treatment centres that do exist are mainly in urban centres that are often distant from rural communities, and lack residential care. For those who are seen by a doctor, the soaring cost of imported drugs means essential medication is often not affordable for the time it is needed.
Mental health is a low government priority, but community mental health now seems to be the adopted strategy for scaling up access to care and treatment. From the mid-2000s pilot projects have been introduced in South-West, South-East and Middle-Belt regions of Nigeria.
Bringing joy and hope: CBM’s medical and social care plan
CBM’s aim has been to improve the quality of life of persons with psychosocial disabilities through its own Comprehensive Community Mental Health Programme (CCMHP) in Benue State. CCMHP’s model for change integrates quality mental health services into government structures, and promotes social inclusion through empowerment activities and peer-to-peer support
I became involved at its inception in 2011 when I was recruited as Project Coordinator.
It wasn’t easy from the outset. But with concerted efforts and working with CBM and other local and State collaborators and beneficiaries, CCMHP has established mental health services in 45 primary health centres across the state, serving over 12,000 clients. Community health workers and general nurses have been trained to identify and manage common mental health conditions themselves or refer advanced cases to hospitals with consultant psychiatrists. At the same time a drug supply scheme has been put in place to provide easy access to good quality essential psychotropic medications at affordable prices .
Supporting self-help community groups has been another priority. A record 774 service users and their carers have been part of advocacy initiatives that have raised awareness and promoted the rights of the mentally ill within society. As part of the economic strengthening of households, CCMHP’s empowerment activities also provide vocational skills, and seed grants for business startups. This has boosted the incomes of service users and their families who previously had little or no resources to help fend for themselves.
Persons with mental illness and their families have witnessed tremendous improvements in their health conditions thanks to CBM and CCMHP’s interventions.
They can now be useful to themselves and society. These service users and their families have expressed joy and happiness to me over such milestones.
One of the many lives transformed
One man who had always been in and out of treatment and who thought his condition was a result of a spiritual attack started accessing treatment when CCMHP established mental health services in his community in 2013. With our help he got involved in the setting up of a self -help group in his community and was elected as chairperson.
Over time his involvement in events with others with psychosocial disabilities has boosted his self-esteem and he is now General Secretary of a confederation at state-level that co-ordinates the activities of local groups. As a result of all this he became increasingly confident in himself and facilitates advocacy in support and care for people with psychosocial disabilities in Benue State.
He was able to start a business using the loan that he accessed from his local group and he freely participates in societal life. Today, he is happily married and blessed with a child.”