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After nearly a decade of the old Lunacy Act of 1958, originally modified from the Lunacy Ordinance of 1916; and several decades of advocating for the mental health bill to be passed by the National Assembly and eventually signed into law, all stakeholders were delighted by the news that President Muhammadu Buhari had signed the Bill into Law. It has been a long and arduous journey and justifiably, the celebratory drums were rolled out. How did we arrive here? Who are those that have served as champions that have pushed this bill over the years until success was achieved? What challenges lie ahead? What roles should we all be playing?
Phase I champions:
Prior to the advent of democracy and since 1999, several champions have attempted to push for the revision of Nigeria’s mental health legislation. The cardinal efforts of Professor Olabisi Odejide, Dr Taiwo Adamson, Professor Oye Gureje, Dr Akintunde Akinkunmi, and the political efforts of Senator Dr Martins-Yellow and Dr Michael Ekpo are noteworthy. Unfortunately, these efforts did not manage to cross the finish line.
Phase II champions:
The final and successful phase of the push for the revision is outstanding for its involvement of all stakeholders in mental health. The Association of Psychiatrists in Nigeria (APN) played a leading role under successive leadership and especially under the term of Prof Taiwo L. Sheikh, immediate past president, and currently, Prof Taiwo Obindo. The Nigerian Association of Clinical Psychologists – under the leadership of Prof Helen Osinowo; The Psychiatric Nurses Association under the leadership of Mallam Sanni; Medical Social Workers – ably led by Alhaji Alhassan and so many others too numerous to mention were also pivotal. We had brilliant legal minds with expertise in medical jurisprudence such as Prof CheluchiOnyemelukwe and the Centre for Health Ethics, Law and Development (CHELD) actively involved all through.
Civil society organizations and mental health organizations such as the Mandate Health Empowerment Initiative (MHEI) ably led by Mr Abba Ameh Zion, the Asido Foundation, Secure the Future Initiative (SDF) led by Dr Saadatu Adamu, Mentally Aware Nigeria Initiative (MANI), and several others too numerous to mention. Pivotal roles were also played by technical partners such as the World Health Organization (WHO) and CBM International.
The legislative push was championed by the current heads of both the Senate and House Committees on Health, ably led by Senator (Dr) Yahaya Oloriegbe and Hon (Dr) Tanko Sununu, as they ensured that the draft bill has passed through the first, second, and third hearings; public hearing inFebruary 2020 and a harmonized version prepared for the president’s assent which has now materialized. Take a bow, Senator Dr Yahaya Oloriegbe for personally sponsoring this bill and aggressively pursuing it to fruition.
Lastly, our list of heroes cannot be complete without the host Ministry, the Federal Ministry of Health (FMOH) which worked assiduously with all partners to achieve this landmark progress. The progress and eventual successful implementation of the new mental health legislation will be dependent on the efforts of the FMOH, moving forward. Congratulations to the Honourable Ministers of Health, Directors, Mental Health Program Desk Officers – from Dr Suleiman Jibrin, through Dr Allison, Dr Zipporah Angyu and the current officer, Dr Massey-Ferguson Ojo.
Challenges ahead:
There is no such thing as perfect legislation, but this is a significant step in the right direction. The benefits and superiority of the current bill will be highlighted in subsequent columns, but yet significant challenges lie ahead.
These challenges include the simple steps of having it gazetted into law, and then the establishment of a mental health department at the FMOH, followed by protected funding streams to empower it to function. Adequate publicity and awareness campaigns will be needed as well as the acceptance of all stakeholders including the Nigerian Police, the Judiciary, Mental Health Professionals and the rigorous enforcement of oversight regulation to protect the human rights and dignity of persons with mental disorders and their families/caregivers.
It is especially pertinent to focus on the challenges as many pieces of legislation and policies have merely been gathering dust with little or no implementation efforts. We certainly do not want the new mental health legislation to go along that route
Conclusion:
The understanding that there is no health without mental health, as well as the appreciation that any and every one of us may suffer from a mental health condition at any point in time in our life should encourage us all to become champions of the new mental health legislation. It guarantees human rights and aims to eliminate the shame, stigma, and discrimination associated with mental illness in our society. Most importantly, it guarantees access to evidence-based mental health services from accredited facilities. Now that the law has been signed, we appreciate all the heroes and champions. The heavy lifting of implementation is next.
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