By Henry Okonkwo
The coronavirus nightmare has entered its second year, and many lives have been turned upside down. The economy is stumbling, businesses are crumbling, and unemployment keeps skyrocketing. Most Nigerians are anxious, lonely, confused, stressed, helpless and angry as they suffer the pangs of the pandemic plus recession. As the grief and trauma keep piling up, there is an acute need for functional mental healthcare resources to help Nigerians cope with the anxieties. In this interview, Mrs Salem Ogunlowo, an author, who trained in the United Kingdom as a professional therapist and mental health advocate, decries the poor awareness and the terrible state of Nigeria’s mental health structure. She proffers solutions on what must be done to enthrone a sane nation.
Last year was rough for many Nigerians, and till now many are still grappling with the harsh effects of the recession and pandemic. As an expert, how would you advise Nigerians to go about managing the different challenges that they are facing?
The effect of the COVID-19 is huge on everyone. We were fortunate that it hasn’t hit us hard like it affected the other countries in Europe, America and Asia. I did a post last year after the pandemic broke out titled, Dealing with the Losses. In that post, I explained how COVID-19 took everyone unawares and affected every sector. I described COVID-19 as a thief that came to kill, steal and destroy. It affected individuals, families, businesses, organisations and countries. And when we lose anything that has to do with our lives, we must grieve it. Many people’s plans were disrupted, businesses were ground to a halt, and people lost a lot of money and opportunities. These are huge losses, and for every loss, it must be grieved. And people were grieving their losses in different ways.
There are five stages of grief- the denial stage, anger stage, bargaining stage, depression stage and the acceptance stage. I notice that many Nigerians were struggling with these stages of grief. People remained in the denial stage for a very long time. A lot of people were angry because their plans for that year were adversely affected.
So the effects of the pandemic itself on our psyche occur when you go through these losses, or choose to bottle your feelings or internalize them. When you don’t let anyone know the anger that you’re feeling, when you keep putting up a strong face saying things like, ‘It is well’ ‘I’m strong’ etc. such attitude would not help you. Nigerians need to understand that there is nothing wrong with being angry. Anger is an emotion God created to be expressed. It is a God-given emotion, so express it. Even when you are angry with God, go ahead and tell Him that you’re angry with Him. Jonah in the Bible did it when God made him go and preach to the people of Nineveh. He was bold enough to tell God he was very angry at Him. And God took time to relate and reason with Jonah.
So Nigerians need to learn how to verbalize anger, because these emotions that we internalize are the things that breed complications with our mental health. It begins to eat you inside. You become depressed, and depression that is not treated leads to suicide.
Some say that our mental health system is virtually a hopeless situation. Do you agree with this notion?
For me, there is no hopeless situation. All we need is, to be honest with ourselves.
We talk and proffer solutions, but what has been the outcome?
Yes, we should be worried. Because anything that has to do with my psychological well-being should be a concern to all. But where are the mental health facilities in place? How many practising psychologists and psychotherapists do we have? Where are the mental health centres? So that when people experience stress or trauma due to COVID-19 losses plus effects of the recession and even the EndSARS damages, who is the person that they can go to? Where is the resource centre?
Some time ago I asked a doctor if they have a mental health centre attached to their hospital here in Lagos. He told me ‘No’. So that means that the only place people look at for mental health treatment is the Yaba Psychiatric Hospital. And because of the stigma attached to the place, even mad people run away from going there.
Ordinarily, there should be a mental well-being centre attached to each of these public hospitals or clinics all over the state. So that when people face trauma, they don’t go to the psychiatric doctors at Yaba. Rather they need a trained therapist to hear them talk and treat their mental pain and emotional distress.
Most Nigerians when under emotional stress prefer to seek spiritual help from their religious leaders. How effective is that?
In the treatment of mental illnesses, there’s a place where the spiritual plays a role, and there’s a place where the medical, and psychotherapy play their roles too. It should be balanced. There is nothing wrong with a pastor praying for a member, but then there are principles, practice and skills put in place, and experts have been trained to apply these skills. One will not advise someone with an injured leg to go on fasting and praying over the wound when you know there is a need to apply medication on the injury.
So I frown at that situation, where someone with mental issues goes to seek help via religion. That is why we have a lot of mad people in our streets, because those are cases that were supposed to have been referred to a psychologist at the early stage when the person was showing signs of depression, aggressive anger or bipolar, schizophrenia or excess anxiety. The therapist should come in to look at the causes of this problem so that it doesn’t become a psychiatric case. Because when it becomes a psychiatric case, then it becomes more complicated. So you don’t spiritualize such, you seek the help of a professional therapist to address it.
But like I said, do we have the structure to provide that aid to Nigerians? In my book, ‘Suffering and Smiling’, in the chapter on ‘Psychosis’, I shared an experience with my aunt that was like a mother to me. She was experiencing psychosis but because people didn’t know; they thought she was bewitched. She later died undiagnosed. It was only when I studied mental health, that I understood that my aunt suffered psychosis. She kept hiding under the bed, seeing everybody as an enemy, and intense hallucinations.
Many Nigerians say that they don’t go for these mental health sessions because they don’t know about the roles of psychology and psychotherapy. What factors fuel this level of ignorance?
Our culture and religion both play a role in this. Nigeria is a very religious country. And culturally, some people were raised to believe that certain ailments are caused by mysterious forces. The lack of awareness is there too. Most Nigerians don’t know that they can get professional help from mental health illnesses. Another challenge is when that awareness is created among the people it raises the question: where would they go to get mental health support?
But would you say that we have enough active professional mental experts here in Nigeria?
I want to believe that we do. But the thing is that we don’t have locations where one can access them. So, the public doesn’t know; the only mental health centre that is loud and known to people is the Yaba Psychiatric Centre or the one at Uselu in Edo State.
There is a need for a mental health registry where people can access and to give referrals to mental health cases. There is need for Nigeria to have a hotline for cases of suicide and trauma. Because most of these people don’t want to die, they need help, but how they could access this help is the challenge.
In our universities, we have many that graduate after studying psychology or psychotherapy and other mental health courses, but after graduation, they seldom practice or aim to become professionals. What could be the cause of this?
To practice fulltime as a psychologist you must have a second degree either in psychotherapy or psychology, but the environment to go private here in this country is not conducive. So, you find out that all the people who practice psychotherapy or psychology are into something else because most Nigerians are yet to see the benefits of seeking support or help via therapy. They only do that when they find out that the situation has become complicated. People come to me for therapy when the situation has become really bad, so I’ll now be the one to refer them to the psychiatric hospital. And having to go to psychiatric hospital, sometimes the situation becomes so bad that it becomes highly complicated that they have to be on drugs for only God knows how long.
What would be your advice to Nigerians on the need to seek help from trained therapists?
Therapy works. It helps because we all have situations weighing us down one way or the other. And that is the reason you should talk to a therapist. People fear to speak up because of confidentiality issues. But a therapist is not emotionally attached to you. So it’s all a professional relationship and a therapist is sworn to confidentiality. So whatever you tell a therapist is safe. It is important to talk to a therapist because he will help you navigate the paths that you have missed, and put you on the right track. It would help you to be reflective and introspective, to come back to yourself.