Nigeria’s mental health act is dying from neglect - The Guardian Nigeria News

By A.G. Ahmed and Taiwo Lateef Sheikh

Imagine surviving a suicide attempt, only to wake up to handcuffs, instead of help. Imagine taking your distressed child to a hospital and discovering that the law promises care, dignity and protection, but the institutions meant to provide them do not exist. Imagine being chained, beaten or hidden away because your illness is mistaken for wickedness, possession or family disgrace.

This is not a problem affecting only nameless people in distant psychiatric hospitals. It may be the father of a senior civil servant developing dementia, wandering away from home and no longer recognising his children. It may be the son of a minister struggling with a substance-use disorder despite every privilege his family can provide. It may be the teacher living with depression, the police officer traumatised by violence or the young graduate who has quietly lost hope.

Mental illness does not check a person’s title, tribe, religion, profession or bank balance before entering the family.

Nigeria’s National Mental Health Act received presidential assent in December 2022 after decades of struggle. It replaced a cruel and outdated colonial system and promised that Nigerians with mental health conditions would be treated as people, not criminals, “madmen” or objects of shame.

The law protects their dignity, privacy and right to appropriate treatment. It provides safeguards concerning consent, admission, restraint and degrading treatment. It also establishes a Department of Mental Health Services, a Mental Health Fund and a Mental Health Assessment Committee.

Almost four years later, the law is still waiting to come alive.

Where is the Department of Mental Health Services? Where is the Fund? Where is the Assessment Committee? Who is inspecting facilities, enforcing standards, protecting patients and holding abusive institutions accountable?

A law that exists only on paper is not protection. It is a promise postponed and, for suffering families, a promise broken.

One of the most troubling objections is the suggestion that establishing a Department of Mental Health Services would amount to giving psychiatrists their own department. That completely misses the point.

Mental health does not belong to psychiatrists. It belongs to all of us.

It belongs to the mother whose child is suicidal, the father watching his daughter disappear into addiction and the family caring for a relative with dementia. It belongs to the soldier living with nightmares, the farmer displaced by insecurity, the kidnapping survivor struggling with fear and the woman experiencing depression after childbirth.

It concerns psychologists, nurses, social workers, occupational therapists, primary healthcare workers, teachers, employers, lawyers, judges, traditional leaders, religious leaders and journalists.

Mental health is not simply about “madness.” It affects how we learn, work, parent, govern, resolve conflict and build safe communities. The department created by law is not a professional trophy. It is essential public infrastructure.

Nigeria has made some progress. The country has developed a revised mental health policy and a national suicide-prevention framework. Mental health units have reportedly been established in 27 states and the Federal Capital Territory.

But this is not enough. Most Nigerians still pay directly for mental healthcare, while fewer than three per cent of people with mental health conditions reportedly have insurance coverage.

For an ordinary family, this may mean travelling hundreds of kilometres, borrowing money, abandoning treatment or desperately accepting help from anyone who promises a cure. Even the senior civil servant may discover that money cannot create a coordinated dementia service that does not exist. Even the minister may learn that influence cannot guarantee effective, confidential and continuing addiction care for his son.

A small programme buried within another department cannot perform all the responsibilities assigned to the statutory Department of Mental Health Services. Nigeria cannot substitute scattered activities for the coordinated system required by law.

In August 2026, the Federal Executive Council approved a proposal to amend the Act and decriminalise attempted suicide. The proposal is expected to proceed to the National Assembly.

Decriminalisation is necessary and long overdue.

A person who attempts suicide is not an enemy of the state. That person is overwhelmed, frightened and often mentally unwell. He or she needs emergency treatment, protection and hope, not a police cell.

We do not arrest people for developing cancer. We do not prosecute people for having a stroke. We should not punish a person for surviving a mental health crisis.

But decriminalisation must not become an excuse to reopen and weaken the entire Mental Health Act.

Why is a law that has not been fully implemented already being returned for amendment? What exactly will be changed? Will the amendment deal only with attempted suicide, or will other protections quietly disappear?

These questions are not unreasonable. They are necessary.

The government should publish the proposed amendment. Nigerians deserve to know what is being removed, added or rewritten. Patients, families, professionals, lawyers and civil-society organisations must be heard before any changes are made.

Decriminalise attempted suicide, yes. But do it through a focused and transparent reform. Do not use one humane correction to dismantle a law that millions of Nigerians still need.

The National Assembly’s responsibility did not end when it passed the Act. Its health committees should summon the responsible officials, demand explanations and establish firm timelines.

When will the department be established? When will the Fund become operational? When will the Assessment Committee be constituted? How much has been budgeted for implementation?

These questions require public answers, not another conference, workshop or beautifully worded communiqué that disappears into a drawer.

The Presidency must ensure that a law signed by the President is obeyed by the government. The Federal Ministry of Health must stop treating mental health as a minor programme. The Attorney-General must protect the integrity of the Act and support the removal of criminal penalties for attempted suicide.

State governments must establish functional services. Professional bodies must educate their members. The Nigerian Bar Association and human-rights organisations must defend people whose dignity and liberty are threatened. Journalists must keep asking uncomfortable questions.

Religious and traditional leaders must replace shame and superstition with compassion and timely referral. Employers and schools must recognise distress early and create safe pathways to care. Families must stop hiding suffering relatives as though illness were a crime.

The next person who needs this law may be the father of a senior official, the son of a powerful minister, your spouse, your colleague, your child or you.

Nigeria’s mental health is part of its social capital. A nation burdened by untreated trauma, addiction, depression and despair cannot become peaceful, productive or secure.

The Mental Health Act must not be allowed to die from neglect.

Establish the Department of Mental Health Services. Activate the Fund and Assessment Committee. Bring care into primary healthcare and health insurance. Train professionals. Protect patients. Support families. Decriminalise attempted suicide without weakening the wider law.

Nigeria has talked long enough. Implement the Act. Protect the people.

Prof. Ahmed is chair of Psychiatry, College of Medicine, University of Saskatchewan, Canada, while Sheikh is Professor of Psychiatry, Ahmadu Bello University, Zaria, is convener, Nigeria Suicide Prevention Advocacy Working Group.