NIGERIA’S worsening insecurity, economic hardship, poverty and weak access to healthcare are taking a heavy toll on citizens’ mental health, Professor Taiwo Obindo has warned.

Obindo gave the warning while delivering the 126th Inaugural Lecture of the University of Jos, titled “Mental Health, the Ombudsman of the Whole-Body System: No Health Without Mental Health”.

The professor of Psychiatry said the pressures confronting Nigerians had gone beyond what could reasonably be described as normal stress, citing insecurity, kidnapping, violence, unemployment, underemployment, rising living costs, poverty, substance abuse and increasing healthcare costs as factors placing people under prolonged psychological pressure.

He said persistent stress could undermine both mental and physical health, particularly when people lack adequate social and psychological support.

Obindo expressed concern over Nigeria’s severe shortage of mental health professionals, saying the country has fewer than 250 psychiatrists, about 900 clinical psychologists and approximately 1,400 psychiatric nurses serving more than 230 million people.

He estimated the country’s mental health treatment gap at over 90 per cent, meaning that most people who require appropriate mental healthcare do not receive it.

The situation, he said, has been aggravated by the migration of health professionals and the concentration of mental health services in urban centres.

According to him, more than 65 per cent of Nigerians live in rural areas, while about 75 per cent of mental health facilities and professionals are concentrated in metropolitan areas.

He said the imbalance forces rural families to spend more on transportation, treatment and accommodation, while relatives caring for patients may also lose income by leaving their jobs.

The psychiatrist argued that mental health should be treated as an economic priority as well as a medical concern.

He noted that mental health conditions often begin early, with more than 34 per cent beginning before age 14 and more than 62 per cent before age 24, according to figures presented in his lecture.

Obindo said early onset can disrupt education, employment and productivity, making investment in prevention, early intervention and accessible treatment economically worthwhile.

He also warned that untreated anxiety and depression can contribute to absenteeism and presenteeism, reducing workers’ ability to function effectively even when they remain at their duty posts.

Obindo highlighted maternal mental health as another major concern, citing studies conducted in North Central Nigeria which found that postpartum depression can affect up to 20 per cent of new mothers, with first-time mothers at greater risk.

He said the consequences can extend to their children, potentially affecting emotional development and increasing the risk of later mental health problems. He therefore called for mental health screening to be integrated into routine postnatal services.

The professor described stigma as one of the major obstacles to effective mental healthcare, saying, “If mental health is the ombudsman, then stigma is the corruption that prevents the ombudsman from doing its job.”

He identified self-stigma, courtesy stigma and institutional stigma as major forms of discrimination that can discourage people with mental health conditions from seeking treatment, leading to social withdrawal and functional disability.

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Obindo described mental health as an “ombudsman” that helps coordinate the emotional, cognitive, behavioural and biological aspects of an individual’s wellbeing, citing research linking mental health to conditions affecting the gastrointestinal system, heart, reproductive health and other parts of the body.

He also drew attention to the psychological burden faced by people living with neglected tropical diseases such as leprosy, lymphatic filariasis and Buruli ulcer, who suffer both the physical consequences of disease and the psychological effects of stigma, depression and social exclusion.

He said research involving mental health interventions and livelihood support showed improvements in wellbeing and reductions in anxiety, depression and stigma among affected populations.

The professor called for full implementation of Nigeria’s National Mental Health Act 2021, describing the legislation as a major shift from the old asylum-based approach towards humane, rights-based and community-orientated mental healthcare.

He expressed concern over delays in implementing the law and establishing the structures required for effective coordination of mental health services.

He also disclosed his involvement in efforts to decriminalise attempted suicide, arguing that survivors should receive treatment and support rather than punishment.

To confront the crisis, Obindo called for mandatory mental health screening in primary healthcare, particularly for patients with chronic diseases such as diabetes, hypertension, HIV/AIDS and neglected tropical diseases.

He also advocated the establishment of a dedicated Mental Health Fund, greater use of digital technology and artificial intelligence, increased funding for mental health research and stronger mechanisms for translating research findings into government policy.

He said Nigeria must also tackle the migration of mental health professionals and expand community-based services if the country is to close its enormous treatment gap.

He urged government and society to recognise mental wellbeing as fundamental to individual health, family stability, national productivity and sustainable socioeconomic development.