Jecinta Powell is a mental health advocate and the founder of SENA Psychotherapy and Counseling. In this interview with NGOZI OKPALAKUNNE, Powell linked poverty, unemployment, underemployment and financial insecurity to the rising cases of mental issues in Nigeria.
She stressed the need for stronger mental health financing and better insurance coverage, urging government to prioritise funding and integrate mental health services in to National Health Insurance Scheme. Excerpts:
What are common mental health issues facing Nigeria and the factors driving them?
I would say some of the major mental-health concerns in Nigeria include anxiety, depression, trauma, substance misuse, relationship difficulties and chronic stress.
But these issues cannot be separated from the environment people are living in. Poverty, unemployment, underemployment and financial insecurity create prolonged stress and uncertainty. We also have gaps in mental-health literacy, which means many people struggle to recognise psychological distress or know when to seek professional help. Our social and cultural environment also plays a major role. Religion, traditions, ethnicity, family expectations and gender roles can influence how people understand and respond to mental-health difficulties. Sometimes distress is spiritualized, stigmatised or simply dismissed. Then there is the gap in access to mental-health intervention.
Even when people recognise that they need help, professional support may be too expensive, unavailable or difficult to access. So, Nigeria’s mental-health challenges are not only psychological. They are also economic, social, cultural and systemic, and addressing them requires us to look at the whole environment in which people live.
Investigations have shown that many Nigerians with mental conditions find it difficult to seek medical attention due to the stigma associated with mental illness. What is your take on this, and how can it be addressed?
I believe this is true. Many Nigerians do not initially consider that what they are experiencing could have a psychological component. We often interpret emotional distress through other lenses, including spirituality, family problems, personality or simply ‘life being difficult.’ Stigma can then make the idea of seeing a psychiatrist, psychologist or therapist feel like an admission that something is seriously wrong with you.
The problem is that when we stigmatise mental-health care, people don’t necessarily stop having problems; they simply learn to suffer privately. I think addressing this requires us to take mental-health education to the places where Nigerians already pay attention: schools, workplaces, religious communities, social media, primary healthcare and community programmes. We need to normalise conversations about mental wellbeing before someone reaches a crisis point.
We also need to change the language. Seeking psychological help should not be presented as a sign of weakness or ‘madness.’ It should be understood as a responsible step towards understanding yourself, managing difficulties and maintaining your wellbeing.
Ultimately, we need to move from only asking, ‘Is this person mentally ill?’ to also asking, ‘How is this person coping, and what support do they need?’
Looking at the economic situation in Nigeria, what step can an ordinary person take to improve his mental health?
The first thing is to recognise that improving your mental health requires intentionality and consistency, but it does not always require money. The first step is self-awareness. This is earning to recognise when you are becoming overwhelmed, when stress is becoming intense or prolonged, and when you need to pause rather than continue pushing yourself. From there, simple practices such as controlled breathing, meditation, journaling, taking breaks, movement and other forms of emotional and somatic regulation can help.
People can also intentionally educate themselves by following credible mental-health professionals and engaging with content that builds emotional awareness and psychological resilience. And importantly, there are free or low-cost sources of support. Mental-health communities, WhatsApp support groups, free webinars, psychoeducational programmes and community initiatives can provide
information, connection and encouragement. We should not underestimate the importance of community. Sometimes improving your mental health begins with simply what you are feeling, learning how to regulate it, and knowing that you don’t have to navigate everything alone.
Having been in this career for years, what are the signs that shows that one has mental issues?
I particularly like this question because psychopathology is not always easy to identify. Normal and abnormal behaviour exist on a continuum, so there is no single point where one suddenly becomes the other. We all experience stress, sadness, anxiety or emotional difficulties at different points in our lives. The concern is when these experiences become persistent, intense or begin to significantly interfere with a person’s psychological, physical, social or everyday functioning. For example, feeling anxious before an important event can be completely normal. But when anxiety becomes excessive, persistent and begins to impair someone’s ability to function, it becomes something that deserves attention. In more severe cases, disturbances in thinking or perception, such as hallucinations or delusions, may also occur.
More on signs, a person may become increasingly withdrawn, neglect themselves, behave in ways that are significantly out of character, or present a risk of harming themselves or others.
However, we have to be careful about labelling behaviour as abnormal simply because it does not conform to social expectations. Social norms change, and being different does not mean being should therefore be treated as part of organisational health, not simply as an employee’s personal responsibility.
How can parents, teachers and employers support the mental wellbeing of individuals?
I think the starting point for parents, teachers and employers is intentionality, empathy and curiosity. We need to listen actively, establish trust, respond appropriately and be slow to judge. Sometimes the most supportive thing you can do is notice that someone’s behaviour has changed and ask, ‘Are you okay?’ rather than immediately criticising or assuming.
For parents and teachers, this means creating environments where children and young people can express themselves without being immediately dismissed, punished or shamed. We should be curious about the behaviour and ask what may be happening underneath it.
For employers, mental wellbeing has to go beyond occasional wellness talks. Organisations need to create psychologically safe workplaces where employees can raise concerns without fear of retaliation or discrimination. This can include anonymous reporting channels, fair and structured performance appraisals to reduce subjective bias, reasonable workloads, employee wellness programmes, mental-health education and interventions that address burnout.
Most importantly, organisations need to recognise that people perform better when they feel psychologically safe, respected and supported. Mental wellbeing.
How can Nigerian government and policy makers improve mental care in the country?
The government needs to move from simply having mental-health policies to having policies that are measurable, properly funded, efficiently implemented and sustainable enough to create lasting change.
One major priority should be integrating mental-health services into primary healthcare, so that people do not always have to travel to specialist psychiatric hospitals before they can receive help. Ghana, for example, has worked towards decentralising mental-health care by integrating services into primary healthcare. South Africa’s current mental-health framework also prioritises community-based care and integration with general healthcare Nigeria also needs stronger mental-health financing and insurance coverage, better training and distribution of mental-health professionals, community-based interventions, school mental-health programmes, workplace initiatives and stronger public education to reduce stigma. Most importantly, policies should drive interventions down to the grassroots, including underserved and rural communities, rather than concentrating services in major cities.
For the ordinary Nigerian, this could mean being able to walk into a nearby health centre and receive basic psychological support or referral, having mental-health services covered or subsidised through health insurance, accessing support in schools and workplaces, and receiving help before a problem becomes a crisis.
Mental health is not separate from development. If we want a healthier, more productive and resilient population, mental healthcare has to be treated as part of healthcare and human development, not as an optional extra.