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.
Jos5930458@aol.com
Published
December 11th, 2011
