Mental Health and Disability Law in Nigeria: A Call for Affirmative Interpretation

Nigeria is the most populous African country, with an estimated population of over 200 million people, with about 20% to 30% of the population experiencing mental health disorder (MHD). Mental disorders have been associated with significant disability. Nigeria’s first mental health regulation came into force in 1916, and it was christened the Lunacy Ordinance.The use of the word, lunacy is not only discriminatory and derogatory; it also falls short of the World Health Organization’s definition of MHDs, violates the rights of persons living with mental disabilities, and discourages their inclusion into the society. Furthermore, since its enactment in 1958, the Lunacy law is yet to be amended, hence its failure to keep pace with modern mental health challenges, and realities. Unfortunately, mental health disabilities are not conspicuously addressed in the current disability law, the Discrimination against Persons with Disabilities (Prohibition) Act 2018, which appears heavily slanted towards physical disabilities based on the tone of its specific provisions.The crux of this paper is that the legislative intention of bringing mental health-related disability under the general rubric of disability should be given affirmative action in terms of interpretation of the terms of the law and the implementation thereof. The extreme focus of the law on physical disability, being the more obvious variety of functional limitation, will serve to impose double jeopardy on the mentally-ill if their equally disabling state of health is subordinated to physical disability. Therefore, we advocate equivalence of focus in terms of both physical and mental disabilities. Keywords: Mental health, Disability law, Nigeria, Affirmative interpretation DOI: 10.7176/JLPG/124-04 Publication date:September 30th 202

A descriptive survey of types, spread and characteristics of substance abuse treatment centers in Nigeria

<p>Abstract</p> <p>Background</p> <p>Nigeria, the most populous country in Africa and the 8th most populous in the world with a population of over 154 million, does not have current data on substance abuse treatment demand and treatment facilities; however, the country has the highest one-year prevalence rate of Cannabis use (14.3%) in Africa and ranks third in Africa with respect to the one-year prevalence rate of cocaine (0.7%) and Opioids (0.7%) use. This study aimed to determine the types, spread and characteristics of the substance abuse treatment centers in Nigeria.</p> <p>Methods</p> <p>The study was a cross sectional survey of substance abuse treatment centers in Nigeria. Thirty-one units were invited and participated in filling an online questionnaire, adapted from the European <it>Treatment Unit/Program Form (June 1997 version)</it>.</p> <p>Results</p> <p>All the units completed the online questionnaire. A large proportion (48%) was located in the South-West geopolitical zone of the country. Most (58%) were run by Non-Governmental Organizations. Half of them performed internal or external evaluation of treatment process or outcome. There were a total of 1043 for all categories of paid and volunteer staff, with an average of 33 staff per unit. Most of the funding came from charitable donations (30%). No unit provided drug substitution/maintenance therapy. The units had a total residential capacity of 566 beds. New client admissions in the past one year totalled 765 (mean = 48, median = 26.5, min = 0, max = 147) and 2478 clients received services in the non-residential units in the past year. No unit provided syringe exchange services.</p> <p>Conclusions</p> <p>The study revealed a dearth of substance abuse treatment units (and of funds for the available ones) in a country with a large population size and one of the highest prevalence rates of substance abuse in Africa. The available units were not networked and lacked a directory or an evaluation framework. To provide an environment for effective monitoring, funding and continuous quality improvement, the units need to be organized into a sustainable network.</p