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LETTER TO EDITOR Table of Contents  
Ahead of print publication
Bridging the gap by strengthening the MHGAP: Integrating mental health care into primary health care in Nigeria


 Department of Mental Health, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria

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Date of Submission15-Feb-2022
Date of Acceptance28-Feb-2022
Date of Web Publication17-May-2022
 


How to cite this URL:
Adekeye AP. Bridging the gap by strengthening the MHGAP: Integrating mental health care into primary health care in Nigeria. Arch Ment Health [Epub ahead of print] [cited 2022 Nov 29]. Available from: https://www.amhonline.org/preprintarticle.asp?id=345403





  Discussion Top


Mental health services in Nigeria consist mainly of large government psychiatric hospitals, psychiatric departments of federal and state teaching hospitals, with few mental health professionals to serve the large population of the country. However, recently, community mental health services, which have been shown to improve access to care and clinical outcomes, are beginning to develop in some locations. Interestingly, a very small proportion of people utilize these services despite efforts to promote more accessible services. Therefore, interventions to increase service use are an essential component of the health system.[1]

Currently, in Nigeria, owing to the rising burden of mental health disorders, the declining numbers of mental health professionals, limited awareness, and availability of mental health services, there is a need to integrate mental health care into the primary care for a wider and an improved mental health service delivery.[2]

First, in every state of the country, a stock of all the federal and state tertiary psychiatric treatment facilities should be taken, and all the primary health-care facilities in each state should be evenly distributed under each tertiary psychiatric treatment facilities. The tertiary psychiatric facilities would be saddled with the responsibilities of training the staff of the primary health-care facilities under their watch through the concept of task sharing and other efficient modalities. This can be done through the WHO MhGAP Intervention Guide (IG) and would consequently position them to identify and treat common mental health disorders, and the complex cases would be referred to the overseeing tertiary centers.[3] After treating the complex cases at the tertiary centers, the patients would be referred to the primary health-care centers for follow-up.[2]

Besides, the patients seen by the specialists at the tertiary centers can be pooled up for specific days of follow-up (at about once every month) at the primary care centers for the specialists to see. This structure would create avenues for further training sessions for the medical and nursing staff of the primary health-care centers and position them for improved mental health care and delivery.[4] Previous reports have shown that it is possible to scale up mental health services in primary care settings in Nigeria using the mhGAP-IG and a well-supervised training method. This format of training is promising, innovative, effective, and efficient, especially in settings where there are few specialists.[3]

Furthermore, knowing that mental health care is delivered at the primary health-care centers would facilitate improved funding of mental health service delivery and research by the federal government.[4] It would also improve the quality of care delivered to the mentally ill nationally and allow more mental health promotion and advocacy to be done at all tiers of government. Public attitudes toward the mentally ill such as prejudice, stigmatization, and discrimination would all be grossly reduced, and patients with mental illness would be able to live optimally in their highest level of potentials and capacities.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Wada YH, Rajwani L, Anyam E, Karikari E, Njikizana M, Srour L, et al. Mental health in Nigeria: A neglected issue in public health. Pub H Pract 2021;100166:1-3.  Back to cited text no. 1
    
2.
Anyebe EE, Olisah VO, Garba SN, Murtala HH, Danjuma A. Barriers to the provision of community-based mental health services at primary healthcare level in Northern Nigeria – A mixed methods study. Int J Afr Nurs Sci 2021;100376:1-9.  Back to cited text no. 2
    
3.
Abdulmalik J, Kola L, Gureje O. Mental health system governance in Nigeria: Challenges, opportunities and strategies for improvement. Glob Ment Health (Camb) 2016;3:e9.  Back to cited text no. 3
    
4.
Eaton J, Agomoh AO. Developing mental health services in Nigeria: The impact of a community-based mental health awareness programme. Soc Psychiatry Psychiatr Epidemiol 2008;43:552-8.  Back to cited text no. 4
    
5.
Gureje O, Abdulmalik J, Kola L, Musa E, Yasamy MT, Adebayo K. Integrating mental health into primary care in Nigeria: Report of a demonstration project using the mental health gap action programme intervention guide. BMC Health Serv Res 2015;15:242.  Back to cited text no. 5
    

Top
Correspondence Address:
Abolaji Paul Adekeye,
Department of Mental Health, Federal Teaching Hospital, Ido - Ekiti, Ekiti State
Nigeria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/amh.amh_34_22





 

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