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The National Assembly: To Meaningfully Invest In Mental Health in Nigeria the Role of Professional Psychology Needs Recognition

By: John Egbeazien Oshodi, Ph.D
 Published December 11th, 2011

In the November 4th, 2011 People’s Daily of Friday an article was featured, “Investing in Mental Health in Nigeria” (p.28).

The world recently celebrated the “Mental Health Day” on October 10th, 2011, a celebration that was fittingly acknowledged by the Nigeria media. The readers of the article could observe essential comments from the likes of medical, psychiatric and neurological doctors. In other media reports on the Mental Health Day, special call for more Psychiatrists and Nurses were made with Psychological Doctors/Specialists left out completely.

There remains a clear line of dissimilarities in trainings and approaches to mental health between medical doctors such as psychiatrists/neurologists, and clinical doctors like Psychologists.
To fully understand the distinct roles between the two groups let’s see how the World Health Organization(WHO) defines Mental Health as it remains the supposed guide for Nigeria.

Here it is: Mental health is “a state of wellbeing, in which the individual realizes his or her own abilities, can cope with normal stress of life, work productively and fruitfully, and is able to make a contribution to his or her community”.
With this WHO definition of mental health the major roles of psychiatrists/neurologists and psychologists in matters and issues of mental health (e.g. in Nigeria) are revealed fully and very clearly.

Within the WHO definition the introductory aspect that reads “a state of wellbeing”, is fundamentally an aspect of human functioning that requires psychological care first and foremost, before anything like medical care, psychiatrically or otherwise.

Psychology as a profession places emphases on the state of wellbeing solely in terms using psychometric or assessment measures/techniques to establish proactive, preventive, attitudinal, practical, and fitting behaviors in humans for the continued assertion of a healthy state of wellbeing.

In cases where an individual’s wellbeing is overwhelmed by negative lifestyle, personal failings or societal distress psychiatry and/or neurology as an end-of-all-purpose input is then warranted. This medical model follows when the individual’s state of wellbeing as determined by psychological assessment is deemed to be chronically unmanageable, therefore in need for bio-chemical, biological, pharmacological and medication/suppository interventions. Here we see a clear difference in approaches to mental health, psychologically, and medically.

Even a market woman, street vendor or a villager will rather want to learn about the positive verbal and non-verbal acts essential to maintaining an adequate state of being than injecting foreign substances (e.g. pills, medicines, drugs and other chemicals) into one’s body.

Within the WHO definition, the aspect that reads “the individual realizes his or her own abilities” strictly falls within the work of psychologists as they are trained to use cognitive assessment measures in regards understanding language, intelligence, memory, perception and reasoning and how each area affect an individual’s abilities. On the other hand psychiatrists/neurologists by training and certification standards are not about ability/intelligence/capability/aptitude testing. The most they can go in these areas is verbally question, and non-verbally observe an individual for the purpose of guesstimating or speculating his or her general capacity, mentally.

Inside the WHO definition, the aspect that reads “can cope with the normal stresses of life “, is principally engaging psychological tests to uncover the social-cultural factors revolving around where one lives and to understand stressful neighborhoods. To help reveal family conflicts, open up stressful physical situations, reveal marital conflicts, measure extreme poverty, define mental age and assess religious factors—as all these assist in classifying one’s level of coping skills to life stressors.

As for psychiatrists/neurologists the use of verbal talk, symptom-check-list, organic analysis , medication assessment and maintenance, remain their principal approach to the issue of poor coping and maladaptive behaviors. Even with the medical approach to the issue of abnormal coping skills to stress, the psychologists known for their expertise in running focused and other forms of supportive or group therapy are the once called ultimately by these medical hands to give supportive assistance.

Within the WHO definition, the aspect that reads “work productively and fruitfully” is solely within the purview of psychological specializations like vocational and occupational psychologists. It is doubtful if there is anything like ‘vocational psychiatry course’ or vocational psychiatry in the medical curricula, as vocational testing and job-related rehabilitation are still core areas in psychology.

Within the WHO definition, the aspect that reads “is able to make a contribution to his or her community” is an area called adjustment psychology which involves adjustment assessment and evaluation using psychometric procedures. As part of investing in the nation’s health, the human capital ought to be mentally fit, and the course of reaching this goal must begin by gaining from the multiple specialties of psychology. Some of these specialty areas include Clinical

Psychology which is concerned with the diagnosis and treatment of psychological disorders. Cognitive Psychology is concerned with what human beings know and how they come to know it. Community Psychology is concerned with the application of concepts, and skills from the areas of counseling, guidance and rehabilitation psychology.

Counseling Psychology is concerned with counseling, teaching, consulting, research, and management. Developmental Psychology is concerned with growth, development and maturation from conception through death. Educational Psychology is concerned with a variety of activities from initial design through development and evaluation of both resources and procedures for education and training. Engineering Psychology is concerned with designing and using environments and systems with which human beings live and work.

Experimental Psychology generally applies to a variety of psychologists who are trained in designing and conducting research in specific basic areas like learning, sensation, perception, performance, and motivation and emotion. Health/Medical Psychology is concerned with understanding how psychological factors can affect physical health. Industrial / Organizational Psychology is concerned with the relation between individuals and work. School

Psychology is concerned with increasing the efficiency of schools in improving the intellectual, social and emotional development of children. Social Psychology is concerned with the ways in which the social context affects the behavior of the individual and groups in the real world and the laboratory. Neuropsychology is concerned with the relationship between the brain and behavior. Geropsychology is concerned with the special problems faced by the elderly. School psychology is concerned with students' learning and behavioral problems, and recommends improvements to classroom management strategies.

Forensic psychology is concerned with the use of psychological principles in the legal and criminal justice system to help judges, attorneys, and other legal professionals understand the psychological findings of a particular case. As against these multiple psychological specialties, psychiatry is purely a medical specialty that studies biological or physiological factors in emotional-related disorders and diagnose, and treats various psychological disorders with prescribed medications.

Nigeria like many societies is where social and economic hardship could affect mental, neurological and behavioral developments; yet there is less emphasis on psychological specialties. As such, the nation is manned sometime by any-how-person even when they are holders of degrees as their productive capabilities remain pitiable—a common display in our society. And the prosperity and greatness of the people in general does not fully reflect in the society as negativity and mix-up acts remain common in the act of governance.

The nation is continuously challenged by issues of high mortality and fatality and socio-economic seclusion. Yet, psychologists who are trained solely to shed light on these issues and help connect the missing dots to societal problems through scientific methods in behavioral and policy analysis remain subjected to irrelevance in national discourse. This is continuously so even when the original source to many issues lies in psychology while psychiatry a much more secondary source to day-to-day issues remains in full display on national matters—a clear mistake on the part of the nation as a wide variety of problems and concerns requires information from psychology first.

No personal or social concern will “just go away” or “vanish” through medication intake or through psychological counseling. But fully understanding behaviors in our homes, in schools and in the workplace/worklife as per psychological or non-medication analysis make many of our everyday concern open to quick replacement with lasting positive motivation, learning and progressive lifestyle.

Mental health issues as they relate to financial resources for services and stigmatization of patients and their families remain problematic as the focus has mostly being in the provision of mental health facilities and psychotropic medications.

But if these sort of historical approaches to mental health continues certainly the cost will remain very huge. Since mental health institutions and facilities are easily recognizable as unusual, expensive, and the attendees of these facilities are subjected to ridicule, shame and stigma, a much more cost saving, less stigmatizing and even much more preventative approach is available—and that is psychology.

With the allowance and practice of psychology come home-centered services like developmental counseling, parenting therapy, behavior counseling, self-help training, preventive health-education, home-support visitation, and workplace counseling.

During these testing times in Nigeria, the Jonathan administration and the various States and local governments should see the science of psychology as indispensable to national issues, policy and decision making on behalf of the people and the society.

John Egbeazien Oshodi, Ph.D., is the Secretary-General of the Nigeria Psychological Association (NPA), Abuja, Nigeria.

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