However slow going, the conversation on mental illness continues to shift from the dark place of shame and silence it had occupied for years in Nigeria to a place of seeking to understand, even if we sometimes bungle the conversation in our attempt to bring it to life.
Take this discussion on Twitter about what a user diagnosed as a tendency for the younger demographic of Nigeran’s to self-diagnose depression when, in his words, they take, “built-up stress and a couple of things as depression.” He asks, “Who diagnosed you?
The irony of self-diagnosing a whole demographic for wrongly self-diagnosing their own issues rather than seeking professional opinion when you are yourself not a professional social scientist aside, the concern is valid. The route the conversation took, one that takes delivery of all the blame to the doorstep of the sufferers who for equally valid reasons – of economic exclusion – find it hard to access professional diagnosis is the thorn that prickles.
Besides the endless horror stories emanating from government health facilities that present to be catering to the mental health needs of Nigerians but are on the inside a chamber of torture and degradation, accessing mental healthcare is expensive.
On average, a visit to a private practice costs between (N) 8, 000 – 25, 000 depending on where you are located. With most of the country’s minimum wage still at just over N 18, 000, it is unrealistic to expect that people’s first choice of trying to understand the changes they are noticing in their mental wellbeing to be a visit to a private practice or a government facility. The latter is a visit that has proven ruinous to many in the past because the facilities operate outdated and/or underfunded systems drained of all empathy from years of unchecked abuse.
That being said, with the world’s tally of existent diseases standing at no less than 10,000 diseases and the symptoms of one condition often overlapping the symptoms of dozens of other conditions, self-diagnosis remains dangerous for two reasons.
There is always the risk of misdiagnosis – which admittedly can occur and does in rare cases even with professionals – which reduces greatly if a professional is in charge. Someone might, for instance, think they have an anxiety disorder of some sort, but a closer professional examination might uncover an underlying serious medical problem such as a heart arrhythmia. Besides, there are over 200 recognised forms of mental illness, ranging from depression to anxiety disorders and schizophrenia to PTSD.
Then there is the risk of wrong treatment.
The slipperiness of the slope of self-diagnosis is rooted in our human capacity for audacious hope. We want to believe that if we hope deeply enough, somehow, we will be right and successfully self-diagnose and self-medicate our problems away. People who self-diagnose are more likely to self-medicate and to abuse drugs – which is a whole other mental health complication.
What’s the way forward
While the healthcare system in Nigeria awaits the necessary overhaul it’s been due for for decades and as private practices continue to emerger to fill the gap we have a responsibility to closely monitor the existing system and push for its restructuring as best as we can.
In response to increased awareness about mental illness, private practices are also creating products to cater to the less privileged. Safe space gatherings in art galleries where people can gather around a practicing therapist and pick up some coping tools that will help them at least manage their conditions. Group therapy and not-for-profit helplines that offer free virtual diagnosis and therapy. The options are there, even if they still fall behind the massive need.
The work isn’t in chastising people for turning to what’s most within their reach. It is continuing to push for mental health services to be available to all regardless of financial means. From government facilities that work for everyone to more inclusive products from private practices that will maintain healthy competition in the industry while catering to its growing customers.
Responding to a question in a Twitter Chat session with BellaNaija that asked, “Who should get therapy?” practicing psychotherapist Amanda Iheme said simply, “Everybody.”
The goal should be to make it accessible for that ‘everybody.’