For the first seven years of their marriage, Bisoye and Lara Adedoyin – not real names – were subjects of mockery by some family members. The couple’s only ‘offence’ was that they didn’t have a child.
“I remember a time my mother-in-law asked me what I was using my womb for since I couldn’t conceive,” Lara told our correspondent. “It was in the presence of five other in-laws at a family function. I felt like vanishing from their presence.”
Bisoye and Lara had met while they were both final year students at a state-owned university in Oyo State sometime in 2007. They got married three years later.
Bisoye described the period between 2010 and 2017 as the “darkest” years of their marriage – suffering humiliation by family members who saw conception as what should automatically occur during the first year of marriage – or at most two.
“As this didn’t happen, it was definitely my wife’s fault,” he said. Bisoye said at a point, he had to ban his wife from attending some functions organised by his family.
He said, “She suffered humiliation more than me. She cried most days. So one day, when our marriage clocked three, I told her not to attend any function organised by my family or take calls from certain individuals.
“These people felt slighted, but I didn’t care. I cared more about my wife’s mental state because she was obviously getting into depression. She would wake up most nights, gazing at the ceiling, and singing mournful songs. She lost appetite and was regularly getting sick.”
But Lara wasn’t the only one getting depressed, Bisoye was too. He just didn’t want his wife to know. He noted that he felt depressed during those darkest years too but wanted to be strong for his wife, so he tried not to let her know about it.
Along the line, as they were both unhappy about their state, the couple said they sought counselling from a therapist, who offered them cognitive behavioural therapy.
Bisoye said, “My wife and I actually felt relieved after we went through the therapy in Lagos. There was fun in our home again, and then, we were also referred to a doctor-cum-sex therapist. She said we should get our sex life back because at a point, my wife and I didn’t see reason to be having sex again. In 2017, my wife got pregnant and we had our child, a beautiful girl, in 2018. Now, my wife has turned to a ‘good woman’ in the sight of those who once despised her.”
By the World Health Organisation constitution, for exhibiting depression for a prolonged period, Bisoye and Lara were both victims of mental illness, depression being among the symptoms.
The organisation’s 2017 data showed that around 30 per cent of Nigerians, that is, 57 million – based on World Bank statistics that Nigeria’s population was around 190 million in 2017 – suffer from mental illness.
As of 2019, WHO estimated that mental illness or disorder made up about 10 per cent of the global burden of disease and 30 per cent of non-fatal disease burden.
Shockingly, research by the organisation indicated that one of every five persons in the world had a mental disorder, adding that around 264 million people were suffering from depression.
WHO said about 800,000 people die by suicide every year, noting that suicide was the second leading cause of death in individuals aged between 15 and 29 years.
Moreover, an April 2018 study by the Mind, Behaviour and Development Unit of the World Bank stated that about 22 per cent of Nigerians – that is, 42.9 million, based on the bank’s estimated population of 195 million – were chronically depressed.
Generally, experts recommend psychotherapy for people suffering from depression. Psychotherapy, according to the experts, is a variety of techniques employed to help people recover from mental illness, resolve personal issues, and create positive changes in their lives.
“We also need societal orientation so we can learn to show empathy towards mental illness patients, encouraging them to seek help,” a consultant psychiatrist at the University College Hospital, Ibadan, Oyo State, Dr Jibril Abdulmalik, told our correspondent.
This approach was what Dolapo Bolajoko (not real name), a software developer at a Lagos-based fintech company, said worked for her when she suffered from depression years after she was allegedly raped by her uncle in 2005. She was 14.
She told our correspondent that her recovery from depression started when she opened up to her mentor at the university.
She said, “I was raped when I was in secondary school by my uncle. My parents went on a trip to the United States and we were on holiday, so they took my brother and me to my uncle’s place in Ibadan before travelling.
“My uncle worked at an engineering company and always mentioned how proud he was to have a beautiful niece. I was naive to know he was only playing with my emotions. He was married with no kid then.
“During one weekend while his wife travelled for a business trip to Kaduna, he told my brother he could go and play football at the estate’s pitch. My brother was excited and left the house. While we were alone in the house, my uncle raped me.”
Bolajoko said she couldn’t tell her parents of the incident because they might not believe her. Even when they returned from the US and asked why she was always moody, she said she couldn’t utter a word.
“I disliked guys and always wanted to be left alone – up to my university level. It was while I was at 200 Level that I happened to have one of the female lecturers as my mentor. She was not just a lecturer; she was a counsellor and took a special interest in me,” she said.
Through counselling over time, Bolajoko said she was able to let go of her pain and depression – which are both signs of mental illness. “I forgave my uncle, after several years of apologising. I also started relating with people. Today, I live my life free of all the pain I was caused,” she said.
‘Indebtedness, business failure nearly ended my life’
At the height of his period of depression, Mr Chris Osahon said he could literally hear voices whispering to his ears to jump into the lagoon on the Third Mainland Bridge in Lagos.
For months, Osahon, who worked at an engineering firm at Lekki, Lagos, said he battled to suppress the voices telling him that all was over and that he should commit suicide.
Osahon told our correspondent it all started sometime in 2016 when he was introduced into an oil and gas importation business by two friends. The new venture needed N150m to kick off and each partner was to contribute N50m.
“I practically emptied my bank accounts to raise N20m. Then, I borrowed N30m from the bank, family and friends. My friends were based in Port Harcourt and they were quite familiar with the terrain where we were to do the business. When I raised N50m, I sent it to them,” Osahon said.
However, two weeks after sending his capital, Osahon said he waited endlessly to get feedback from his friends. To his amazement, their contact numbers no longer went through. Emails were not responded to. Contacts could not also be made on social media. Osahon started getting unsettled.
“I travelled to Port Harcourt, contacted the police, and arrested my supposed business partners. They claimed the business flopped. All attempts to recover my money, even with the police involvement, were futile,” he said.
For two years after the incident, Osahon said it got to a point when he would be driving to and fro work via the Third Mainland Bridge and he would be contemplating suicide.
He said, “The voices telling me to jump into the lagoon became stronger in late 2018 when the year was about to end. I would hear sentences like, ‘Chris, you owe the bank N30m, you can’t pay it back. Just jump into the lagoon and end it all.’
“I used to cry each time this occurred. I was losing my mind. The thought of turning my wife into a widow and my children into fatherless kids deterred me from committing suicide. In addition, I sought help from clinical psychologists, pastors, some family and friends.”
Osahon said he got his mind back in 2019 and started repaying the bank loan gradually. He said he had since ventured into other businesses which turned out profitable.
Similarly for Olaide Olurotimi, the loss of her life savings nearly made her commit suicide.
Olurotimi, whose identity has been protected, said she saved N100,000 during her one-year National Youth Service Corps scheme in Enugu State.
At the end of the scheme in 2019, she said she learnt of an investment programme, wherein she was expected to earn a profit of N144,000 over a three-month period.
“I put N100,000 in the investment. It was my life savings. I was supposed to have N244,000 at the end of the period,” she said.
Olurotimi said she planned to use the money to buy a laptop and other gadgets to start a podcasting career.
But when the investment period was due, she received no alert, a situation that caused her to develop anxiety and other mental illness signs.
“I couldn’t also sleep and had a loss of appetite,” she said, adding that even when she opened up to her mother, it didn’t help matters as her mother kept on scolding her.
Olurotimi said, “At a point, I had suicidal thoughts because of only N100,000. It was my life savings!”
Olurotimi said even though she lost her life savings, she had since moved on thanks to a friend who observed what was wrong with her and was there for her.
“He encouraged me, he was there for me, and over time, I saw reasons to be alive. I also thought about what would become of my dreams, or how my parents and loved ones would feel if I committed suicide because of N100,000,” she said.
“I think if I had not spoken with someone, I might still be in depression,” she added.
Another survivor of mental health challenge is Peter Nnaji, who, in May 2020, lost his job as a chef at one of the hotels at Lekki, Lagos amid the COVID-19 pandemic.
The father of three noted that the sacking destabilised him greatly. He had worked for the hotel for more than a decade and didn’t have enough savings to see him through the difficult times.
His wife was also unemployed – she was a housewife planning to return to the corporate world by 2021 when their last child would turn two.
Nnaji woke up one Tuesday morning in May to find out he had been relieved of his job.
“I looked at my wife beside me on the bed, checked on my kids in their room next to ours, then burst to tears,” he said. “The first thought that came to my mind was how I was going to take care of them going forward.”
Not long after, Nnaji said he resorted to drinking excessive alcohol, hoping to find solace in it.
He added, “Really, I never knew I could be so depressed. I used to see myself as an emotionally strong person. It was that bad that my wife had to inform my parents and our church pastor of my predicament.’’
Thankfully, with proper counselling, Nnaji said he was able to get out of depression later in 2020. After he snapped out of depression, he started an online food business.
In the first week of posting pictures of his food company’s menu online, he stated that he realised about N230,000 after taking orders from several people and organisations.
Mental illness, Nigeria’s silent burden
In March 2021, the United Nations, in its World Happiness Report, ranked Nigeria the 116th happiest country in the world, dropping from its 115th position in 2020 and 85th in 2019.
Out of the 149 countries ranked, Finland was the happiest country on earth in the 2021 report, followed by Denmark, Switzerland, Iceland, and the Netherlands.
Key indicators used to measure the countries’ levels of happiness were social support, personal freedom, gross domestic product, and levels of corruption.
The 2021 report also factored in the effects of the COVID-19 pandemic on the structure and quality of people’s lives, as well as how governments all over the world dealt with the pandemic.
Nigeria’s decline in the happiness index is not surprising, according to a clinical psychologist at a private university in Ogun State, Dr Akin Adebusoye.
Adebusoye told our correspondent that amid the difficult economic times – indicated by rising inflation, unemployment, insecurity, loss of purchasing power, poverty, and so on – more Nigerians might indeed be living in depression, a symptom of mental illness.
“The 2017 WHO report on Nigeria stated that 30 per cent of the citizens, approximately 57 million, were suffering from mental illness. If the organisation did another study today, more than 57 million would be having mental illness,” he said.
“Of course, the figure is not focused on those in depression because of economic difficulty alone. There are various factors that are contributing to this huge number of people with mental illness. Whatever it is, it’s a bad situation for the country,” Adebusoye added.
Despite the huge number of mental illness cases in the country, data by the Association of Psychiatrists in Nigeria showed that there only 250 licensed psychiatrists in the country.
Since Nigeria has a population of at least 200 million, according to World Bank data, this implies that one psychiatrist will need to attend to 228,000 Nigerians – a far departure from WHO’s recommended 1:8,000-10,000 psychiatrist to population ratio.
Asides from this problem, there are also only eight federal neuropsychiatric hospitals in Nigeria, and due to poor welfare, many psychiatrists, as well as medical doctors, have been forced to quit and travel abroad for greener pastures.
A 2017 survey by NOI Polls showed that the US, the United Kingdom, and Canada were the top destinations for Nigerian doctors. As of 2016, over 5,000 Nigerian doctors were in the register of the General Medical Council of the UK.
Abdulmalik, who is also the founder of Asido Foundation, a mental health advocacy nonprofit, said the facts were clear that mental health was suffering great neglect in Nigeria.
He said, “Particularly from the government, mental health is suffering great neglect. For instance, there is a desk officer for mental health at the Federal Ministry of Health, but mental health itself has no department and directorate.
“At the ministries of health in many states, there is not even a desk officer for mental health. This shows systemic neglect for mental health, and you cannot plan for what you don’t have. There is no budget for mental health in the health budget.”
The Director, Hospital Services, Ministry of Health, Dr Adebimpe Adebiyi, did not respond to request for comments on the issues.
Meanwhile, experts decried that though Nigeria has policies aimed at addressing mental health issues, in-depth information on mental health service in Nigeria was non-existent, making it difficult to identify areas of needs, coordinate activities of advocacy groups, and make informed decisions about policy direction.
“Nigeria has a mental health policy. Unfortunately, it’s very old for this age and time and it’s due for renewal,” said the National Secretary, Nigerian Association of Clinical Psychologists, Dr Olugbemi Olukolade.
Also, Abdulmalik noted that Nigeria’s mental health policy was dated 1958 and inherited from the British.
“Between then and now, the British have revised their mental health laws 13 times whereas Nigeria has not revised its own even once,” he said.
However, Abdulmalik said the good news was that the committees on health at the Senate and the House of Representatives were working on a Mental Health Bill, which has gone through the first and second readings.
If signed into law, Abdulmalik said the Mental Health Bill offers the legislative framework that provides an environment for providing mental health services that promote human dignity and are in tandem with global best practices.
Abdulmalik said, “What we have now promotes inhuman treatment of mental illness victims, who are taken to traditional healing homes and chained. We need to give mental health the proper attention at the federal, state, and local government levels. They need to pay attention to it and fund it.
“Also, in the mental laws that Nigeria has, attempted suicide is a crime. Meanwhile, between 80 and 90 percent of people who attempt suicide likely have mental illness. But in our law, we believe anyone who attempts suicide should be arrested and charged to court, and jailed for one year. All these should be removed from the mental health policy. People who attempt suicide should rather be rehabilitated, not jailed.”
The yoke of suicide cases
Until all the necessary resources are committed to mental health, experts said Nigeria might experience a mental illness pandemic in terms of a rising number of people with mental illness and an increasing number of people committing suicide.
According to WHO Suicide Ranking, Nigeria in 2017 ranked the 30th most suicide-prone of 183 countries, with 17.1 suicides per 100,000 people in a year.
Nigeria was also ranked 10th African country with higher rates of suicide – with many of the cases as a result of depression.
For instance, in January 2021, one Dele Bandele, who was said to be a digital strategist, was found dead a few hours after he was declared missing. In a viral suicide note left behind, Bandele said he had battled with depression for seven years.
He revealed that he had previously attempted suicide on three occasions but had been discouraged by thoughts of the consequences to those around him, particularly his mother.
In July 2020, a 32-year-old man, Aboh Ogbeche, also committed suicide at his family residence at Lawanson, Surulere area of Lagos State. Aboh was said to have drunk bleach, which made him convulse to death.
On March 25, 2019, a physician, Dr Allwell Orji, was reported to have parked his car on the Third Mainland Bridge in Lagos and jumped into the lagoon, ending his life in the process.
In August 2020, a middle-aged man, popularly known as Tailor, committed suicide after his lover allegedly jilted him in Rivers State.
In July 2020, a truck owner, Fatai Salami, committed suicide after his truck was seized by officials of the Ogun State Traffic Compliance and Enforcement Corps for flouting COVID-19 laws in the state.
Salami reportedly drank an insecticide (Sniper) within the premises of the TRACE after he was allegedly fined.
In February 2020, one Princewell David jumped into the lagoon after his girlfriend reportedly dumped him.
Twelve days earlier, a 21-year-old, Toju Daibo, also allegedly plunged into the Lagos lagoon from the Third Mainland Bridge.
In May 2019, Chukwuemeka Akachi, an undergraduate of the Department of English and Literary Studies, University of Nigeria, Nsukka committed suicide in an uncompleted building located at the Sullivan Road, Nsukka. He was said to have slipped into a coma after taking two bottles of Sniper.
In a related case, in June 2019, Christabel Buoro, a 21-year-old 300 Level student of the Department of Medical Laboratory Science, University of Benin, reportedly killed herself after she was allegedly jilted by her boyfriend.
Meanwhile, in August 2020, men of the Lagos State Police Command prevented a businessman, Abiodun Adeyinka, from committing suicide by jumping into the lagoon for owing a microfinance bank.
Arresting the situation
According to experts, mental health conditions get harder to treat if one waits until the symptoms are bad, which is why it is important to pay attention to the signs.
According to Olukolade, the main sign people should look out for to know a family or friend may be suffering from mental illness is a deviation from societal norms.
He said, “However, we don’t pick deviation from societal norms in isolation. Another sign could be when someone is in distress, is taken to drugs, or when someone is talking to themselves or seeing things that other people are not seeing. Another is when there is social dysfunction.
“Someone who has serious problems relating with other people, or has sleeplessness over a period of time may also be suffering from mental illness.”
Olukolade said anyone was prone to suffering from mental illness, adding that many people were suffering from it unknowingly.
“Having anxiety over a prolonged period can be a mental illness case. And it’s not a good question when people ask if it’s possible to avoid suffering from mental illness during one’s lifetime because it makes it look as if mental illness is a bad thing,” he said.
Olukolade said some of the ways of recovering from mental illness include social support and consulting with therapists or clinical psychologists.
On his part, a Lagos-based therapist, Benjamin Adewunmi, said there was a need to promote awareness about mental health.
He also debunked some myths surrounding mental illness.
He said, “There are some people who believe that mental illness is caused by a spiritual attack, and because of this, many people hide when they have mental illness, and when they have someone suffering from it, instead of going to the hospital for treatment, they go to homes where they are abused emotionally and physically.
“Other myths to ignore are that people with mental illness are dangerous/violent, or that victims can’t lead a normal life again, or that mental health problems are a sign of weakness. None of these is true.
“All organisations – both profit and non-profit – should also have mental health departments to treat workers having mental health challenges like depression.”
Abdulmalik said alternative mental health providers, for example, traditional healing homes, might be needed to attend to the myriads of cases the country has.
He said, “One of the challenges is that traditional healers’ work is shrouded in secrecy; they don’t want you to know how they operate because they think we want to know their secrets. But we need to collaborate because most victims patronise them.
“Also, most people turn to religious leaders when they have mental health issues. However, clerics are not professional counsellors. Of course, they offer emotional support, which is also useful. But the alternative service providers must know when a case is severe and refer such to professionals.”
A clinical psychologist and lecturer at the Department of Psychology, Olabisi Onabanjo University, Ogun State, Mr Oladotun Adeyemi, said it was important not to stigmatise those with mental health challenges.
He said, “Before a victim’s condition degenerates to a level where they cannot cope again, the people around them should help them. People should not stigmatise those having mental health issues. Those of us who treat mental illness victims also share in the stigma. I remember someone telling me that attending to mental illness patients could make me have mental illness.”
Adeyemi also advocated more funding and awareness of mental health.
He said, “It’s because there are inadequate modern mental health facilities that victims are taken to healing homes where they are tied down and abused. Religious houses should also be a part of the awareness initiative.
Another Lagos-based therapist, Bola Adesiyan, advised people to make their mental health a priority.
She advised those in depression to engage in activities such as meditation, deep breathing exercises, yoga, socialising with others, exercising regularly, eating a balanced diet including seeking support from family members.
Meanwhile, the Medical Director, Federal Neuro-Psychiatric Hospital Yaba, Lagos, Dr Oluwayemi Ogun, has identified relapse as a major challenge in the management and treatment of psychiatric ailments.
According to her, relapse is bound to occur especially when the psychiatric condition is caused by drug abuse, drug addiction or overdependence on toxic substances.
“Also, during the recovery process, addicts will inevitably face stress from work or family, which compels them to start using drugs again. The cravings for drugs never completely vanish, and they’ll return in full force during periods of stress,” Ogun told the News Agency of Nigeria.
She said relapses could have devastating consequences for people with mental disorders such as schizophrenia, bipolar disorder, depression, or anxiety disorder.
For this reason, she said it was important for people with mental disorders to do everything possible to reduce the risk of a relapse.
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