Community Psychiatry Care: An Urgent Need in Nigeria

Soroye, Modupeoluwa Omotunde; Oleribe, Obinna Ositadimma; Taylor-Robinson, Simon D

doi:10.2147/jmdh.s309517

Cited by 13 publications

(7 citation statements)

References 21 publications

(25 reference statements)

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“…Poor and underserved populations are particularly vulnerable to the adverse effects of mental disorders, experiencing a more severe impact on functioning, having drastically limited access to early intervention, and discontinuing treatment due to cost [ 11 ]. Significant factors limiting access to formal mental health care in Nigeria include the scarcity of mental health specialists, with only 0.15 psychiatrists per 100 000 of the population (compared to the US’s 10.54 per 100 000) [ 12 ], a lack of community-level care for mental disorders [ 13 ], the limited integration of mental health integration in primary care [ 14 ], and the pervasive stigma towards mental disorders, even among health care providers [ 15 , 16 ]. In Nigeria, stigma has been widely documented as a deterrent to help-seeking [ 17 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

Chu¹,

Roxas

Aguocha

et al. 2022

BMC Health Serv Res

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Background The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization’s Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training’s impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement. Methods Trainees (n = 13) completed a 43-item questionnaire before and after their 5-day training to assess perceptions of mental disorders and attitudes towards people with mental illness. These responses were analyzed using paired-sample t-tests for four subscales of the questionnaire: acceptance of socializing with people with mental illness, normalizing activities and relationships with people with mental illness, supernatural causation of mental illness, and endorsement of a biopsychosocial approach to mental illness. Semi-structured key informant interviews (n = 11) with trainees, trainers, and local health officials who participated in or supported the HAPPINESS project were thematically analyzed to understand their experiences and perspectives of the project’s barriers, facilitators, and opportunities. Results Trainees showed significant improvements on socializing, normalizing, and supernatural causation subscales of the stigma questionnaire (p < 0.05). No significant effect was seen on the biopsychosocial subscale; however, evidence of biopsychosocial beliefs was found in interview responses. Key informant interviews revealed that the HAPPINESS project enhanced trainees’ diagnostic and treatment abilities, mental health awareness, and empathy towards patients. Misinformation, stigma, inadequate funding, and lack of road access to clinics were identified as barriers to mental health care integration into general care in Imo State. Respondents also suggested ways that the HAPPINESS project could be improved and expanded in the future. Conclusions This study adds to the limited evidence on the implementation of mhGAP-IG in Nigeria. Using mixed methods, it evaluates how mhGAP-IG can impact perceptions and knowledge of stigma among primary care trainees. It also highlights barriers, facilitators, and opportunities to consider for project growth. Future efforts should focus on clinical support, supervision, health outcomes, as well as scaling up and assessing the cost-effectiveness of the HAPPINESS project intervention.

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Section: Introductionmentioning

confidence: 99%

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

Chu¹,

Roxas

Aguocha

et al. 2022

BMC Health Serv Res

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“…Previous studies reported an inverse correlation between eHealth literacy and depression and that improving eHealth literacy may contribute to maintaining good psychological well-being ( 21 , 22 ). Mental health services are severely sparse in Nigeria, and related stigma persists ( 42 ). Hence, it is likely that individuals are accessing online sources of mental well-being information, and this could be harnessed to help manage their anxiety and depression.…”

Section: Discussionmentioning

confidence: 99%

eHealth literacy was associated with anxiety and depression during the COVID-19 pandemic in Nigeria: a cross-sectional study

Akingbade

Adeleye

Fadodun

et al. 2023

Front. Public Health

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BackgroundElectronic health (eHealth) literacy may play an important role in individuals’ engagement with online mental health-related information.AimTo examine associations between eHealth literacy and psychological outcomes among Nigerians during the Coronavirus disease-2019 (COVID-19) pandemic.MethodsThis was a cross-sectional study among Nigerians conducted using the ‘COVID-19’s impAct on feaR and hEalth (CARE) questionnaire. The exposure: eHealth literacy, was assessed using the eHealth literacy scale, and psychological outcomes were assessed using the PHQ-4 scale, which measured anxiety and depression; and the fear scale to measure fear of COVID-19. We fitted logistic regression models to assess the association of eHealth literacy with anxiety, depression, and fear, adjusting for covariates. We included interaction terms to assess for age, gender, and regional differences. We also assessed participants’ endorsement of strategies for future pandemic preparedness.ResultsThis study involved 590 participants, of which 56% were female, and 38% were 30 years or older. About 83% reported high eHealth literacy, and 55% reported anxiety or depression. High eHealth literacy was associated with a 66% lower likelihood of anxiety (adjusted odds ratio aOR, 0·34; 95% confidence interval, 0·20–0·54) and depression (aOR: 0·34; 95% CI, 0·21–0·56). There were age, gender, and regional differences in the associations between eHealth literacy and psychological outcomes. eHealth-related strategies such as medicine delivery, receiving health information through text messaging, and online courses were highlighted as important for future pandemic preparedness.ConclusionConsidering that mental health and psychological care services are severely lacking in Nigeria, digital health information sources present an opportunity to improve access and delivery of mental health services. The different associations of e-health literacy with psychological well-being between age, gender, and geographic region highlight the urgent need for targeted interventions for vulnerable populations. Policymakers must prioritize digitally backed interventions, such as medicine delivery and health information dissemination through text messaging, to address these disparities and promote equitable mental well-being.

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“…The high rate of mental disorders across developed and developing countries has been made worse by the psychological challenges associated with the emergence of Stanley et al COVID-19 (Moynihan et al, 2021). Approximately 71% of people diagnosed with mental disorders lack access to any treatment; only 0.6% of these who live in developing countries have access to treatment from mental health professionals (Uwakwe, 2019; Soroye et al, 2021). This review shows that this shortage is likely to worsen for specialties like psychiatry, highlighting the need for policies and deliberate actions by training institutions to provide career guidance for health science students, to address the global need across specialties.…”

Section: Factors Influencing Career Choices Among Health Science Stud...mentioning

confidence: 99%

Career Intentions and the Determining Factors among Health Science Students: A Systematic Review

et al. 2023

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Background Health systemsneed adequate personnelin order to function; improvements in health-care services delivery, and coverage and the enjoyment of standard healthcare as a right, depend on the availability, mixture, quality, and accessibility of the health-care workforce. Purpose This review aimed to synthesize reliable evidence ondetermining factors among health science students’ career choices to enhance policy advocacy for better health-care delivery. Method We sourced empirical studies from Scopus, PubMed, ScienceDirect and Google Scholar. From a total of 9,056 researcharticlesfrom 2010 to 2022, 27 studies with a total of 45,832 respondents met the inclusion criteria. Results The majority of the studies were of medical students; internal medicine was the commonest choice (64.3%), with psychiatry and public health receiving lesser attention. In the four available studies of nursing students, midwifery was not chosen at all. There is a paucity of studies on this all-important concept for nursing students. The determining factors of choice of specialty were in four themes: personal, socioeconomic, professional, and educational/policy. Among the barriers to choosing particular specialties were low prestige among colleagues, stigma, long working hours, and poor public recognition. Conclusion The career choices of health science students do not reflect an adequate mix of health-care team members to meet the health-care needs of the world. Reforms of policy and educational training are needed.

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Community Psychiatry Care: An Urgent Need in Nigeria

Cited by 13 publications

References 21 publications

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

eHealth literacy was associated with anxiety and depression during the COVID-19 pandemic in Nigeria: a cross-sectional study

Career Intentions and the Determining Factors among Health Science Students: A Systematic Review

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