Godwin Okoduwa-Nigeria

  • September 26, 2020 at 3:31 am #2881
    Daniel Ochieng

    Please write a short paragraph of fewer than 300 words on your definition of mental health from a youth’s perspective. How has it made you feel about the concept of mental health? Have you experienced mental health challenges in your past or do you know of someone who has or is ongoing mental health management challenges? Tell us their story (you may be anonymous or use fictional characters, we respect our privacy and of those around you). How was this managed, if at all?
    Mental health encompasses how we feel about our lives, our work, our goals, our relationships, our emotional state, and our bodies. It is our present state of mind at any given time.
    An old high school mate of mine recently suffered severe mental health problems and committed suicide. His story is a very sad one. Few months to his death, he was implicated in a sexual harassment scandal. A lady he had met on Twitter falsely accused him of sexual harassment and published his name on an unverified list of sexual offenders. This list went viral on the internet, and his brand reputation was affected. It also soiled his family name. He tried contacting the lady to protest his innocence but she blocked him from her accounts. Worse still, no one seemed to believe him. Some said he was just another ‘rapist’. Left with a wrecked brand and soiled family name, he slipped into depression; and on the morning of 18 July 2020, his lifeless body was found in his studio apartment. He left a heart-wrenching video, explaining his side of the story and apologizing to his family. His last words were “I no longer have a cause to live for”.
    This was his second suicide attempt in as many years.
    He shouldn’t have died.
    Until his death, he lived in the U.S., where world-class health services are available. He was rich and educated, yet he did not decide to seek help when he needed it. This proves that the uptake of mental health services is at the mercy of the decisions that the affected people make. Therefore, effective management must address the barriers to seeking care – which includes accessibility, social constructs, and the decisions and behavioral patterns of affected persons.

    In your opinion, is mental health management necessary in society? What are the signs and symptoms that someone is experiencing mental health challenges? Do you believe that these signs and symptoms are more common in their communities or are they seen as the typical signs and symptoms of mental health worldwide? Why?
    I think that mental health management is an absolute necessity in society today. It has been the most underrated public health issue for several years, and I am glad that it is finally getting the attention it deserves. Every day, our minds are bombarded with all sorts of stimuli from social media, physical interactions, and daily events in life. These experiences shape our mindset and influence our mental health state.
    People experiencing mental health problems typically tend to become socially withdrawn, and they may exhibit irrational and/or unusual behavior. Additionally, the kind of content they put up on their social media accounts may be indicative of the nature of the mental health issue that they are facing. Typical signs and symptoms of mental health challenges include prolonged sadness, significant alterations in eating and sleeping patterns, hostile behavior, isolation from friends, difficulty concentrating on tasks, tendency to bury themselves in work, overindulgence in alcohol, and substance abuse. They may also become frustrated, irritable, angry (with frequent outbursts), and abusive. These signs and symptoms cut across regions of the world. Mental health challenges are not location-biased: youth from all corners of the globe can be affected.

    The common statement is that mental health management especially among the youth is a developed world problem and not an issue that affects developing countries. Is this true or false? Please provide an explanation and possible examples.
    Mental health management is an issue that applies to youth in both the developed and undeveloped world. Therefore, the statement that mental health management is only for youth in the developed world is biased and untrue. Nonetheless, youth in developing and least developed countries may be more susceptible to mental health problems than those in the developed world due to the realities of their local contexts. For example, an unemployed university graduate on the streets of Ibadan, Nigeria may be more susceptible to developing mental health challenges as a result of poverty, prolonged unemployment, and a bleak job outlook than another university graduate in a place like the United Kingdom who has better access to internship, volunteering, and employment opportunities. Similarly, poverty-stricken households, individuals suffering from chronic health conditions, malnourished and maltreated infants, minority and refugee groups, LGBTQ communities, and individuals facing discrimination in the least developed and developing countries may be significantly more prone to experiencing mental health problems, compared to their counterparts in more developed and advanced countries.
    Therefore, even though the realities within local contexts can influence the nature and prevalence of mental health challenges, these issues generally exist in both the developed world and developing countries.

    What do you think are the main reasons for Mental Health issues among youth in developing and least developed countries? Do you think the issues are less or more severe than in developing countries?
    Youth in developing and least developed countries have the following causative factors for mental health issues in common:
    One, poverty. Lack of finance to further education, feed, and live comfortably is a perfect precursor for mental health issues among young people in developing and least developed countries.
    Two: social expectations. In many developing and least developed countries, society sets huge – and often unfair – expectations for young people. Society sets the standard of success for them, and this puts many young and innocent people under undue pressure to perform. Without adequate infrastructure and government support in building institutions and industries, and with limited access to life-changing opportunities, many youths fail to live up to social expectations. In the end, many of them get disillusioned, sad, and depressed.
    Three: lack of adequate, youth-friendly mental health services.
    In many cases, the issues may be less severe in developing countries. This is because, the local realities in those countries – bad as they could be – are often better than what is found in the least developed countries.

    Please refer to assignment 2: Social Media and Personal Banding. We posted a study by Dr. Primack and colleagues in 2014-2016 at the University of Pittsburgh, the study found that there is a significant, linear relationship between social media use and depression, measured either as total time or frequency of visits. Do you think social media has an impact on Youth Mental Health? How are your community leaders dealing with it?
    The study by Dr. Primack and his colleagues is so profound. It has become one of my leading resource materials whenever I want to speak to young and middle-aged people about the impact of social media on our daily lives. Thank you for sharing such precious research material with us!
    I think that social media has a tremendous impact on youth mental health, and the effects are both positive and negative. When faced with the right content and the right stimulus from social media, young people are inspired to do more to achieve their goals and become better individuals. Conversely, when faced with the wrong kind of content, youth may begin to develop feelings of low self-esteem, fear of missing out (F.O.M.O), fear of failing, anxiety, and even depression. Unfortunately, I presently do not know of any community leader who is doing something significant to deal with it. The mental health statistics for Nigeria provide infallible evidence. In recent times, depression and other forms of mental health disorders have become the trend. In the first half of 2019 alone, no fewer than 42 young persons committed suicide – the majority of whom were students and young career professionals. This is based on a report published by the Nigerian Ministry of Health. Additionally, a study by an independent epidemiologist in Nigeria, Haruna Ibrahim revealed that there were 79 reported cases of suicide between April 2017 and May 2018.
    From all indications, community leaders are not doing enough to deal with the situation. They may even be exacerbating the problem by providing youth with Wi-Fi-enabled parks and hubs for them to go and surf the internet for free, all day, and without restrictions. Previously, due to the high cost of internet connectivity, youth were occasionally hindered from accessing the internet, and this offered some form of part-protection from the negative impact of social media during the time. However, with the recent introduction of innovative internet-enabled spaces and facilities with unrestricted internet access, perhaps our last line of defense may be under severe threat.

    Is there decent access to mental care for youth in your country? Do you think youth seek the help of mental care officers first when they have mental health issues? Are the officers being active in helping the youth?
    According to the Nigerian Medical Council, there are approximately 140 registered practicing psychologists and mental health therapists in Nigeria. This means that there are presently less than 200 experts left to cater to the needs of a population of 200 million people. Given the obvious shortage in human resources, coupled with severe infrastructural deficiencies in the health sector, stating that there is no decent access to mental care for youth in my country will be just apt. Mental health officers are in short supply and are strained on all fronts. Due to this, they are not active in helping the youth. They just cannot be. Also, there is a dire lack of political will from the leaders of my country to implement a strategic mental health management plan and to establish services and mechanisms that cater to this very important challenge facing youth. Only a few youths, especially those who live in urban areas and who have some degree of higher education and global exposure, will ever decide to seek the help of mental care officers when they have mental health issues. On the other hand, young people in rural areas and slums who are affected will most likely never decide to seek expert care.
    However, bad as it may seem, there is a silver lining to this thick cloud. Thanks to technology and the emergence of some mental health-inclined social impact enterprises in recent times, mental care is gradually becoming more available and accessible than before. Some well-meaning individuals and organizations who are aware of global trends have committed themselves to provide mental health services for the population.

    Please write a paragraph of 400 words or less on whether your government is taking into account mental health management. Give suggestions on what changes you as a youth would advocate for. List a few steps you are willing to undertake as a youth to fight for change in terms of mental health.
    The government of Nigeria certainly does not take mental health management into account. According to the last World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) report on the mental health system in Nigeria, information on the state of mental health services in Nigeria is severely lacking. The report, which was published in the year 2006, highlights several issues that are reflective of the gross lack of leadership, political will, and effort in establishing sustainable mechanisms for effective mental health management in the country. The country’s first-ever policy addressing mental health issues was formulated in the year 1991. Since then, the policy has not been revised, neither has it ever been evaluated to check if the targets and indicators were met. Also, across the federal and state ministries of health, no office exists for mental health management. To cap it all, presently only 4% of the government’s healthcare budget is earmarked for mental health management. This is certainly not enough!
    As a youth leader, I will advocate for a specific office for youth mental health within the state and federal ministries of health. Can a directorate of a Mental Health Services be created within the ministry of health in my country? Yes, I think it is possible; the relevant authorities and leaders only need the right amount of pressure, backed by current evidence and trends to make them realize the urgency of the matter. I think that there must be a public officer whose sole responsibility will be to develop, implement, and oversee mental health interventions across regions of the country. This will be my advocacy and campaign goal. Additionally, I am willing to lend my voice in advocating for the establishment of more youth-friendly mental health clinics because young people need safe spaces to talk about their mental health problems. If we cannot create those safe spaces for them where they can come to receive help without the fear of victimization or stigma, then the problem will never go away.
    To fight for change, I am willing to mobilize other young leaders within my community and in my social network to start a campaign on social media, pressuring the leaders to consider these suggestions. I am also willing to organize a meeting with local community leaders and if possible, political leaders in the health sector to present my suggestions and to solicit their commitment to addressing mental health management in the country.

    Highlight a role model in your life who was battling with mental health and is a survivor. Explain in depth what makes this individual unique to you as a youth. Tell us their story on how they overcame mental health and the lessons you derived from their history.
    I presently do not have a role model in my life who has battled with mental health at any time. However, I can speak about a mentor of mine whom I think has successfully built a level of immunity against mental health problems. This individual, a male in his mid-thirties, does not just live life as though challenges do not exist: but each time unfavorable events happen and when his expectations are not met, he does not take them to heart. He is rarely affected by negative situations, and he always calls them ‘a part of life’. In his life, I have observed a pattern of living that is both simple and effective in managing and preventing mental health problems. A key component of his principles is a near-total absence from social media: he only comes on social media once in a week, and his total screen time never exceeds 40 minutes!

    The meeting was held on WhatsApp and had 6 persons in attendance, including me.
    Their view on mental health:
    It was generally agreed that mental health issues are now more pronounced than they have ever been. During the discussion, I spoke about my bout with depression earlier this year, and another participant, a female, also spoke about her mental health situation.
    A few months ago, I was depressed. Read my story. Everything that could go wrong all went wrong at the same time. First, my sister developed a life-threatening disease. Second, my education and work were halted due to the pandemic. Third, the absence of social interaction due to lockdown restrictions and the pain of having to stay home for so long meant that I had limited options to socialize and get together with other people. To cap it all, I received a rejection letter for a grant that I applied for: I thought I had a really good chance of obtaining it because I met and surpassed the eligibility criteria, but I was turned down in the end. A series of similar rejection emails followed. I was devastated. The cumulative effect of all these negative experiences began to weigh heavily on me, and in no time I had lost interest in everything around me. For about two weeks nothing seemed interesting to me. In the middle of that crisis, a good friend of mine reached out to me to check on me and to recommend me for a remote job opportunity. He was recruiting for a particular company and he thought I was a very good fit. They offered good pay and honestly, this helped to lighten my mood a bit. I passed the interviews and secured the job. Gradually, I began to pick myself up and put the pieces of my life together. Thankfully I was able to catch myself back just in time to finish up my KECTIL Assignment 3!
    Another participant on my panel, a lady, actually joined the discussion to look for help for her mental health issues. She had lost her job during the pandemic, been thrown out of her house, and had her wedding plans called off by her partner. She soon got depressed after everything that had happened. She lost her appetite, got sick, and was in dire need of help. Thankfully, we (the panel) were able to help her in our little way. We connected her with an organization that helps individuals facing mental health challenges in her community. Afterward, we committed to check on her and to visit her often. One of the panelists even offered to send her some money to help her get by! She is presently getting ready for another job interview and we are hopeful!
    I can say we both recovered because we were lucky to be contacted by somebody at a time when we needed help the most. The importance of having good social connections, especially in times of mental health crises, cannot be overemphasized. Sometimes, a phone call, a text, an email, or a visit could be the difference between life and death.

    The most common mental health issues among the youth in my country.
    Anxiety disorders, post-traumatic stress disorder, feelings of low self-esteem, F.O.M.O, social media addictions, and depression.
    These issues are very common among youth in Nigeria. According to an independent study, approximately 8 in 10 youth in Nigeria have either experienced at least one of these mental health problems or know someone who has experienced them.
    Solutions provided:
    The 15 KECTIL rules of social media use are just what the doctor ordered! They are critical to maintaining one’s sanity while on the internet. In addition to adopting the rules, young people must also not be afraid to reach out to their peers whenever they have any ‘low moments’. Furthermore, we must always be equipped with the contact information of mental health organizations and experts, in case we ever come across a mental health case that requires a level of skill and knowledge that we do not possess at the time.

    Do your panelists think youth have equal and enough access to mental health care services? What are hindrances for youth in your country from access to this service?
    Based on infallible research evidence and daily experiences, the panel unanimously agreed that youth in Nigeria do not have equal and sufficient access to mental health care services. The hindrances are both on the part of the providers and the part of the individuals. On the part of the providers, the lack of practicing psychologists and mental health therapists is a huge problem. The health sector in Nigeria suffers from a human resource crisis, and mental health is perhaps the most understaffed component of our health care system. Another problem is the unavailability of mental health care facilities in the country. As at the time the last WHO-AIMS report for Nigeria was published, the country had only 7 mental health hospitals in Nigeria, and most of them are only equipped to handle psychiatric cases and individuals who need to be admitted.
    On the part of the patients, hindrances to accessing mental health services include the following: One, high cost of mental health care; fear of being judged by another individual; and the mental health issue itself which may convince even the people affected to keep silent and not talk about it. No one wants to sound ‘crazy’ or to be tagged as the ‘crazy one’, so most times they resort to silence and self-help.

    Do they feel as though they receive mental health services as frequently? Should youth find their way to overcome mental health challenges or should they lean to external services? Give options on the type of services that can be offered.
    In Nigeria, young people do not receive mental health services as frequently as they should, due to several factors. In all circumstances, it is always advisable for young people who suffer from mental health problems to seek professional help instead of trying to find their way through it. Self-medication and self-help rarely resolve the situation. Temporary fixes and occasional episodes of happiness that are obtainable through self-help means may be an enticing option in the short term, but they never make the problem go away. Seeking professional care is always the best option.
    Services that can be offered include; first, information sessions facilitated by certified psychologists and mental health therapists. This would help people to identify the specific mental health issues that they are facing and how they can resolve them because oftentimes, problem resolution begins with first identifying the problem. Second, toll-free mental health hot-lines for affected people to have teleconsultation with certified mental health experts. Both information sessions and seminars can be placed on a regular schedule so that people can have frequent and regular access to relevant information and services. Thirdly, affordable mental health therapy sessions. Young people will seldom seek expert care if they always have to pay through their noses.

    What are their suggestions to Kectil on raising awareness and educating the youth on the topic of Mental Health? What do you think you as a Kectil Colleague can do to combat Mental Health in your communities?
    The panel suggested the following three points for raising awareness and educating the youth on the topic of mental health. One, leverage on our vast network of KECTIL Colleagues to run a vibrant social media campaign on the Mental Illness Awareness Week, which comes up on the 4th to 10th of October. Two, engage peer educators. They will help to spread the message to the target groups more effectively than any advertisement campaign. Three, mental health management should be incorporated into educational curricula and work training modules. We need to start preparing the next generation for effective mental health management.
    As a KECTIL colleague, I can mobilize young leaders and organize information sessions to inform people about mental health issues. I can invite a certified mental health therapist as a facilitator for such sessions. Additionally, I can campaign for mental health awareness during the mental illness awareness week coming up next month. This will galvanize more attention to mental health management in my country. Finally, as young people return to school, I can mobilize funds and volunteers to give out stress kits containing positive notes, inspiring quotes, and even juice packs!

    Briefly introduce the actionable points derived from the Mental Health Action Plan 2013-2020 (World Health Organization). Do your panelists think the plan is feasible? What has been accomplished thus far?
    I shared the Mental Health Action Plan 2013-2020 with the panel a few days before the panel discussion for them to study. The following issues shone through in the discussions:
    One, the mental health action plan 2013 – 2020 appears feasible and detailed. If followed strictly, there is no reason why we should not succeed in effectively managing mental health challenges in our world today. However, taking a cue from the failure of developing and least developed countries to achieve the old Millennium Development Goals, we may be on course to witness similar outcomes with the WHO’s mental health action plan. In developing and least developed countries, there remains the concern of lack of political willpower, implementation and monitoring mechanisms, infrastructure, and finance; hereafter collectively referred to as the ‘grand limiting factors’. According to data from the UN MDGs report and local country reports, the grand limiting factors hindered many developing countries from achieving the Millennium Development Goals (MDGs). Presently, these factors are still prevalent in many developing countries like Nigeria to date, and they have hindered the progress of the mental health action plan so far. When the minimum requirements for implementing, executing, and monitoring such a plan in a local context are not in place, it never works out well. This explains why, seven years after the plan was introduced, Nigerians have slipped from being tagged some of the happiest people on earth, to now being referred to as one of the top 10 nations in the world most affected by mental illnesses and depression, and 1st in Africa (WHO Estimates). Since the plan was established, 30% of Nigerians now suffer from at least one form of mental illness; just 3.3% of the country’s budgetary allocation for healthcare goes to mental health management, and as many as 7 million Nigerians (3.9% of the population) suffer from depression – with youth making up at least a quarter of this figure (WHO, (2017). Depression and Other Common Mental Disorders, Global Health Estimates; WHO, (2012). Depression. A Global Public Health Concern).
    If anything, we have not made progress on the action plan. We only moved backward.
    The question of the compatibility of these strategies with local contexts cannot be overlooked. Grand as the plans may be, a country like Nigeria has her work cut out in making the steps in the action plan applicable to our context. The majority of the mechanisms and required infrastructure for implementing, monitoring, and evaluating these plans are simply not in place, which means there is more work to be done than developed countries.

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