Mental Health Services and Online Therapy in NigeriaIn a country with a population of nearly 200 million, there are only 250 psychiatrists in Nigeria. These services mostly exist in urban areas. With 70% of the population in rural communities, it is difficult to access mental health services. One in four Nigerians suffer from mental illnesses, so there is a high need for these services, specifically therapy.

Mental Health Services

In Nigeria, there are limited resources for mental health services. An estimated 80% of people with mental illnesses are not able to access the correct care facilities. The majority of care is in the hand of family members, who are not properly trained or informed. The lack of facilities, resources and proper information on mental health services and illnesses worldwide is why the World Health Organization (WHO) is determined to help. In a 2013 mental health action plan, the WHO planned to have 50% of countries by 2020 update or expand on its law in order to revise with the international and regional human rights instructions.

Militant Group Causes Need for Therapy

One significant reason for the need for therapy in Nigeria is the militant group Boko Haram in the northeastern part of the country. The group has been trying to gain more territory, and in doing so, it has caused more than 20,000 deaths and nearly 1.8 million people displaced from their homes, according to a June 2019 report. In Maiduguri, the group’s violence has affected almost the entire population. Due to the ongoing brutality, many are suffering from post-traumatic stress, and the WHO recorded that Nigeria has the seventh-highest number of suicides in Africa.

Online Therapy in Nigeria

Nearly 103 million Nigerians have access to the Internet. As such, receiving virtual therapy is far easier than traveling to one of the few facilities in the country. A typical therapy session can be about $70 a meeting, which is unaffordable for most of the population since the minimum wage is $49 a month. Online therapy makes for an easier and a more reasonable form of care.

Additionally, online therapy is an easier option for some because it does not require the person to be face to face with the therapist. The patient is able to have these conversations from the comfort of their own home. Services like Talkspace, Calmerry and Amwell include packages that can be paid for weekly, and some even accept insurance. These packages may also include unlimited messages, live video chats and phone calls. All of the programs also go through a questionnaire process to match the patient with the best therapist for them.

Another program, MANI, is run through Twitter and WhatsApp. The nonprofit mental health service has counselors that are volunteer psychiatrists and medical officers. Since volunteers run the program, a patient cannot receive more than five sessions. However, the suicide hotline is always free to call.

It is clear that Nigeria needs more mental health services. Therapy is hard to access and often too expensive. With the country’s rising population, there is still a long way to go in order to provide reasonable access to people suffering from mental illnesses. However, through these online programs, therapy in Nigeria is increasing. Additionally, with the growing amount of Internet access, there is now an increase in the availability of these services.

Sarah Kirchner
Photo: Flickr

After the program’s continued success both outside and within internal displacement camps in northeastern Nigeria, the Mental Health Gap Action Programme (mhGAP) plans its first expansion by training 70 new healthcare workers.


Since the program’s inception in September 2017, mhGAP has trained 64 primary healthcare workers and assisted more than 5,000 people from over 35 different primary healthcare facilities, including local clinics. The project was launched by the World Health Organization (WHO) in partnership with Borno state authorities and the Federal Neuropsychiatric Hospital of Maiduguri in order to treat mental illness in emergency situations, particularly internally displaced persons and low-income individuals (often times intersecting).

The prevalence of mental health disorders in Nigeria is estimated at around 12 percent, an unproportionately high figure compared to the small number of clinics that offer treatment. Due to the widespread violence in northeastern Nigeria, nearly 7 million people live in camps meant for internally displaced persons and WHO estimates that nearly 1 in 5 of said 7 million may need mental health care, much of which is largely unavailable. In fact, the Federal Neuropsychiatric Hospital of Maiduguri is the only facility in the region that focuses primarily on mental health.

Prevalence of Mental Illness

Mental illness is particularly prevalent in communities that experience extreme levels of stress and adversity, such as internally displaced persons and those living in extreme poverty. According to WHO, experiences such as abductions, violence, gender-based violence and atrocities can trigger mental illness and other psychological problems.

The prevalence of disorders such as anxiety, depression and Post-Traumatic Stress Disorder (PTSD) have increased by an average of 5 to 10 percent, and the instances of psychosis double on average, according to public data published by the World Bank. These percentages are often higher among children and adolescents, with incidents of PTSD ranging from 50 to 90 percent.

mhGAP Intervention Methods

To combat increased prevalence, mhGAP utilizes programs for intervention and management, focusing on neurological, mental and substance-use-associated disorders such as psychotic disorders, epilepsy, suicide, dementia, alcohol and illicit drug abuse and childhood mental illness.

The program provides access to mental healthcare otherwise unattainable for the majority of those displaced. This lack occurs due to an absence of monetary resources and a scarcity of functioning mental health facilities.

Approximately two-thirds of the 749 known healthcare facilities in Borno have been destroyed or damaged as a result of the Nigerian army’s eight-year-long conflict with Boko Haram. The ongoing violent conflict has also forced over 2 million people from their homes, negating any possibility of regular access to affordable health services — mental or otherwise.

Hope, Help and Knowledge

Borno, accompanied by the majority of northeastern Nigeria, struggled socioeconomically prior to any conflict with Boko Haram. Over 70 percent of Borno’s population lives under the poverty line — almost 30 percent higher than the national average of 46 percent, according to the U.N. Global Multi-Dimensional Poverty Index.

While mental health continues to remain only one of the many pressing issues of internally displaced persons, mhGAP’s success both inside and outside displacement camps demonstrates a positive shift towards the national perception of mental illness. mhGAP’s resources enables the most vulnerable to hope and provides the knowledge that their situations are not permanent.

– Katie Anastas
Photo: Flickr