What does psychiatry say to Nigerians?
Psychiatry as a discipline and a metaphor might, indeed, be more relevant to the understanding of some psycho-social dimensions and being-ness of the postcolonial context we call Nigeria than might be obvious. Indeed, the Nigerian post-colony is filled with lots of terrible pathologies occasioned by a state that is existing in denial of its significant responsibilities. And in that denial lies the emergence of all the tragic symptoms of poverty, unemployment, infrastructural decay, underdevelopment, impunity, criminality, religiosity without spirituality and humanity, and bad governance, which have together turned Nigerians into angry and bitter citizens always demanding for a better quality of life without getting it. I believe that between legitimate aspirations that the citizens hold and the constant denial and deferral of such expectations by underperforming governments, there is a dark abyss in between that generates unhappiness and debilitations of all kinds. Carl Jung was critically perceptive: “Show me a sane man, and I will cure him for you.” This implies, I surmise, that there is only a thin line between the sane and the insane. Thus, sanity is not a state of mind that should be taken for granted.
And that means psychiatry ought to be taken with the utmost professionalism, patriotism and passion, if we must take Nigeria seriously. With these qualities, I am attempting to describe the humanity of Prof. Oyewusi Gureje— reputed to be Nigeria’s “most influential” researcher, a professor extraordinaire of neuropsychiatry, professional mediator of mental health, and a most unique human. I am referring to a scholar whose intimidating research oeuvre has remarkably inserted Nigeria into the global scientific map deserving of celebration.
Thomas Szasz, the Hungarian-American psychiatrist, once asked, “Is psychiatry a medical enterprise concerned with treating diseases, or a humanistic enterprise concerned with helping persons with their personal problems? Psychiatry could be one or the other, but it cannot—despite the pretensions and protestations of psychiatrists—be both.” It is definite that Szasz was being precipitated about his judgement, and even more so because the capacity of psychiatry to be both a medical and humanistic enterprise depends on the person and commitment of the psychiatrist. Gureje is not only an outstanding researcher—the most cited researcher in Nigeria according to the Web of Science Group, he brings patriotism and humaneness to a discipline that is one of the most vilified, but whose views on mental health are fast becoming fundamental in the world.
Gureje weaves a brilliant web of research, community service and advocacy that brings psychiatry and mental health into the consciousness of Nigerians. His Mental Health Leadership and Advocacy Programme has achieved the grand status of a continental initiative that draws together mental health caregivers, specialists and civil society to confront the ills of mental health and its relevance. And this is all the more significant because the lack of statistical analysis and impact assessment that correlate incidences of banditry, kidnapping, infrastructural burden and the general insecurity and civil conflicts with the mental health of Nigerians complicates the situation badly. And the predicament is terrible because it implicates both the elderly and the youth. Let us not forget that Nigeria is a youthful country, with a median age of 18. This means that 53.7 per cent of the Nigerian population resides between 15 and 65 years. With the increasing incidence of drug abuse, drug-induced crimes, money rituals, kidnappings for ransom, etc., that youthful population that ought to be the bedrock of human capital development is compromised. And the elderly that ought to be the repository of tradition and values are equally battling multilayered insecurity as the national economy exits and re-enters depression in equal measure, and have proven to be incapable, as yet, of providing a safety net to cushion their old age.
And so, we are back, undoubtedly to the late Prof. Adeoye Lambo and his call for Nigeria’s political class to be subjected to a mental health check before they contest for any political post. This seems logical given the spate of primitive accumulation and corrupt practices that, for instance, sees a person stealing N100bn in a country where about 95 million Nigerians are living below the poverty line. This is further complicated by sociocultural practices by Nigerians themselves, that stretch the curve between the search for money (through money rituals) and the frivolous and wanton display of wealth (through owambe partying). There are also paradoxical incidences of seemingly fulfilled individuals and professionals committing suicide. Medical doctors and psychiatrists speak about the revolving-door syndrome whereby an individual is diagnosed with a mental health issue, is treated and leaves only to return a few weeks later because such an individual took her healing for granted and thus stopped taking the drugs.
And so, Gureje and his associates and colleagues will keep lamenting a state of national mental health debilitation occasioned by leadership that itself requires a mental health check. Most unfortunately, Nigeria’s elite nationalism has occasioned morbid symptoms that complicate her developmental trajectory, especially the urgency of birthing a democratic developmental state that will take good governance seriously. The theories and rhetoric of Nigeria’s development failures keep mounting abysmally. We have heard of the wasted generation, the characteristic of Nigeria as a crippled giant, as well as the tragic horror of prebendalism and neopatrimonialism. And yet, these terrible epithets do not discourage a profligate leadership from its tragic course. Nigeria’s leadership quotient seems devoid of creative governance initiatives. I should know because I have struggled for many years to champion institutional and governance reforms that could help nudge the country toward development progress. Nigeria has not been fully integrated into the fourth industrial revolution, not to talk of being ready for the fifth. And the source of the trouble lies in the predilection of the leadership—administrative and political—to favour mediocrity at the expense of meritocracy, and the lack of critical attention to those Nigeria’s human capital development requirements that lead to an uncaring attitude about the state of higher educational development. No wonder the brain drain phenomenon is truly draining the critical mass of competences and skills that could have been deployed for Nigeria’s progress.
As Cassius says to Brutus in Shakespeare’s Julius Caesar, “Men at some times are masters of their fates: The fault, dear Brutus, is not in our stars, But in ourselves, that we are underlings.” The leadership of the Nigeria state has so far failed to take charge of the fate of Nigeria and Nigerians. And this in itself, from a psychiatric perspective is a mental health issue. And so, we begin to understand the predicament of scholars like Gureje who are patriotic enough to stand with the task of treating Nigeria’s psychosis. There is a point in scholarship that scholars like Gureje gets to that it becomes clear that more is required beyond research and scholarly visibility. The way Gureje has mediated that relevance is to continually maintain large collaborative networks involving students and colleagues to facilitate broader academic capital and public education. Much more than this, Gureje also ardently curates his research findings and outputs to policymakers across Nigeria and beyond. This is a significant strategy by which he seeks to maintain a firm touch with his environment.
Now, Gureje has achieved a septuagenarian pride—he has just added the hoary grace of age, as an àgbàlagbà, to the whole list of his overall excellence. The number seventy carries abundant sociocultural and theological significations. Even as the scripture pegs the normal span of human life at 70, Gureje has filled that span with enviable values of being a worthy human blessed with a heart that reaches the very depth of sacred and providential enablement. But then, 70 is just the beginning for a man who is relentless in doing good, from scholarship that bends tradition and orthodoxy to the demands of necessity, to mentorship that raises millions to keep passing the baton of the excellence of outreach, advocacy and patriotic assistance to the nation that made him possible.
One can imagine the pain of someone who has made the diagnosis, epidemiological studies and prevention of mental health crisis his life-long endeavor, now waiting for the government to respond to many years of scholarly research and policy initiative to be backed by the political will that will attend to the psychosis of the Nigerian society. And yet, the Mental Health Bill has still not seen the light of the day, as a sort of crowning patriotic reward for someone who has given so much effort to redeem the mental stress of Nigerians. And by still oscillating over the status of that bill, we arrive at the height of Nigeria’s neurological imbalance—this is a nation that has a host of critical minds and intellects working around her mental health issue, and yet the nation prefers to languish in that situation. Nigeria is deeply enmeshed in the revolving door syndrome.
- Prof Olaopa is of the National Institute for Policy and Strategic Studies, Kuru, Plateau State.