Journal of Law, Policy and Globalization www.iiste.org ISSN 2224-3240 (Paper) ISSN 2224-3259 (Online) Vol.55, 2016 63 Stigma and Mental Health in Nigeria: Some Suggestions for Law Reform Cheluchi Onyemelukwe School of Law and Security Studies Babcock University, Ilishan Remo, Ogun State, Nigeria Abstract Nigeria has a significant number of people with mental health challenges. Unfortunately, this is perhaps the most neglected area of health in the country. This paper argues that this neglect is both caused and exacerbated by stigma. Stigma remains the most basic, cultural and moral barrier to the relief of mental health challenges. As a result of this, human rights abuses with deep roots in the stigma attached to mental illness continue to flourish largely unrestrained, impacting negatively on the dignity of mentally disabled persons as human beings. In this Article, therefore, I discuss stigma, a key challenge that affects persons living with mental illness in Nigeria. I review the effects of stigma and propose some reforms to law and the law making process as one way to reduce stigma and its adverse effects. Keywords: mental health, stigma, mental illness, law reform, legislation, rights, discrimination. 1. Introduction Nigeria has a population of about 180 million people. It is estimated that about 20 per cent of this population suffers some form of mental health challenge. 1 Yet other reports place the figures at about 30 per cent. 2 This is a significant number, running into millions of persons suffering some form of mental health challenge in Nigeria. Unfortunately, many of these persons have little recourse in terms of treatment, protection of their rights, rehabilitation or other support. Mental health remains one of the most neglected areas of health in Nigeria. The challenges of mental health in Nigeria are multi-faceted. The World Health Organisation AIMS report on mental health services in Nigeria 3 indicates that mental health services are grossly inadequate. Thus mentally disabled persons face several other challenges namely: poor mental health services, poor financing of mental health, limited access to available services and a limited number of providers. In terms of mental health financing, health financing in Nigeria is generally poor. 4 Of this poor government financing, only about 3.3% of the health budget of the Federal government goes to mental health, with over 90% of this going to mental hospitals. 5 Unfortunately, much of the inadequate funds available are not provided to the people who provide direct care to the mentally ill - families and friends. Reliance on certain alternative methods outside Western psychiatry has not often provided relief or reduced suffering and has, in many cases, promoted human rights abuses. Yet many people continue to use these avenues for lack of effective services. As a result, there continues to be deep suffering for the mentally challenged in Nigeria. Until recently, the policy for mental health was also outdated. There is some evidence that this is changing, at least at a policy level. The new National Health Policy (2016) notes the increasing numbers of persons with mental health issues and the need to address mental health. 6 A policy for mental health services delivery was developed in 2013: National Policy for Mental Health Services Delivery Nigeria, 2013. 7 However, several of the key provisions, including establishing a body at the Federal Ministry of Health to be focused on mental health, are yet to be implemented. The lack of a legal framework for protecting the human rights of people with mental disability is also emblematic of the gross neglect of mental disability. The 1951 Lunacy Act is outdated containing provisions which are not aligned with current international human rights standards. In short, there are myriads of problem facing mental health. Yet there are very few advocates for mental health issues, inclusion of mentally challenged persons and promotion of the rights of mentally ill persons. 8 One of the reasons for this situation is, in my view, the stigmatisation of mentally ill persons in Nigeria. Stigmatisation of mental illness and mentally ill persons in Nigeria is very high in the country. 9 Stigma remains the most basic, cultural and moral barrier to the relief of mental health challenges. As a result of this, human rights abuses with deep roots in the stigma attached to mental illness continue to flourish largely unrestrained, 1 WHO-AIMS Report on Mental Health System in Nigeria, WHO and Ministry of Health, Ibadan, Nigeria, 2006 2 MHLAP, Mental Health Situation Analysis in Nigeria, 2012 at 4. 3 WHO-AIMS Report on Mental Health System in Nigeria, WHO and Ministry of Health, Ibadan, Nigeria, 2006. 4 Mental Health Situation Analysis, p.4. 5 Mental Health Situation Analysis, 2012 p. 4). 6 Federal Ministry of Health, National Health Policy, 2016 (Abuja, Nigeria). 7 Federal Ministry of Health, National Policy for Mental Health Services Delivery Nigeria, 2013 (Abuja, Nigeria). 8 (WHO-AIMS Report 2006; Mental Health Situation Analysis, 2012). 9 WHO-AIMS Report, 2006