With the closure of all public places, the stay-at-home order and the worsening economic indices occasioned by the fall in the price of crude oil with no foreseeable end, learned helplessness, negative emotions, and other psychosocial problems are bound to thrive. Interventions to improve social capital, coping resources, resilience, and good community and family cohesion are needed to promote psychosocial well-being during and after the COVID-19 pandemic in Nigeria.
Background
People with mental health problems are more vulnerable to a broad range of coercive practices and human rights abuses. There is a global campaign to eliminate, or at the very least decrease, the use of coercion in mental health care. The use of coercion in psychiatric hospitals in developing countries is poorly documented. The primary aim of this study was to explore service users’ perceptions and experiences of coercion in psychiatric hospitals in Nigeria.
Methods
Four focus group discussions were carried out among 30 service users on admission in two major psychiatric hospitals in Nigeria. The audio recordings were transcribed verbatim and then analyzed thematically with the aid of MAXQDA software.
Results
The Focus group participants included 19 males and 11 females with a mean age of 34.67 ± 9.54. Schizophrenia was the most common diagnosis (40%, n = 12) and had a secondary school education (60%, n = 18). The focus group participants perceived coercion to be a necessary evil in severe cases but anti-therapeutic to their own recovery, an extension of stigma and a vicious cycle of abuse. The experience of involuntary admission revolved mainly around deception, maltreatment, and disdain. Participants in both study sites narrated experiences of being flogged for refusing medication. Mechanical restraint with chains was a common experience for reasons including refusing medications, to prevent absconding and in other cases, punitively. The use of chains was viewed by participants as dehumanizing and excruciatingly painful.
Conclusion
The experiences of coercion by participants in this study confirm that human rights violations occur in large psychiatric hospitals and underscore the need for mental health services reform. The use of coercion in this context reflects agelong underinvestment in the mental health care system in the country and obsolete mental health legislation that does not protect the rights of people with mental health problems. The study findings highlight an urgent need to address issues of human rights violations in psychiatric hospitals in the country.
Objective
Psychosocial aspects of adult cancer patients in sub‐Saharan Africa (SSA) have been described in silos of research articles. Integrative analysis of regional evidence is lacking. This review aimed to describe the scope of existing research on mental health problems, identify research gaps and make informed research, policy and practice recommendations.
Methods
Search was conducted for original peer‐reviewed research articles, irrespective of their quality, on psychosocial aspects of cancer in all SSA countries using PubMed, Google Scholar, Google search, African Index Medicus and direct searches of reference list of pertinent journal articles. Publications in English or translated to English were included. Case reports, dissertations, abstracts, publications without primary focus on psychosocial issues, psychosocial issues in children and studies conducted with SSA populations living outside the sub‐region were excluded. The methodological framework described by Arksey and O’Malley was used to synthesize and present the results. Inductive approach was used to arrive at the thematic areas. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guideline was used to describe the review.
Results
Eighty‐three studies conducted across 15 countries were identified. Six thematic areas emerged namely; psychosocial needs, psychiatric disorders, coping strategies, suicidality, psychometrics and psychosocial interventions. Fifteen of 46 countries had at least one study with the majority of articles emanating from Nigeria. Research articles on psychosocial needs, psychiatric morbidities and coping strategies appears adequate for systematic review in SSA region. Despite the overwhelming evidence of high unmet psychosocial needs, a huge gap exists regarding psychosocial interventions.
Conclusion
Further research is needed into identified gaps in the region and quality of evidence of these studies need to be improved upon. Comprehensive policies and action plan development are sin qua non for addressing psychosocial problems of adults with cancer in SSA.
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