With one in four Nigerians reportedly experiencing some form of mental illness, the country’s mental health system is under immense pressure.
Despite a population exceeding 200 million, Nigeria has fewer than 150 psychiatrists, and less than 10% of those with mental health conditions receive the care they need.
The treatment gap is driven by a severe shortage of professionals, poor integration into primary healthcare, limited access to neuropsychiatric hospitals, and widespread stigma.
In this exclusive interview with Nairametrics, Dr. Tochukwu Orjiakor, a clinical and forensic psychologist, Senior Lecturer at the University of Nigeria, Nsukka, and Postdoctoral Fellow at the University of Toronto, speaks on why Nigerians are still hesitant to talk about mental health.
He discusses the systemic neglect of non-medical professionals, the impact of medical brain drain, and the urgent need for grassroots-driven reform. Excerpts:
Nairametrics: Why are Nigerians still afraid to talk about mental health?
Dr. Tochukwu Orjiakor: One major issue is the lack of awareness. Many people don’t realize that conditions like depression, psychosis, schizophrenia, or bipolar disorder can affect anyone. Stress and genetics are contributing factors, and with better awareness, more people will start recognizing these issues in themselves or others and seek help.
Sadly, mental illness is still viewed as a sign of personal weakness or shame. This discourages people from speaking out, even when they are clearly suffering.
The stigma remains one of the biggest obstacles to mental healthcare in Nigeria. People fear being labeled “mad” or weak, so they stay silent. Families often hide these issues, which delays treatment and worsens outcomes.
Globally, mental health is becoming a more open conversation. But in Nigeria, it’s still heavily stigmatized and under-prioritized.
Access is important, but often the bigger barrier is awareness and acceptance. Many don’t recognize they’re experiencing a mental health issue.
They may dismiss symptoms as tiredness or just being “moody”, not realizing it could be depression or chronic stress.
Mental illness is like any other medical condition. It needs understanding, support, and treatment.
Nairametrics: What role should workplaces and organizations play in improving mental health in Nigeria?
Dr. Tochukwu Orjiakor: Workplaces have a critical role to play. Employers should introduce wellness programs that focus on education, prevention, and access to care. Mental health not only affects personal life—but it also directly impacts workplace productivity, performance, and morale.
Organizations and policymakers must promote awareness and ensure that employees understand that mental health is real and can manifest in different ways.
More research is also needed to identify specific challenges in various sectors and communicate these findings to stakeholders. For example, employers should be informed of the mental health issues most common in their industries.
It might surprise the public to know that medical doctors are equipped to treat mental health conditions. The more we acknowledge that anyone in the workforce can be affected, the more likely employers and authorities will take it seriously.
Some businesses, especially banks, have already started implementing assessment-based mental health strategies. This is a good start.
Federal agencies, start-ups, and established corporations need to follow suit. For professionals, participation in workplace wellness programs should be seen as essential for long-term productivity and sustainability.
We must also normalize help-seeking. When someone hits a breaking point, it should be okay, encouraged, and even to seek help.
Nairametrics: Does Nigeria have adequate data on mental health issues? If not, what gaps exist?
Dr. Tochukwu Orjiakor: We do have professionals working in this area, but it’s difficult to say we have “enough,” especially in underserved regions.
The major gap is in research funding. We need to invest in studies that explore how mental health issues arise, who is most at risk, and how these conditions are distributed across the population.
There are promising collaborations. For instance, I’m aware of partnerships between local professionals and global agencies like the WHO and the UN Office on Drugs and Crime (UNODC), particularly around substance use data. But it’s not enough.
The problem isn’t the lack of researchers, it’s the lack of funding to support them. These teams are identifying rising drug trends and health consequences, but their efforts need to be expanded significantly if we’re going to understand and address Nigeria’s mental health landscape effectively.
Nairametrics: How is doctor migration affecting mental health services in Nigeria?
Dr. Tochukwu Orjiakor: The brain drain is seriously damaging our healthcare system. Many doctors have left the country, and this affects mental health care delivery. As a result, people are turning to unqualified alternatives for help, which can worsen outcomes.
Meanwhile, countries like Canada are investing heavily in mental health. They have dedicated institutions like the Centre for Addiction and Mental Health, essentially ministries focused solely on mental health. They’re hiring Nigerian doctors and nurses because they recognize the importance of mental health care.
Nigeria, on the other hand, has not effectively utilized other mental health professionals, like psychologists, sociologists, and counselors. These experts have the training to manage mental health cases, especially those linked to behavior and environment.
We don’t have enough psychiatrists, and those we do have are leaving. Why not empower and integrate other mental health professionals, as we did with counselors during the HIV epidemic?
These professionals can help reduce the pressure on our overstretched system if the government acknowledges their value and involves them meaningfully.
Nairametrics: Many policies exist, but why don’t we see impact at the community level?
Dr. Tochukwu Orjiakor: The Mental Health Bill is still pending, despite years of advocacy. It’s frustrating. Government responsiveness is a major problem. We often hear promises that aren’t followed by action.
Honestly, I’m tired of saying “the government should…” It’s exhausting. Policy documents with fantastic ideas are collecting dust while communities remain unchanged.
The disconnect lies in implementation. Policies only work when they’re translated into real action at the grassroots level. And that’s where real change must happen.
Local communities are the solution. We need to start there—build awareness, help people identify where to get support, and empower existing community structures.
I’ve seen communities come up with their own (imperfect) ways of handling mental health challenges. While some methods are questionable, like physical punishment, it shows people aren’t waiting for the government. They’re doing what they can.
I believe in engaging village groups, market women, schools, universities, and neighborhood associations. These are the real change-makers. They’re already organized and can take ownership of mental health advocacy if given the right tools.
Nairametrics: Should Nigeria invest more in mental health infrastructure?
Dr. Tochukwu Orjiakor: We do have mental health facilities, like those in Yaba and Aro, but building more hospitals isn’t the main priority right now.
In advanced countries, mental health services are increasingly delivered through telemedicine, via phone calls, Zoom, or digital platforms. These methods can reach more people, especially in rural areas.
We should focus on awareness and service accessibility. Many children with autism or learning disabilities are misunderstood and mistreated due to ignorance. People with chronic conditions like diabetes often suffer from comorbid mental health challenges that go unrecognized.
Universities often have mental health researchers and practitioners who are accessible. So, rather than just constructing new facilities, let’s improve awareness and integrate services into existing systems.
Nairametrics: How does stigma affect the use of mental health services?
Dr. Tochukwu Orjiakor: The stigma around mental health is significant. People often refer to psychiatric hospitals using derogatory terms, which discourages others from seeking help.
Even in the West, people hesitate to visit mental health facilities despite less stigmatizing language. Public education is key. We must change how we talk about mental health and create safe, supportive environments that reduce shame.
Changing the narrative and how we brand mental health services is a necessary step toward reducing stigma and improving service utilization.
