Skip to main content
Top
Published in: International Journal of Mental Health Systems 1/2013

Open Access 01-12-2013 | Research

Mental health care policy environment in Rivers State: experiences of mental health nurses providing mental health care services in neuro-psychiatric hospital, Port Harcourt, Nigeria

Authors: Izibeloko Omi Jack-Ide, Leana R Uys, Lyn E Middleton

Published in: International Journal of Mental Health Systems | Issue 1/2013

Login to get access

Abstract

Background

Mental health services for Rivers State and surrounding States in the Niger Delta region of Nigeria are provided only at the neuropsychiatric Rumuigbo Hospital in Port Harcourt City, Rivers State, Nigeria. The study explored mental health nurses’ experiences of providing mental health services at the hospital in an attempt to understand policy implications, identify difficulties and challenges of delivering mental health care services.

Methods

A qualitative study using in-depth interview was conducted among 20 mental health nurses working at the neuropsychiatric Rumuigbo Hospital. This was reviewed within the Townsend mental health policy template of context and resources domains.

Results

A lack of political support and senior position in the Ministry of Health hinders service delivery, the prevalence of institutionalized stigma, a lack of training, and system failure to provide services at all levels of care is hampering service delivery. The inadequate allocation of resources for hospital renovations and equipment is preventing appropriate client care, as does the lack of funding for drugs, the cost of which makes them unaffordable, affecting clients staying on treatment.

Conclusion

Education and training of mental health care professionals should be given priority to remedy human resource shortage, provide incentives to motivate health professionals for psychiatric practice, and move toward decentralization of care into general health care services. Information should be provided at all levels to overcome the myths surrounding the causes of mental illnesses, to reduce stigma and discrimination of the affected and their families.
Literature
1.
go back to reference World Health Organization: Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group. 2010, Geneva: World Health Organization World Health Organization: Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group. 2010, Geneva: World Health Organization
2.
go back to reference World Health Organization: Improving Health Systems and Services for Mental Health. (Mental health policy and service guidance package). 2009, Geneva: World Health Organization World Health Organization: Improving Health Systems and Services for Mental Health. (Mental health policy and service guidance package). 2009, Geneva: World Health Organization
3.
go back to reference Gavois H, Paulsson G, Fridlund B: Mental health professional support in families with a member suffering from severe mental illness: a grounded theory model. Scand J Caring Sci. 2006, 20: 102-109. 10.1111/j.1471-6712.2006.00380.x.CrossRefPubMed Gavois H, Paulsson G, Fridlund B: Mental health professional support in families with a member suffering from severe mental illness: a grounded theory model. Scand J Caring Sci. 2006, 20: 102-109. 10.1111/j.1471-6712.2006.00380.x.CrossRefPubMed
4.
go back to reference Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A: No health without mental health. Lancet. 2007, 370 (9590): 859-877. 10.1016/S0140-6736(07)61238-0.CrossRefPubMed Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A: No health without mental health. Lancet. 2007, 370 (9590): 859-877. 10.1016/S0140-6736(07)61238-0.CrossRefPubMed
5.
go back to reference Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A, De Sliver M, Hosman C, McGuire H, Rojas G: Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet. 2007, 370 (9591): 991-1005. 10.1016/S0140-6736(07)61240-9.CrossRefPubMed Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A, De Sliver M, Hosman C, McGuire H, Rojas G: Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet. 2007, 370 (9591): 991-1005. 10.1016/S0140-6736(07)61240-9.CrossRefPubMed
6.
go back to reference World Health Organization WHO: The World Health Report: Primary Health Care Now More Than Ever. 2008, Geneva: World Health Organization World Health Organization WHO: The World Health Report: Primary Health Care Now More Than Ever. 2008, Geneva: World Health Organization
7.
go back to reference World Health Organization and World Organization of Family Doctors (WONCA): Integrating mental health into primary care: a global perspective. 2008 World Health Organization and World Organization of Family Doctors (WONCA): Integrating mental health into primary care: a global perspective. 2008
8.
go back to reference World Health Organization: Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological and Substance Use Disorders. 2008, Geneva: World Health Organization World Health Organization: Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological and Substance Use Disorders. 2008, Geneva: World Health Organization
9.
go back to reference Crisp AH, Gelder MG, Rix S, Meltzer HI, Rowlands OJ: Stigmatisation of people with mental illnesses. Br J Psychiatry. 2000, 177: 4-7. 10.1192/bjp.177.1.4.CrossRefPubMed Crisp AH, Gelder MG, Rix S, Meltzer HI, Rowlands OJ: Stigmatisation of people with mental illnesses. Br J Psychiatry. 2000, 177: 4-7. 10.1192/bjp.177.1.4.CrossRefPubMed
10.
go back to reference Ssebunnya J, Kigozi F, Lund C, Kizza D, Okello E: Stakeholder perceptions of mental health stigma and poverty in Uganda. BMC Int Health Hum Rights. 2009, 9: 5-10.1186/1472-698X-9-5.PubMedCentralCrossRefPubMed Ssebunnya J, Kigozi F, Lund C, Kizza D, Okello E: Stakeholder perceptions of mental health stigma and poverty in Uganda. BMC Int Health Hum Rights. 2009, 9: 5-10.1186/1472-698X-9-5.PubMedCentralCrossRefPubMed
11.
go back to reference Lund C, Kleintjes S, Campbell-Hall V, Mjadus S, Petersen I, Bhana A, et al: Mental health policy development and implementation in South Africa: a situation analysis Phase 1. Country Report Cape Town. Mental Health and Poverty Project. 2008 Lund C, Kleintjes S, Campbell-Hall V, Mjadus S, Petersen I, Bhana A, et al: Mental health policy development and implementation in South Africa: a situation analysis Phase 1. Country Report Cape Town. Mental Health and Poverty Project. 2008
12.
go back to reference Funk M, Drew N, Saraceno B, De Almeide JMC, Agossou T, Wang X, et al: Framework for Mental Health Policy, Legislation and Service Development: Addressing Needs and Improving Services. Harvard Health Policy Review. 2005, 6 (2): 57-69. Funk M, Drew N, Saraceno B, De Almeide JMC, Agossou T, Wang X, et al: Framework for Mental Health Policy, Legislation and Service Development: Addressing Needs and Improving Services. Harvard Health Policy Review. 2005, 6 (2): 57-69.
13.
go back to reference World Health Organization: World Health Report 2001: Mental Health: New Understanding, New Hope. 2001, Geneva: World Health Organization World Health Organization: World Health Report 2001: Mental Health: New Understanding, New Hope. 2001, Geneva: World Health Organization
14.
go back to reference Federal Ministry of Health (FMOH): The National Mental Health Policy in Nigeria. 1991, Lagos Federal Ministry of Health (FMOH): The National Mental Health Policy in Nigeria. 1991, Lagos
15.
go back to reference Federal Ministry of Health (FMOH): Revised Draft National Health Policy. 2004, Abuja: Federal Ministry of Health, 1(1): 12 Federal Ministry of Health (FMOH): Revised Draft National Health Policy. 2004, Abuja: Federal Ministry of Health, 1(1): 12
17.
go back to reference Omigbodun O: A cost-effective model for increasing access to mental health care at primary care level in Nigeria. J Ment Health Policy Econ. 2001, 4: 133-139.PubMed Omigbodun O: A cost-effective model for increasing access to mental health care at primary care level in Nigeria. J Ment Health Policy Econ. 2001, 4: 133-139.PubMed
18.
go back to reference Odejide O, Morakinyo J: Mental health and primary care in Nigeria. World Psychiatry. 2010, 2 (3): 164-165. Odejide O, Morakinyo J: Mental health and primary care in Nigeria. World Psychiatry. 2010, 2 (3): 164-165.
19.
go back to reference Afolayan JA, Peter IO, Amasueba AN: Prevalence of schizophrenia among patients admitted into neuro-psychiatric hospital, Rumuigbo, Port Harcourt, Rivers State Nigeria. Continental J. Nursing Sciences. 2010, 2: 8-16. Afolayan JA, Peter IO, Amasueba AN: Prevalence of schizophrenia among patients admitted into neuro-psychiatric hospital, Rumuigbo, Port Harcourt, Rivers State Nigeria. Continental J. Nursing Sciences. 2010, 2: 8-16.
20.
go back to reference Townsend C, Whiteford H, Baingana F, Gulbinat W, Jenkins R, Baba A, et al: The Mental Health Policy Template: Domains and Elements for Mental Health Policy Formulation. Int Rev Psychiatr. 2004, 15 (1–20): 18-23.CrossRef Townsend C, Whiteford H, Baingana F, Gulbinat W, Jenkins R, Baba A, et al: The Mental Health Policy Template: Domains and Elements for Mental Health Policy Formulation. Int Rev Psychiatr. 2004, 15 (1–20): 18-23.CrossRef
21.
go back to reference Crabtree BF, Miller WL: Doing Qualitative Research. 1999, London: Sage, 164-194. 2nd Crabtree BF, Miller WL: Doing Qualitative Research. 1999, London: Sage, 164-194. 2nd
22.
go back to reference QSR International: NVivo qualitative data analysis software Version 8. 2008, Victoria, Australia: Pty Ltd Doncaster QSR International: NVivo qualitative data analysis software Version 8. 2008, Victoria, Australia: Pty Ltd Doncaster
23.
go back to reference Banister P, Buraian E, Parker I, Taylor M, Tindall C: Qualitative methods in psychology: A research guide. 1994, Buckingham: Open University Press Banister P, Buraian E, Parker I, Taylor M, Tindall C: Qualitative methods in psychology: A research guide. 1994, Buckingham: Open University Press
24.
go back to reference Kapungwe A, Cooper S, Mwanza J, Mwanza L, Sikwese A, Kakuma R, et al: Mental illness- stigma and discrimination in Zambia. Afr J Psychiatry. 2010, 13: 192-203. Kapungwe A, Cooper S, Mwanza J, Mwanza L, Sikwese A, Kakuma R, et al: Mental illness- stigma and discrimination in Zambia. Afr J Psychiatry. 2010, 13: 192-203.
25.
go back to reference Aghukwa CN: Attitudes towards psychiatry of undergraduate medical students at the Bayero University. SAJP. 2010, 16 (4): 147-152. Aghukwa CN: Attitudes towards psychiatry of undergraduate medical students at the Bayero University. SAJP. 2010, 16 (4): 147-152.
26.
go back to reference Byrne B: Stigma of mental illness and ways of diminishing it. Adv Psychiatr Treat. 2000, 6: 65-72. 10.1192/apt.6.1.65.CrossRef Byrne B: Stigma of mental illness and ways of diminishing it. Adv Psychiatr Treat. 2000, 6: 65-72. 10.1192/apt.6.1.65.CrossRef
27.
29.
go back to reference Atilola O, Olayiwola F: Mind frames in Nollywood: frames of mental illness in home videos. Research Journal of Medical Sciences. 2011, 5 (3): 166-171.CrossRef Atilola O, Olayiwola F: Mind frames in Nollywood: frames of mental illness in home videos. Research Journal of Medical Sciences. 2011, 5 (3): 166-171.CrossRef
30.
go back to reference Aghukwa CN: Attitude of health workers to the care of psychiatric patients. Annals of General Psychiatry. 2009, 8: 19-10.1186/1744-859X-8-19.CrossRef Aghukwa CN: Attitude of health workers to the care of psychiatric patients. Annals of General Psychiatry. 2009, 8: 19-10.1186/1744-859X-8-19.CrossRef
31.
go back to reference Gureje O, Lasebikan VO, Ephraim-Oluwanuga O, Olley BO, Kola L: Community study of knowledge of and attitude to mental illness in Nigeria. Br J Psychiatry. 2005, 186: 436-441. 10.1192/bjp.186.5.436.CrossRefPubMed Gureje O, Lasebikan VO, Ephraim-Oluwanuga O, Olley BO, Kola L: Community study of knowledge of and attitude to mental illness in Nigeria. Br J Psychiatry. 2005, 186: 436-441. 10.1192/bjp.186.5.436.CrossRefPubMed
32.
go back to reference Kabir M, Iliyasu Z, Abubakar IS, Aliyu MH: Perception and beliefs about mental illness among adults in Karfi village, northern Nigeria. BMC International Health and Human Rights. 2004, 4: 3-10.1186/1472-698X-4-3.PubMedCentralCrossRefPubMed Kabir M, Iliyasu Z, Abubakar IS, Aliyu MH: Perception and beliefs about mental illness among adults in Karfi village, northern Nigeria. BMC International Health and Human Rights. 2004, 4: 3-10.1186/1472-698X-4-3.PubMedCentralCrossRefPubMed
33.
go back to reference Mkhize N, Kometsi MK: Community access to mental health services: Lessons and recommendation. South African Health Review. Edited by: Barren P. 2008, Durban, South Africa: Health Systems Trust, 103-113. Mkhize N, Kometsi MK: Community access to mental health services: Lessons and recommendation. South African Health Review. Edited by: Barren P. 2008, Durban, South Africa: Health Systems Trust, 103-113.
34.
go back to reference Jack-Ide IO, Uys LR, Middleton LE: Caregiving experiences of families of persons with serious mental health problems in the Niger Delta region of Nigeria. Int J Ment Health Nurs. 2012, 10.1111/j.1447-0349.2012.00853.x. Jack-Ide IO, Uys LR, Middleton LE: Caregiving experiences of families of persons with serious mental health problems in the Niger Delta region of Nigeria. Int J Ment Health Nurs. 2012, 10.1111/j.1447-0349.2012.00853.x.
35.
go back to reference Eaton J, McCay L, Semrau M, Chatterjee S, Baingana F, Araya R, Ntulo C, Thornicroft G, Saxena S: Scale up of services for mental health in low-income and middle-income countries. Lancet. 2011, 378: 1592-1603. 10.1016/S0140-6736(11)60891-X.CrossRefPubMed Eaton J, McCay L, Semrau M, Chatterjee S, Baingana F, Araya R, Ntulo C, Thornicroft G, Saxena S: Scale up of services for mental health in low-income and middle-income countries. Lancet. 2011, 378: 1592-1603. 10.1016/S0140-6736(11)60891-X.CrossRefPubMed
36.
go back to reference Saxena S, Thornicroft G, Knapp M, Whiteford H: Resources for Mental Health: Scarcity, Inequity, and Inefficiency. Lancet. 2007, 370 (9590): 878-89. 10.1016/S0140-6736(07)61239-2.CrossRefPubMed Saxena S, Thornicroft G, Knapp M, Whiteford H: Resources for Mental Health: Scarcity, Inequity, and Inefficiency. Lancet. 2007, 370 (9590): 878-89. 10.1016/S0140-6736(07)61239-2.CrossRefPubMed
37.
go back to reference Gureje O, Chisholm D, Kola L, Lasebikan VO, Saxena S: Cost-effectiveness of an essential mental health intervention package in Nigeria. World Psychiatry. 2007, 6: 42-48.PubMedCentralPubMed Gureje O, Chisholm D, Kola L, Lasebikan VO, Saxena S: Cost-effectiveness of an essential mental health intervention package in Nigeria. World Psychiatry. 2007, 6: 42-48.PubMedCentralPubMed
38.
go back to reference Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al: Barriers to Improvement of Mental Health Services in Low-income and Middle-income countries. Lancet. 2007, 370: 1164-74. 10.1016/S0140-6736(07)61263-X.CrossRefPubMed Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al: Barriers to Improvement of Mental Health Services in Low-income and Middle-income countries. Lancet. 2007, 370: 1164-74. 10.1016/S0140-6736(07)61263-X.CrossRefPubMed
39.
go back to reference Dixon A, Mcdaid D, Knapp M, Curran C: Financing Mental Health Services in Low- and Middle-income Countries. Health Policy and Plannin. 2006, 21 (3): 171-182. 10.1093/heapol/czl004.CrossRef Dixon A, Mcdaid D, Knapp M, Curran C: Financing Mental Health Services in Low- and Middle-income Countries. Health Policy and Plannin. 2006, 21 (3): 171-182. 10.1093/heapol/czl004.CrossRef
40.
41.
go back to reference World Health Organization: Human Resources and Training in Mental Health. Mental Health Policy and Service Guidance Package. 2005, Geneva: WHO World Health Organization: Human Resources and Training in Mental Health. Mental Health Policy and Service Guidance Package. 2005, Geneva: WHO
42.
go back to reference Browne G, Courtney M: Housing, Social Support and People with Schizophrenia: A Grounded Theory Study. Issues Ment Health Nurs. 2005, 26: 311-326. 10.1080/01612840590915694.CrossRefPubMed Browne G, Courtney M: Housing, Social Support and People with Schizophrenia: A Grounded Theory Study. Issues Ment Health Nurs. 2005, 26: 311-326. 10.1080/01612840590915694.CrossRefPubMed
43.
go back to reference Langeland E, Wahl AK: The Impact of Social Support on Mental Health Service Users. Sense of Coherence: A Longitudinal Panel Survey. Int J Nurs Stud. 2009, 46 (6): 830-837. 10.1016/j.ijnurstu.2008.12.017.CrossRefPubMed Langeland E, Wahl AK: The Impact of Social Support on Mental Health Service Users. Sense of Coherence: A Longitudinal Panel Survey. Int J Nurs Stud. 2009, 46 (6): 830-837. 10.1016/j.ijnurstu.2008.12.017.CrossRefPubMed
44.
go back to reference Magliano L, Fadden G, Economou M, Held T, Xavier M, Guarneri M, et al: Family Burden and Coping Strategies in Schizophrenia: 1-Year Follow-up Data from the BIOMED I Study. Soc Psychiatry Psychiatr Epidemio. 2000, 35: 109-115. 10.1007/s001270050192.CrossRef Magliano L, Fadden G, Economou M, Held T, Xavier M, Guarneri M, et al: Family Burden and Coping Strategies in Schizophrenia: 1-Year Follow-up Data from the BIOMED I Study. Soc Psychiatry Psychiatr Epidemio. 2000, 35: 109-115. 10.1007/s001270050192.CrossRef
Metadata
Title
Mental health care policy environment in Rivers State: experiences of mental health nurses providing mental health care services in neuro-psychiatric hospital, Port Harcourt, Nigeria
Authors
Izibeloko Omi Jack-Ide
Leana R Uys
Lyn E Middleton
Publication date
01-12-2013
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2013
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/1752-4458-7-8

Other articles of this Issue 1/2013

International Journal of Mental Health Systems 1/2013 Go to the issue