Mental Health Infographic. Image from Pixabay
©️ Pixabay

From illness to disability: changing the mental health conversation in Nigeria

22nd June 2020

As I prepare to take 20mg of escitalopram - an antidepressant - I can’t help but ponder what point exactly - what exact decision - altered the course of my life. It was in November of 2015 that I had first innocently expressed the thoughts in my head. I casually said, “Do you sometimes just feel like dying?” The response said it all. This wasn’t normal. It wasn’t okay to express such thoughts. “How can you say such? You should be grateful”. Grateful? Of course I was. I had a decent paying job as a research analyst in an investment firm and I come from a middle-class family. So what was it about this dark feeling inside of me that I couldn’t shake off?

Not all ‘illnesses’ are created equal

At home, I withdrew from family gatherings, talked less, and was often called lazy and moody. At work, I began to lose fragments of my day, could barely process information, and was generally performing very badly. At least that’s what I thought. What’s worse than going through unexplainable feelings is going through it alone. It’s having to say, “I’m fine” when I’m clearly not and agreeing that “it’s a phase” when well intentioned people get uncomfortable and run out of words of consolation.

“Bipolar Affective Disorder and Post Traumatic Stress Disorder”, the psychologist said. I recall the relief I felt knowing that it was all ‘an illness’. It meant that something was happening to me. At the same time, I soon realised that not all ‘illnesses’ are created equal. For a mental health diagnosis, it meant a possibility of being shamed and having loved ones being shamed by association. It also meant that I had to prove something that was invisible to many eyes. It meant that if I was rightly upset, my sanity will constantly be called into question. You see, not all ‘illnesses’ are created equal.

Overcoming the stigma of mental health conditions

Living with a ‘mental illness’ is being in a constant battle with a term that has long been associated with “madness”, penance for witchcraft and somehow not being strong enough to handle what everyone else is going through. It is somehow realising that you fell off the wagon while everyone else weathered the storm.

As my work in giving mental health a voice in Nigeria continues to evolve, I am constantly faced with new ways of looking at mental health. Not just because of my diagnosis, but for the nearly 60 million Nigerians who live with ‘mental disorders’, according to the Federal Ministry of Health. Something about the labelling of mental health conditions as “illness” has had me unsettled for a long time. It somehow means that something is ‘wrong’ with us.

For me, I see my life experience as...different. I find that with the right understanding, accommodations and environment, I thrive unhinged. So, is something “wrong” with me? Or am I “different” in a way that is not yet widely understood? As I battled internally in Nigeria, my answers lay unknown to me in one of the defining conventions of the United Nations, drafted 11 years before.

“Recognizing that disability is an evolving concept and that disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others.” (UN CRPD Preamble). 

This was my eureka moment! It made sense.

I am different. We are different.

Nothing is “wrong” with us.

Shifting the focus on mental health

'Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others' (UNCRPD, 2006, p. 4).

Armed with this liberation, I went on to make history at the Nigerian parliament on 17 February 2020 as the first openly identifying person with a mental health condition/psychosocial disability to testify on the floor.

Why then did it look like I disagreed with Nigeria’s long overdue Mental Health Bill that fateful day? This is how I see it - when the lens through which we see mental health conditions shifts from illness to disability as defined in the UN CRPD, the consequences also change drastically in solutions, policies and human rights.

When my condition is not seen as something that is wrong with me but as a set of qualities that my environment is yet to adapt to, people with mental health conditions are no longer seen as a problem that needs to be fixed, cured and solved. By extension, we become humans first before our conditions. We then shift the focus of solutions and policies from fixing people to fixing the environment.

This is why we must deliberately take a second look at the mental health conversation in Nigeria and how these conversations shape our identity as persons with mental health conditions and psychosocial disabilities.

About the author

Hauwa Ojeifo is a multi-awarded young leader and advocate on mental health and sexual violence in Nigeria. She is the Founder and current Executive Director of She Writes Woman. More recently, Hauwa was selected for the Young Health Programme and has become an Ambassador for One Young World. Hauwa also shares her thoughts on social media at @hauwa_ojeifo and can be emailed at: [email protected].