Cases of mental illness have constantly been on the rise since 2016 in neuro-psychiatric hospitals across the country, Saturday PUNCH investigations have revealed.

Psychiatrists, who linked the development to economic hardship, depression, distress and anxiety, among others, explained that while most psychiatric disorders were related to drug abuse prior to 2016, non-drug related cases were now on the increase.

Investigations revealed that at the Federal Neuro-Psychiatric Hospital in Kware, Sokoto State, the average number of mental illness cases attended to on a daily basis has increased from 167 in 2015 to 255 from 2016 till February 2017.

The statistics released by the hospital’s Head of Health Information, Peter Eneojo, showed that 60,991 patients comprising 31,408 males and 29,583 females were attended to at the hospital in 2015,  while 56,884 males and 36,161 females, totaling 93, 045 patients, were attended to from 2016 till date.

The acting medical director of the hospital, Dr. Francis Nnaji, noted that with people going through distress and depression, there are tendencies for the number of psychiatric patients to increase and with people having anxiety problems, the number of mentally ill people tends to increase.

Confirming the development, a Consultant Psychiatrist at the University of Ilorin Teaching Hospital, Dr. Baba Issa, said, “In 2016, UITH had 4,311 adult psychiatric patients in our outpatient clinic. About 3,500 cases of mental illness were recorded in the hospital in 2015. Of the 2016 figure, 2,017 were males and 2,294 were females. We also had 62 patients in our child and adolescent clinic for psychiatric treatment in 2016. It got worse that we had 161 patients on admission in our psychiatric clinic in 2016. This is only in the psychiatric ward aside from the other cases that we co-manage with the surgical or medical department.

“For example, the case of someone who attempted suicide and shot himself will be treated as a surgical case, but the reason behind the suicide attempt will be handled as a psychiatric case. But such medical conditions are treated at the medical ward, so they are not part of the above figures. Obviously, we have an increased number of people being admitted for psychiatric disorders now.”

He described the economic downturn and attendant hardship affecting the finances and living conditions of Nigerians as the major factors responsible for the increasing cases of mental illness in the country.

He said, “It is a fact that the number of patients being treated for mental illness is on the increase. Reports from UITH and the state General Hospital, Ilorin show that there is an increase in the number of psychiatric patients being treated compared to the situation in the previous years. This has also been supported by figures from hospitals and psychiatrists from outside Ilorin.

“Mental illness is on the increase in Nigeria. Generally, people are becoming more and more stressed due to the hardship and difficulties we have in the country. They do not have money, so an increasing number of people are engaging in self medication. More people are abusing alcohol and drugs like Tramadol and Cannabis sativa.

Issa, who is the Head, Department of Behaviourial Sciences, UITH, said there had been an increase of about 23 per cent in the cases of mental illness brought to the hospital in the last one year.

During a recent presentation of the 2016 annual report for the Federal Neuro-Psychiatrist Hospital, Yaba, Lagos, the hospital’s Acting Medical Director, Dr. Richard Adebayo, said the institution witnessed 111 per cent increase in overall patients’ attendance and 59 per cent increase in number of new patients from January to November 2016 compared to 2015.

According to the hospital’s records, 53, 287 patients were attended to between January and November 2016 compared to 25,267 in the same period in 2015.

The records showed that the number of male patients increased by 82 per cent from 11,537 to 21,026, while female patients increased by 135 per cent from 13,730 to 32,261. Also during the period, the number of new patients in the hospital increased from 2,531 to 4,031.

It was learnt that 2,001 of the new patients were males, which represented 53 per cent increase over 2015’s figure. There were also 2,030 females, which represented a 66 per cent increase on the figure recorded in 2015.

According to the statistics, there was a 46 per cent increase in the overall number of admissions in 2016 (867) compared to 594 in 2015, while the community clinic attendance figure also increased from 1,793 to 3,510, which showed a 95 per cent increase.

It was also learnt that the number of follow-up patients seen at the hospital increased by 74 per cent from 19,889 (9,076 males and 10,813 females) to 34,536 (11,608 males and 22,928 females).

In Akwa Ibom State, the Medical Superintendent/Consultant, Psychiatric Hospital, Eket, Dr. Uche Nwaopara, also noted that the number of psychiatric patients had been on the increase in the state.

Nwaopara said a total of 431 patients (276 males and 155 females) were treated in 2015, while 659 patients (458 males and 201 females) were treated in 2016. He said for January, 2017 alone, 75 patients were treated in the hospital.

A doctor at the Neuro-Psychiatric Hospital, Maiduguri, Borno State, who spoke on condition of anonymity, said, “The number of patients at the hospital has increased and I can say that the incidence of mental illness is on the increase.”

Although, the source could not provide the figures to show the increasing number of patients at the hospital as of the time of filing this report, he insisted that the number of patients visiting the hospital was a lot more than what it was in the past.

He identified the factors contributing to increase in the number of mental illness cases in the state to include “insurgency, poor socio-economic status and lack of awareness,” adding that more women were being affected.

He, however, lamented that the “ratio of psychiatrists to patients is way below the required need.”

A Senior Consultant Psychiatrist, Neuro-Psychiatric Hospital, Aro, Abeokuta, Dr. Sakeeb Lateef, noted that the economic downturn had contributed to the increasing incidence of relapse in the clinical cases of depression among the patients he had seen recently.

According to him, a relapse of depression occurs when a patient fails to meet up with his or her appointment with the clinical physician in charge of his or her case, due to lack of funds for transport fare or to purchase of drugs or both.

He said, “Currently, among the cases of mental depression that I am handling, I will say the rate of relapse of such depression is on the increase.

“This happens when such patients fail to honour appointments with their consultants due to either lack of transport fare or money to buy drugs at the hospital.

“Eventually, when such patients show up, they tell their stories. This definitely will lead to a relapse because they have defaulted in taking their drugs consistently as prescribed.”

In a recent news report on Channels TV monitored by one of our correspondents, the CMD, Federal Neuro-Psychiatric Hospital, Benin, Edo State, Dr. Sunday Olotu, said the hospital had an average of 28,000 patients, adding that the number had increased by 5,000 as of the end of 2016.

He said the situation “may also show the increase in mental health maladies in the society.”

A source at the Federal Neuro-Psychiatric Hospital, Enugu, also said there had been a rise in mental health cases at the hospital in recent months.

The source disclosed that since 2016, more patients are being brought to the hospital for treatment.

The source identified the current economic situation in the country as responsible for the increase in mental health cases.

The source said, “We have witnessed a rise in mental health cases in recent times, particularly since 2016 and we believe that this is tied to the economic situation in the country. Recession is related to depression. An economy that is going through recession is a depressed economy, so it is not unusual that we are witnessing a rise in mental health cases at this time.

“Before now, most mental health cases involved youths abusing drugs or substance, but recently, there is an increase in depression-related cases. Many of the fresh cases involve middle-aged people, who are mostly suffering from economic hardship.”

In addition, the source revealed that the hospital had been attending to more female patients lately, saying, “this is not surprising because women suffer more of the hardship caused by economic crisis.”

The source did not provide records of the number of mental health patients treated in the hospital in 2015 and 2016.

However, our correspondent also learnt of concerns over ‘inadequate’ number of psychiatrists in the hospital.

“The hospital is not adequately staffed, and there are other challenges such as poor remuneration, inadequate funding, and inadequate facilities. The wards are not enough to serve the rising number of patients,” another source in the hospital said.

Efforts to speak to the hospital’s Chief Medical Director, Dr. Jojo Onwukwe, were, however, not successful.

A top source at the Federal Neuro-Psychiatric Hospital in Calabar, Cross River State, said the health institution had been having at least five new cases of mentally ill patients on a daily basis in the last one year.

The source, who could not give the exact details of the number of patients that were treated in 2015 and 2016, attributed the increase to the current economic hardship in Nigeria.

He said, “The rate of increase in psychiatric patients is tied to hardship. In the current economic recession, people worry a lot. The underlying factor is stress. Things are hard. There is the high cost of rentals, foodstuff and transport fares. These are enough reasons to cause stress. This is in addition to drug abuse by youths.”

Speaking on the availability of psychiatrists across the country, the Head, Public Relations Unit of the hospital, Mrs. Obot Edet, said, “Psychiatric doctors are grossly inadequate at the moment.”

At Abia Psychiatric Hospital, Mgboko Umuocha, Abia State, a senior health worker, who spoke on condition of anonymity, observed that the current economic crisis had been leading to mental breakdown among more Nigerians.

The source said, “Generally, cases of mental health have recently been increasing day by day. More people are also having mental breakdown because of the current economic situation. Other causes include substance abuse and disappointment in marriages or academic pursuit.  Failure in examinations also makes some people develop mental illness.

“The economic crisis makes people worry a lot and they can get depressed. It creates problems in the family. Because of hardship, some women have depression while their husbands have problems coping with the demands of the family. We have a recent case of that nature here. Some women suddenly become aggressive and have mental illness when they can’t cope with certain family problems, especially with their husbands.

“The federal and state governments should do more by providing free treatment and rehabilitation for people with mental disorders like it is done in some other countries.”

Meanwhile, experts have described Nigeria’s current economic hardship as the perfect harbinger of suicide because it makes all the stressors available.

According to them, the factors capable of causing mental illness like poverty, hopelessness, insecurity, and high level of stress are on the increase in Nigeria, hence the rising cases of psychiatric disorders in the country.

Issa said it was unfortunate that with the increasing number of cases of mental illness, “there are less than 300 psychiatrists to Nigeria’s estimated 180 million people, when at least 5,000 are needed.”

According to him, the situation is worse in Kwara State, which has only 10 psychiatrists.

Also, lamenting the ratio of psychiatrists to mentally ill in the country, Nnaji said, “We do not have enough psychiatrists in the country. General hospitals lack experts to handle psychiatric issues and that is why we have mentally ill people on the streets, constituting nuisance and sometimes going wild.”

  • Additional reports: Ihuoma Chiedozie, Etim Ekpimah, Kayode Idowu, Ebere Uzoukwa and Godwin Isenyo

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