Term Paper on "Psychological Therapy in Nigeria"

Term Paper 6 pages (1800 words) Sources: 1+

[EXCERPT] . . . .

Psychological Therapy in Nigeria person who suffers from Major Depressive Disorder has impaired quality of life and functioning at home, work and socially... women have double the risk... while rising levels of urbanization increase the risk by 40%." (Kau-nu 2007).

Prevalence of Depression in the Developing World

The World Health Organization warned that depression could become a main cause of disability and the second leading health problem in the world by the year 2020 (Acharya 2001). In 1996, Dr. Vikram Patel of the London Institute of Psychiatry conducted a study on the link among poverty, inequality and mental health in the developing world, using the Indian state of Goa as a case. He found that more than 40% of the adults receiving primary health care in clinics in the state had common mental disorder, such as anxiety or clinical depression. He also discovered that women were twice to thrice more likely to develop common mental disorders than men. Patel concluded that relative poverty, disability and gender were linked with the mental disorders and that poverty is an important "risk factor." Depression can develop or be triggered by adverse life-events, including physical illness, housing problems and joblessness. Mental disorders can develop in either gender, at any age or background. He also concluded that poverty, war and displacement can determine or influence the start, severity and duration of these disorders (Acharya).

Wife Battering, a Common Practice survey of 450 married Nigerian men and women, aged 15 to 50, revealed that wife battering is a common practice (Bandru 2004). It found that the practice tends to occur early in a marriage. Of the respondents, 35% of the men admitted to have beaten their wives, while 41% of the wives admitted having been assaulted by their husbands often in drunkenness. Nigerian marriages are polygynous, i.e., men have sex with women other than their wives. Polygynous marriages are said to be more prone to conflict. The survey also discovered that women with higher education qualification were subjected to beatings more than those with lower or no education (Bandru).

There is common agreement that women are at a higher risk for depression (Acharya 2001). Mental health experts, including Dr. Patel, acknowledged a huge amount of depression among Nigerian women. Women tend to internalize situations. Other experts view depression and low self-esteem as originating from the home environment. Women are raised without a sense of identity and subjected to domestic violence and abuse (Acharya).

Nigeria's Human Rights Conditions and Depression

In its 2005 Human Rights Report Practices around the world, the U.S. Department of State rated Nigeria's human rights conditions as "poor (Federal Research Division 2006)." The report said that Nigerian government officials and police were themselves behind politically-motivated killings, the use of deadly military force, beatings and torture and extortions. Other abuses include violence, discrimination, genital mutilation, child labor, prostitution and human trafficking. These are made worse by the imposition of Islamic law in 12 Northern states. Punishments are amputation, stoning and caning. Furthermore, there is curtailment of freedom of speech, press, assembly, religion, movement and privacy in Nigeria (Federal Research Division). United Nations reports also said that at least 200,000 children are trafficked out of West and Central Africa every year. The U.S. Department of State also estimates that approximately 400,000 children are engaged in child labor in areas including Nigeria. The Nigerian Police Force and the Women Trafficking and Child Labor Eradication Foundation also reported that between March 1999 and April 2000, approximately 1126 women taken out of the country were deported by different countries of destination. The maimed, the normal and those who sneaked out are included in this number. Other reports said that about 20,000 Nigerian women were in the sex industry in Italy, 80% of foreign prostitutes in 2002 were Nigerian (Federal Research Division). Under these conditions, wide-scale depression understandably occurs.

Nigeria, or the Federal Republic of Nigeria, is located in West Africa (Infoplease 2006). It is bound by the Gulf of Guinea in the south, Benin in the west, Niger in the northwest and north, Chad in the northeast and Cameroon in the east. Its capital is Abuja and its largest city is Lagos. As of 2006, it had a population of approximately 140 million.(Infoplease).

The National Agency for Prohibition and Trafficking in Persons and Other Related Matters likewise revealed that more than 15 million Nigerian children are brought from rural to urban cities to work and to become slaves (Child Rights Information Network 2005). Godwin Morka of the Lagos Zonal Office said that child trafficking in Nigeria was deeply rooted in the people's custom of having as many children to work at their parents' farms. The practice was aggravated by the establishment of the Structural Adjustment Programme in the 80s as it made it more difficult for parents to tend to their children. Human trafficking has developed into a highly organized transactional crime with severe criminal, moral and social effects. Nigeria has become a source country from which thousands of young Nigerians are taken to Italy, Belgium and even Saudi Arabia. As a destination country, thousands of trafficked victims are brought to it from different parts of Africa and the world for domestic labor and sexual exploitation (Child Rights Information Network).

The Depressed Elderly

Besides the women and children, older people in Nigeria suffer from depression. Among the elderly, the women are more prone to the major depressive disorder or MDD (Nordqvist 2007). Research revealed levels of urbanization as among the factors. The condition has been described as serious and disabling, yet a study showed that very few patients with the disorder ever obtain any kind of treatment. Professor Oye Gureje of the University of Ibadan, Nigeria 2,152 respondents aged 65 and over who lived in the Yaroba-speaking regions. This represented around a fifth of Nigeria's population. The results showed that lifetime depression was experienced by 26.2% of the respondents, while 7.1% of them experienced the disorder for the last year previous to the survey. Among them, women had twice the risk of developing MDD and urbanization can enhance it by 40%. MDD impairs the sufferer's quality of life and functioning at home, at work and in social relationships. Other studies disclosed that MDD occurred in 96.9% of all cases. Only 37% of lifetime cases acquired any treatment and it takes five years from the start of the symptoms for any treatment to start. The average MDD sufferer is poor, lives in the rural areas and is unlikely to receive treatment. Overall findings stress a high level of unmet needs for treatment among these sufferers and the need to provide increased and more responsive treatment for them (Nordqvist).

Mental health experts agree that the first part of the solution consists of an understanding of the local concepts of the mental illness and its specific syndromes (Nordqvist 2007). Then appropriate methods can be developed to measure its prevalence and incidence. Innovative intervention strategies can then be evaluated. Until this is done, they believe that they can only be limited with a cultural uncertainty instead of capturing the mental health problem, which is their common objective (Nordqvist).

Everyone, including Dr. Patel, agrees that women face a higher risk of developing depression (Acharya 2001). Women tend to internalize situations. Other experts, however, believe that depression and low self-esteem among women develop from the home environment. They are raised without a sense of personal identity and are traditionally subjected to domestic abuse and violence. Dr. Patel and the others held that health policies at both national and state levels should be formulated and implemented effectively. Dr. Patel also emphasized the importance of preventive strategies that will strengthen protective factors in the local communities. These can be in the form of resources that can supplement or duplicate extensive health systems existing in the developed world (Acharya).

Psychotherapy for Depression randomized controlled trial of group interpersonal psychotherapy with treatment for sufferers of depression provided evidence of immediate effectiveness following the intervention (Bass 2006). Another trial was conducted to evaluate the effectiveness of the therapy over a six-month period on participants with depression diagnosis and symptoms and functional impairment. It concluded that their participation in the intervention continued to benefit them mentally afterwards (Bass).

Studies conducted in Africa showed depression rates ranging from 0.8% for 12-month prevalence in Nigeria as compared to 25% in Zimbabwe, 15.5% in Rwanda and 20% in Uganda (Bass 2006). There have been many randomized controlled trials in developed countries on the effectiveness of psychotherapy-based interventions in controlling depressive symptoms. However, those conducted in developing countries have been few and clinic-based rather than the ideal community-based. This follow-up trial showed initial reductions in the symptoms for psychotherapy maintained at the six-month trial period and a year after as follow-up. In some cases, however, psychotherapy for depression may be impractical for the local government on account of the costs of antidepressants, employing medically trained personnel to monitor dosage and side-effects, and possible logistics problems. In the case of Nigeria, interpersonal psychotherapy in a… READ MORE

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