Young Nigerians are tackling the stigma of mental health

Elizabeth Ita had her first encounter with depression when she was 12 years old. After her beloved father died in their hometown of Calabar in southern Nigeria, she had no one to talk to about her grief – or the difficulties that quickly followed. “Nothing could have prepared me for that loss,” she says. “I felt overwhelmed, sad, guilty, and angry.” 

Living her teenage years under a dark cloud, Ms. Ita was among the one-third of Nigerians who have mental health challenges. But even if Ms. Ita or her family had wanted to seek professional help, access to such resources is scarce – just 300 psychiatrists serve Nigeria’s 206 million citizens.

Feeling lost and bullied at school, Ms. Ita spiraled. “It was as if there was a song in my brain playing on repeat and telling me I was stupid, worthless, and that no one loved me or cared,” she says.

A recent university graduate, Ms. Ita eventually found a renewed sense of purpose through volunteering. She also found solace and solidarity as she shared her story with other young Africans who had been through similar struggles. The experience drove her to set up Stilt NG, a nonprofit organization powered by 25 young volunteers who have all successfully dealt with mental health issues. 

Healthwise, it’s a rare bright spot for Africa’s most populous country, which has a mental health crisis that advocates say the government pretends doesn’t exist. But as such organizations – typically set up by young people – spread, many hope to slowly change the way the issue is discussed among Nigerians, underscoring the importance of mutual support, care, and a lack of judgment in helping people move forward. 

Courtesy of Stilt NG

Participants march on Oct. 11, 2021, in Calabar, Nigeria, to raise awareness about mental health. Marches like these and other public events seek to supplant a culture of silence about the issue. They also underscore the importance of mutual support, care, and a lack of judgment in helping people move forward.

“Possession by an evil spirit”

One sunny morning in February, Ms. Ita stood outside a community center in the port city of Calabar as several buses full of high school students pulled up. In all, some 250 children gathered for Children’s Mental Health Week.

Held simultaneously across three southeastern states in Nigeria, the event is one way Stilt NG hopes to demystify the concept of mental health. 

They face an uphill battle. More than half of all respondents to a 2019 survey believed that mental illness is the result of “possession by an evil spirit,” while 24% stated it was a punishment for doing something bad, highlighting the kind of popular misconceptions Ms. Ita and her team will need to counter.

“These children will today be introduced to something they might be going through but have never heard about,” Ms. Ita said as the children streamed into an assembly room. “I have confidence that the knowledge they gain today will make our society better.” 

Once the hall was full, she began by asking anyone who had ever felt depressed to raise their hands. In the long silence that followed, not a single hand was raised. Taking a deep breath, she started to tell the children her own journey.

She told them about her father dying, and how she’d been bullied at school. She told them about how she’d started self-harming. And she told them about how when she tried to talk with both her mom and her aunt, they’d brushed her off. “What do [you] even have to think of, or worry about, at such a young age?” they’d told her. 

After sharing her story, she asked the students once again. If you have ever felt this way, please lift your hands.

This time, around half of those in the room silently raised their hands. 

A culture of silence 

The stigma surrounding mental health in Nigeria is sustained by a culture of silence and outdated portrayals in local media, says Dr. Umar Baba Musami, a consultant psychiatrist at the University of Maiduguri.

But government negligence is at the heart of the problem. Just 3.5% of Nigeria’s health budget is assigned to mental health care, most of which is swallowed up by staff salaries and hospital-based care. The latter puts treatment further out of reach for millions who rely on clinics, particularly in rural areas. In Maiduguri, a city that has endured 17 years in the crosshairs of a violent sectarian conflict between Boko Haram Islamists and the Nigerian army, there is only one specialized hospital offering mental health treatment.

Among the most damaging policies is the colonial-era law known as the Lunacy Act, which is “the worst thing that has happened to the mentally ill in Nigeria,” Dr. Musami says. 

The law prescribes that those deemed “lunatics” by a judge in a local court or a doctor should be arrested and confined to “asylums,” encouraging the treatment of people with mental illnesses as criminals. In Nigeria, such institutions today are typically understaffed and overcrowded, and routinely include abuse such as chaining patients to the floor. 

But, says Dr. Musami, “trends have changed, and the country needs to move along with that trend.” 

Courtesy of Stilt NG

A student of St. Patrick's College in Calabar, Nigeria, shares his story with his schoolmates as Elizabeth Ita watches at Stilt Ng's 2019 Children's Mental Health Week. Since launching that same year, the organization has reached some 5,000 young people through public talks, publications, and visits to schools.

Fragile gains 

For now, updating archaic practices mostly falls on nascent nongovernmental organizations like Stilt NG. 

After Ms. Ita shared her story with the schoolchildren in February, many were eager to ask questions about mental wellness – the first time some had ever been able to do so. One student wanted to know if people got “madness” from what she called “spiritual attacks.”

A volunteer called Ifeanyi Agwazia stepped forward to answer the question. He explained that rather than “madness,” the medical term was “psychosis,” a physical process that could arise from drug abuse, trauma, untreated fever and – he concluded to rapt silence –  untreated mental illness.

Since its launch in 2019, Stilt NG’s team has reached some 5,000 young people through public talks, publications, and visits to schools. Before starting outreach programs, the organization’s volunteers receive training from mental health experts on emotional intelligence, active listening, and different types of disorders. And although the main focus is raising awareness, volunteers make referrals to professional psychiatrists when necessary.

But even as Stilt NG expands, any gains are fragile. Recently, after days of lobbying schools so they could hold awareness talks, only three agreed to open their doors. 

For those whom the organization does reach, though, the results can be life-changing.

Laurel Ugoji endured years of bullying in secondary school by her teachers who constantly told her she wouldn’t amount to much. 

“Nothing was worth doing,” says Ms. Ugoji. “I got awards, but ... a few times I rejected them because I concluded I wasn’t worth anything. What could a dull girl achieve after all?” 

Not until a friend encouraged her to attend Stilt NG sessions, both in person and online, did she slowly find a support network. 

“I gained my strength back,” says Ms. Ugoji, who is now a university graduate. “I saw myself as more than a conqueror – [I am] a valid human, one who is loved.” 

This article was published in collaboration with Egab.