SOUND MENTAL HEALTH AND AKWA IBOM CHALLENGE

The increase in social vices within Nigerian society, particularly since 1989, is a concerning trend that
has also impacted Akwa Ibom.

Drawing from my nearly four decades of experience in mental health practice, both in Nigeria and
internationally, especially in the United Kingdom, I can provide insights into the significant impact of
mental health on our society. Although this brief note cannot cover the topic comprehensively, I am
prepared to explore it in detail in the future if need be.

It is unfortunate that the government and the public, particularly in African societies, often fail to
recognize that the brain governs both body and mind. Dysfunction in the mind can lead to
psychosocial issues, causing substantial damage to human lives and material resources. The
government’s tendency to prioritize physical health over the vital link between mental well-being
and overall health is regrettable. A sound mind is crucial for a sound body, and when mental health
is compromised, it distorts behaviour and reality perception, affecting individual welfare and societal
fabric.

Regrettably, the importance of protecting mental health and psychological well-being is often
overlooked, contributing to the deterioration of Nigerian society. The widespread mental instability
calls for urgent and unified efforts to implement measures that address these detrimental
behaviours and attitudes.

Our Society is experiencing swift changes, with human behaviours adjusting to a constantly changing
environment. In today’s challenging world, as class disparities grow, so does the drive to succeed.
Consequently, the quest for livelihood opportunities has become unyielding, leading some to adopt
unethical practices, which have become the unfortunate by-product of these challenges.

The recent Global Health Report indicates that nearly 970 million people globally are dealing with
mental illness or substance abuse issues. Alarmingly, one in four individuals will face a mental health
challenge at some point in their lives. Furthermore, mental disorders are responsible for a significant
share of global mortality, accounting for 14.3% of deaths worldwide, or about 8 million deaths each
year.

Therefore, my aim in presenting this information to the government is not to undermine the value of
existing curative measures, which I acknowledge as necessary. Instead, my focus is on a proactive
approach to prevent mental health issues. While the existence of a psychiatric hospital in Eket is
notable, it is crucial to evaluate its integration, collaboration, adaptation, and competitiveness with
modern preventive strategies. Currently, this facility does not participate in collaborative preventive
initiatives, as it is primarily focused on curative measures, yet there is more to be done in
contemporary terms. It is clear that the prevalence of positive mental attitudes is waning, while
aggressive behaviours are on the rise in our society. This shift is stark when comparing today’s
society with that of the 50s, 60s, 70s, and 80s. Nevertheless, it is not too late for a turnaround,
provided there is a firm commitment to change. Human behaviour and mental well-being need to be
fostered, and I am confident that Akwa Ibom has the resources and capacity to turn negatives into
positives.

Professionally, I take pride in my role as one of the founding staff members of the Psychiatric
hospital in Eket during its transition from a unit within Immanuel General Hospital. This change took
place in 1988, after we returned from Calabar following the creation of Akwa Ibom State in 1987. At
that time, the state government showed no intention of establishing a dedicated psychiatric
hospital. To the best of my knowledge, such a facility has not been realized, apart from the existing
structure initially constructed by Immanuel general Hospital, which was primarily intended for
maternal care. If the Government of Akwa Ibom State has built a purposeful Psychiatric Hospital, it is
not within my awareness.

In the early days of Akwa Ibom state, a small group of us, passionate mental health nurses, were
deeply concerned about the mental and psychological well-being of our fellow residents. We took
the initiative to create a space for mental health care, borrowing five beds from Immanuel general
Hospital’s management when it became clear that the government was not prepared to budget for a
Psychiatric Hospital, nor were there discussions to consider establishing a suitable facility for mental
health care.

I remember the initial resistance from our community, which strongly protested against the
establishment of a mental health facility due to the stigma attached. Nonetheless, a few of us were
determined to educate and sensitize the community, which eventually led to the establishment of
the current Psychiatric Hospital, initially within a unit borrowed from Immanuel General Hospital in
Eket.

After persistent efforts, the Akwa Ibom government recognized the need and legitimacy of our
cause, culminating in the official commissioning of what is now known as the Psychiatric Hospital in
Eket by our former Governor, the late Obong Akpan Isemin, in April 1992. I clearly remember that
following the commissioning, the late Professor Thomas Adeoye Lambo, OBE, a Nigerian scholar,
administrator, and psychiatrist who was then the deputy director-general of the World Health
Organization (WHO), visited the hospital in either 1992 or 1993. During his visit, he offered
scholarships for two psychiatric nurses working there to be sponsored annually for postgraduate
studies in the UK for the duration of his lifetime. Unfortunately, this never materialized as the
ministry of health did not follow up for reasons unknown. There was also a request from the late
Professor Lambo to the hospital to set up a ward in his name, so he could return to equip it, but this
too did not come to fruition.

Understanding the complex relationship between mental health and society is crucial. The social
environment can significantly influence an individual’s mental well-being, while an individual’s
mental health can profoundly affect social relationships and community health.

Social determinants of mental health include a variety of social, economic, cultural, and
environmental factors that determine mental well-being outcomes. These determinants cover issues
like poverty, unemployment, discrimination, and social isolation. For example, those dealing with
poverty or facing discrimination may be at increased risk for mental health problems such as
depression, anxiety, and arguably aggression, which is a major contributor to high social vices in our
society today.

Culture and diversity have a significant impact on mental health stability. Cultural beliefs, values,
religions, and customs play key roles in shaping an individual’s view of mental health issues and their
approach to seeking and receiving mental health support, sometimes in unsuspecting and unethical
ways.

Access to mental health treatment is crucial for those facing mental health challenges.
Unfortunately, many barriers prevent people from getting the help they need, from financial and
geographical limitations to cultural differences, religious beliefs, and notably, ignorance—especially
in African societies. Nonetheless, I firmly believe that Akwa Ibom state can set a positive example
and make strides in overcoming these obstacles.

When individuals face mental health challenges, it can obstruct their engagement in education,
leading to absenteeism or poor academic performance. Moreover, it may impair their ability to
reason and complete tasks at work, resulting in unexplained absences and reduced productivity.
These difficulties can lead to substantial economic costs and, in some instances, may even lead to
criminal behaviour and the relentless destruction of property and lives through the use of physical or
psychological means. Morality appears to be a casualty.

Unfortunately, in African societies, the stigma of being labelled as “mad” is often based solely on
overt behaviours, such as public nudity. It is crucial to understand that this view is markedly different
from that in developed societies and even our own modern society, where mental health is
recognized as a complex issue that goes far beyond simple outward behaviours.

Consider individuals who maintain a polished exterior yet engage in behaviour that starkly contrasts
with societal expectations. For example, psychopaths, who are characterized by their callous,
unemotional, and morally corrupt traits, independent of their social standing. These individuals
often display self-centered, antisocial behaviour, devoid of remorse or empathy, and frequently
engage in criminal activities. They typically view rules as optional and laws as obstacles rather than
moral guidelines.

The range of criminal activities associated with psychopaths varies widely, from minor traffic
offenses to grave financial crimes, acts of violence, and deceit. They often commit perjury, theft, and
other acts that undermine justice with seeming impunity. Many operate covertly, partaking in
dubious business dealings or unethical conduct that, while not always resulting in legal
consequences, can create a harmful domino effect. This can detrimentally affect the physical and
mental health of others and have a significant impact on the economic progress of communities and
society at large.

The way forward lies in integrating a positive mental and behavioural developmental model.
To prevent further deterioration of the situation, it is critical that both the Government and Akwa
Ibom society take proactive and intensive steps now, in line with modern global mental health and
social care standards. Addressing the growing number of vagrants and delinquents, as well as
protecting the younger generation, including kindergarteners, from adopting these negative traits, is
essential.

Long-term incarceration in correctional facilities and other security institutions is not the ideal
solution. Individuals who defy the law, regardless of their social class, often have attitudinal
problems that they have adopted due to a lack of understanding of their mental shortcomings.
There is an urgent need for widespread modern psychiatric and psychological care to restore our
society to an acceptable level of morality.

It is a clear fact that immediate action is needed to prevent and mitigate social vices. The
responsibility for tackling this issue should not fall solely on our security agencies, despite their
laudable efforts. They are dealing with the outcomes of a system that has overlooked mental
education for too long. Although their current methods are valuable, they are insufficient to curb the
rise of social vices. Thus, it is crucial to promote diversification and collaboration in transforming the
current narratives by effectively implementing the following urgent preventive measures if they
have become inactive; I advocate for a sincere revival with comprehensive inclusivity.

I urge the government of Akwa Ibom State to consider incorporating into its ‘A.R.I.S.E’ agenda the
establishment of a comprehensive system for promoting mental health. This should include mental
health education, early detection of mental illness, intervention, prevention strategies,
rehabilitation, and collaborative efforts, specifically through:
a. Introducing Early Child Psychology Education from primary to secondary levels, if not already in
place, by implementing a dedicated psychology program in schools, ensuring access to qualified
psychologists, and redesigning the curriculum to instil good moral values and an understanding of
the consequences of negative behaviour from a young age.
b. Hiring and assigning Social Workers to educational institutions, hospitals, and primary healthcare
facilities, if this has not yet been considered.
c. Appointing Psychiatric Nurses and General Nurses in educational institutions and establishing
Mental Health Assessment and Liaison Units in every hospital.
d. Integrating Health Educators into educational institutions, primary healthcare units, and hospitals.
e. Creating Outreach Teams composed of Mental Health and General Nurses, Psychologists,
Occupational Therapists, Social Workers, and other specialists for awareness, monitoring, and
guidance.
f. Reinforcing the communication team tasked with actively promoting ‘ethical and attitudinal re
orientation’ in practical terms.
g. Establishing support groups consisting of psychiatric nurses, social workers, and health educators
in all government offices, councils, and villages to assist those seeking help during times of mental
health uncertainty and direct them to the appropriate collaborative network for further action.
h. The employment of psychiatric doctors and consultant psychiatrists, rather than general
practitioners, is pivotal to the revolutionary advancement of modern mental health care provision in
AkwaIbom State.
i.Recognizing the necessity to construct a modern psychiatric hospital. (Neuro Psychiatric hospital)
J. Possible establishment of Forensic Mental Health Hospital to cater for those who has come in
contact with criminal justice system as a result of mental/psychological issues.

In conclusion, the collaborative creation and integration of supportive environments into human
development can lead to extraordinary and unparalleled outcomes. Imagining our children growing
up with the correct mindset is not merely conceivable but a likely result. Moreover, there is a
possibility for beneficial transformation even for those negatively impacted by unethical attitudes
and behaviours, which can contribute to advancements in both economic and human development
metrics. Indeed, the saying “prevention is better than cure” is apt in this context.

By Mr. Uwemedimo Jumbo
Forensic Mental Health Practitioner, UK