COVID-19-RELATED DISRUPTION IN MENTAL HEALTH SERVICES IN NIGERIA: THE EVIDENCE AND A PROPOSED MODEL FOR TELEPSYCHIATRY

Abstract

Ever before the advent of the COVID-19 pandemic, Nigeria has had one of the most constrained mental-health service delivery systems in the world, with only a tiny fraction of persons with disabling mental disorders being able to access needed mental-health services. For instance, data from the Nigerian National Mental Health Survey showed that only a paltry 9% of Nigerians with diagnosable mental and behavioural disorders had received any form of orthodox treatment, among whom only about 1% received specialist mental health service.1 Furthermore, a recent survey of primary health facilities in northern Nigeria showed that, despite having mental-health services on their reported scope of services, none of the facilities was providing any formal mental health services2. In recognition of these treatment- and service-gaps, there have been efforts to expand and increase access to mental-health services in the country through interventions such as deliberate integration of mental-health services into primary health care3,4 and community-based mental-health awareness programmes.5 In this opinion paper, we provide both original and review-based evidence that the restrictions that came with the COVID-19 pandemic has led to an increase in the burden of mental-health problems among Nigerians and has also occasioned further disruption in the already constrained mental-health services in the country. We will also propose telepsychiatry as the panacea to bridge the gap while presenting a model of how this might work.