Special Report: Depression is disabling Nigerians due to inadequate mental health experts and services – UK based Nigerian expert
A United Kingdom based Nigerian mental health expert, Josephine NwaAmaka Bardi, says in this interview with Emerald News that depression is a major challenge in Nigeria. She suggested that Nigeria needed to establish mental health institute to conduct on mental health issues in the country.
Tell us about yourself
I am Josephine NwaAmaka Bardi, from Onicha Uku in Aniocha North local government area of Delta state. I am a registered mental health nurse in the United Kingdom, and l am the founder of the campaign to raise awareness of mental health in higher education (RAMHHE). I am also a Senior Lecturer in Mental Health and Learning Disabilities Nursing at the London South Bank University.
Currently I lecture and run the campaign side by side. My interest in mental health campaign was based on the anxiety that I experienced when I was an international student and could not afford the tuition fees. As an international student when I could not pay my fees and I felt anxious. I thought it was just me only but when I volunteered for a homelessness charity and women’s refuge, I realised that mental health challenges can affect anyone. So, I made up my mind to study mental health nursing so that I could understand this thing that affects people everywhere without discrimination, be of help to the society.
As a mental health student nurse, I noticed that students are also experienced this challenge. I began to understand that the issue of mental health challenge was more than I could think of. At the time, studying for mental health nursing was free and they paid you bursary. I read and slept in the library because I wanted to understand what mental health is and get the best from the nursing program. As a result, I received First Class Honours in BSc mental health nursing and completed the Master of Science (MSc) in Public Health with Distinction at the University of East London.
Soon after completing the MSc in Public Health, I applied to for a PhD. I emailed three professors of mental health, and the third one, Professor Peter Bartlett at the University of Nottingham. The second time that I emailed Peter about studying for a PhD, he informed me that I was lucky because that day was the closing date for the prestigious Economic and Social Research Council (ESRC) PhD funding application, and he asked me to send a proposal. I had never written a proposal before; I received his email at 11am that day and universities close at 5pm so I had six hours to write a PhD proposal. I was very anxious as I wrote and emailed my proposal to Peter, so when he did not reply for a week, so I thought my proposal was not good enough. You can imagine my excitement when Peter told me that my proposal was one of the top three.
Subsequently, I successfully applied and received the funding to study for a PhD in Mental Health and Wellbeing at the University of Nottingham, one of the most elite universities in the world. There, I realised that I was the only Black British in my cohort who received the ESRC funding in 2015. During my PhD studies, I won several awards and had the privilege to attend 21 national and international conferences where I presented the findings from my PhD.
What is mental health all about?
Mental health is the ability to cope and contribute to community regardless of what is happening to you mentally. It is invisible. Because of that invisibility, people generally do not talk about it. Mental health is about that thing that borders you so much. It could be clinical like some people will have schizophrenia, they talk to themselves, they hear voices, they see visuals, they have conversations with people but the next person to them do not see these people. For example, depression is a mental health challenge that might make individuals withdraw from society and stop enjoying activities they previously enjoyed. At the worst times, depression could lead to suicidal ideation or suicide.
So, mental health can be positive, it can also be negative, depending on how people experience the signs and symptoms, and how they can cope with those experiences. But the problem with mental health challenges is that someone can be depressed but mask it. There are people walking on the street but are very depressed. They could be smiling but before you know, but have plans to take their own lives, otherwise known as suicide. In Nigeria, we hear of people jumping into 3rd mainland bridge, students killing themselves after spending time with their friends. None of the people who jumped into the bridge were hidden. For example, there was the woman who packed her car and jumped into 3rd Mainland Bridge.
“Mental health is so hidden that is worse than wearing a mask to prevent infectious diseases, because you can take the mask off.” JNB, 2021
Now, how do you solve this problem?
You cannot solve mental health challenges, but you can put things in place to inform people about what mental health, and ultimately reduce the incidence of mental health challenges in the community. When people know the signs and symptoms of mental health challenges, it will help them to speak about their experiences and seek help. The government is doing their best. Look at COVID-19, how many cases do we have in Nigeria compared to the UK and other developed countries?
Therefore, in terms of the incidence and prevalence of mental health challenges In Nigeria, you cannot blame the Nigerian government. We need to have an Institute of Mental Health in this country, conduct additional research on the state mental health in Nigeria. and adopt health promotion strategies through community outreaches where we go into communities to inform, educate, and advocate on behalf of community members with mental health challenges. Community outreaches should also include the distribution of posters and flyers in local languages about the different types of mental health challenges, their signs, and symptoms, and where to seek help.
Also, it is important to train mental health nurses and employ them within university health and wellbeing teams. Universities need student mental health ambassadors who can host mental health campaigns where they walk around the campus and engage in collective dialogue with staff and students. We need mental health studies to be embedded into the curriculum from primary school to the university level.
Currently, very few people are talking about the state of mental health in Nigeria. It is about information. If you go to rural areas, they have hospitals, but it is only about physical health. For example, okada (motorcycle) hit someone and appendicitis, but nothing about mental health. That is an important aspect that is missing in our health system.
What inspired you to run the campaigns?
It was from my personal experience. It was in 2006 and I panicking a lot due to not having enough money to pay my tuition fees. So, when you fast forward to becoming a lecturer and seeing students suffering the same thing, you know what it means. My interaction with students and staff also added to my inspiration to start the RAMHHE campaign.
My personal experience and seeing people around suffering. Hearing about students who have killed themselves. Without adequate information about mental health and how to seek help, more students will die.
Nigeria government and the people are not given attention to this mental health issue, could this be the reason we are hearing of suicide everywhere?
Nigerian government is trying their best. COVID-19 is killing people in developed countries but not so in Nigeria. The government cannot do everything. You need somebody who is knowledgeable with a track record about mental health. The government needs special advisers. It is because people are not informed that is why they are killing themselves while others suffer in silence.
We need an institute of mental health in Nigeria. We can then begin to plan and develop programmes to change people’s mindset towards mental health challenges. So, we need mental health experts to work with the government, give them suggestions on what to do, and enable the delivery of positive mental health awareness in Nigeria.
Like I always say:
“Malaria can kill you, but mental health challenges won’t.”
If you were asked to come over to Nigeria and pioneer this project, what will you do?
It depends. East, West, home is the best. There is a lot of work to be done regarding raising awareness of mental health in Nigeria. I will work for my country if called upon toa do so. I am very keen to come and support the mental health awareness program in Nigeria.
Some people are afraid of the stigma when they say some things they experience, how do you convince such people to talk?
That is why I say in most of the hospitals in the villages we do not have mental health experts. They are all physical health workers. If you have a mental health nurse there, people who experience stigma will be talking to professionals. We cannot keep quiet because somebody does not want to talk. Out of 10, we get three to share their experiences, one day number 4 will talk. That is how it works.
How were you able to get breakthrough amid the racial discrimination in the United Kingdom?
Racial discrimination does not exist alongside competence, excellence, good morals, and good behaviour. In the UK, I made up my mind that I was not going to just pass, I will achieve excellent result. I slept in the libraries and I excelled in my studies. If you do well in the UK, whether you are black, green, yellow, it does not matter. If you behave wrongly whether you are black, white, you will bear the consequences. So, I walked the right path, and I prayed a lot too. When you go to school overseas, ask questions, forget about the racism, forget about the conspiracy theories, and focus on your studies.