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Soc Psychiatry Psychiatr Epidemiol (2008) 43:552558 DOI 10.1007/s00127-008-0321-5
ORIGINAL ARTICLE
Julian Eaton Ahamefula O. Agomoh
Developing mental health services in Nigeria
The impact of a community-based mental health awareness programme
Received: 4 October 2007 / Accepted: 25 January 2008 / Published online: 20 February 2008
j Abstract This grass-roots level mental health awareness programme considerably increased use of community-based mental health services in a part of Nigeria where knowledge about treatability of mental illness was limited. The benets of the programme were sustained for a signicant period after the initial awareness programme. In order for attitude changes to be reinforced, similar awareness programmes must be repeated at regular intervals.
j Key words community mental health services health education health promotion Africa Nigeria
Introduction
Providing effective psychiatric services in low and middle income countries is beset with practical difculties. Despite a growing body of evidence for cost-effective intervention [7], a major hurdle to implementation is the attitudes of the population towards mental illness and their beliefs about treatment options [10, 12].
The parlous state of mental health services in Nigeria has been well documented [5, 11]. Annual expenditure on health in Nigeria is just 3% of Gross Domestic Product, with mental health taking only a small part of this total health budget. There are 0.4
psychiatric beds per 10,000 population [14]. Nigeria is the most populous country in Africa, with around 140 million people [1]. There are around 100 working psychiatrists in the whole of Nigeria and four psychiatric nurses per 1,00,000 population [6, 14]. Almost all of the psychiatrists are based in one of the countrys eight Federal Psychiatric Hospitals or 12 Teaching Hospital Psychiatric Departments. Due to lack of facilities, many trained psychiatric nurses do not actually work in the eld but return to general nursing once they nish their training. In our three states of operation; Abia and Ebonyi State Teaching Hospitals each have a part-time visiting psychiatrist, and Imo State has no state sector psychiatrist. The south-east of Nigeria is relatively well served in terms of psychiatric nurses, with more available than in the north of the country. This allowed all the nurses to be recruited from their own states (with most transferred out of a general nursing context into this...