Universal Health Coverage and Healthy Living in South-East Nigeria: How Far with Mental Health?

Abstract

Background: Universal health coverage implies access to key promoting, preventive, curative, and rehabilitative health interventions for all at an affordable cost, thereby achieving equity in access and service. The mentally-ill belongs to a vulnerable group that has not been given adequate attention especially in the south-eastern part of Nigeria. In September 2015, a health summit was organized in Enugu, South-East Nigeria with the sole aim of strategizing towards achieving universal health coverage in the zone. From all indications, much of the efforts being made towards achieving universal health coverage in the zone are geared towards physical conditions with mental disorders being grossly neglected.

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

“…Even if people obtained NHIS, these plans only cover care at certain federal hospitals and do not cover drugs that are not on the essential drug list of Nigeria, which excludes many common psychotropic medicines (e.g., SSRIs) [ 51 ]. NHIS plans also do not cover care provided by clinical psychologists, social workers, and occupational therapists, and they also do not cover mental health services such as psychotherapy and addiction clinics [ 24 ].…”

“…Social distance and isolation are the most common attitudes, and traditional (unorthodox) medicine is a major treatment preference [ 23 ]. There are also stigmatizing beliefs and myths that perpetuate the idea that mental disorders are untreatable [ 24 ]. Stigmatizing and negative attitudes toward mental disorders and people with mental illness are also common among health care professionals in Nigeria, which can adversely impact the therapeutic alliance and clinical outcomes [ 16 , 25 , 26 ].…”

Integrating mental health into primary care: Evaluating the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

“…SSRIs) [43]. NHIS plans also do not cover care provided by clinical psychologists, social workers, and occupational therapists, and they also do not cover mental health services such as psychotherapy and addiction clinics [20].…”

“…In Nigeria, there are high levels of self-stigma among Nigerians with a mental illness in addition to stigma at the community level [18,19]. Mental illness is commonly believed to be something that should be concealed by the bearer and cannot be effectively managed once the mentally ill person begins to roam the streets and marketplaces [20]. Stigmatizing and negative attitudes toward mental disorders and people with mental illness are also common among health care professionals in Nigeria, which can adversely impact the therapeutic alliance and clinical outcomes [13,21,22].…”