Experts Urge Implementation of Mental Health Act 2021
By Prof Cheluchi Onyemelukwe and Peace Folorunsho
Prior to the operational commencement of the National Mental Health Act 2021 on 28th December 2022, the Lunacy Act 1958 regulated mental health disorders in Nigeria. The Lunacy Act 1958 began as a lunacy Ordinance 1916. The quest for comprehensive mental health legislation that aligns with contemporary best practices can be traced to 2003 when a bill to enact a new mental health law was first introduced in the National Assembly. Although the process was arduous and challenging after similar bills were proposed up to the 8th National Assembly, yet none came to fruition until the 9th National Assembly passed the bill in 2021.
The National Mental Health Act is comprised of five parts and 58 sections. Part I covered sections 1-11 and focuses on the objectives, coordination and administration of the Act. Part II covered sections 12-23 (the rights of persons with mental health conditions). Part III covered sections 24-45 with focus on facilities-based treatment or care. Part IV provides for three sections (46-48), covering persons with mental health conditions and criminal proceedings. Part V covers sections 49-58 (property and affairs of persons with mental health conditions).
It has been over 16 months since the Act was signed into law, and to date, key provisions of the Act are yet to be implemented, thereby making it difficult to realise the purpose of the Act. This blog postdiscusses the urgent need for establishing the Department of Mental Health Services in the Federal Ministry of Health and Social Welfare and the composition of the Mental Health Assessment Committee, highlighting the consequences of delay and urging prompt action to tackle urgent mental health issues in Nigeria.
Importance of the Department of Mental Health Services and the Mental Health Assessment Committee
The Department of Mental Health Services is fundamental in the implementation of the provisions of the Mental Health Act. Similarly, the Mental Health Assessment Committee serves as an oversight body, allowing individuals with mental health conditions to challenge and appeal the decisions made by medical professionals or facilities if they feel their fundamental rights have been violated. These two bodies are of prime importance in the implementation of the Act.
The Department of Mental Health Services
Section 2 of the Act provides for the establishment of the Department of Mental Health Services in the Federal Ministry of Health and Social Welfare with the mandate to administer the provisions of the Act. The power to administer the Act resides in the Department. The Department is the driving force behind the implementation of the Act; hence its establishment is of critical importance. For example, the core objectives of the Department include proposing and advocating for national mental health policies, overseeing their approval and subsequent implementation, promoting mental wellness and healthcare services, supporting the delivery of humane care – including treatment and rehabilitation – in the least restrictive setting, and advocating for culturally sensitive, affordable, accessible, and evenly distributed mental healthcare that is integrated and specialised, involving both the public and private sectors.Consequently, the successful implementation of the Act hinges on the establishment of the Department in the Federal Ministry of Health and Social Welfare.
Mental Health Assessment Committee
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Section 9 of the Act establishes the Mental Health Assessment Committee, which is tasked with safeguarding individuals with mental health conditions. In fulfilling this role, the Committee is mandated to hear and determine appeals against decisions made by mental health care facilities regarding the treatment of individuals with mental health conditions, receive and investigate complaints from individuals admitted under the provisions of this Act, and discharge individuals with mental health conditions if it determines that they no longer meet the conditions for involuntary admission under the Act.
Challenges and Delays
It remains unclear what challenges might be responsible for the non-establishment of the Department of Mental Health Services after the signing into law of the Act, a period of over 16 months. The failure to set up the Department is solely responsible for the non-implementation. As it is the body empowered to implement its provisions. The delay has adversely impacted people with mental health conditions, whom the Act is meant to protect.
The challenge facing the Minister of Health and Social Welfare in constituting the Mental Health Assessment Committee could be attributed to the non-establishment of the Department. If the Department were existing and operational, it would have catalysed the composition of the Committee. The delay in forming the Committee is adversely affecting individuals with mental health conditions, particularly in protecting their rights from violations by medical professionals or facilities administering treatment to them.
Call to Action
Immediate action is required for the:
Establishment of the Department of Mental Health Services
The absence of the Department of Mental Health Services impedes the implementation of the provisions of the National Mental Health Act 2021. To that end, we call on the Federal Ministry of Health and Social Welfare to swiftly establish this Department to ensure the effective implementation of the provisions of the Act.
Composition of the Mental Health Assessment Committee
The delayed constitution of the Mental Health Assessment Committee continues to lengthen the vulnerability of persons with mental health conditions. The Minister of Health and Social Welfare must do the needful and expedite the composition of this committee, granting persons with mental health conditions access to essential safeguards and avenues for recourse.
Why it Matters
The timely establishment of these bodies is crucial in the protection of the rights and well-being of persons grappling with mental health conditions. In the absence of inadequate infrastructure and oversight, vulnerable populations are left without essential support and safeguards;
“The National Mental Health Act 2021 marks a significant stride in tackling mental health issues in Nigeria. Nevertheless, its impact and effectiveness rely heavily on the timely formation and operation of critical bodies like the Department of Mental Health Services and the Mental Health Assessment Committee.
Take Action Now
We call on stakeholders, policymakers, and advocates to unite in pushing for the prompt establishment of the Department of Mental Health Services and the expedited composition of the Mental Health Assessment Committee. By giving priority to these measures, we uphold the principles of dignity, equity, and access to mental health services for all Nigerians.
Conclusion
Effective implementation of the National Mental Health Act 2021 hinges on establishing the Department of Mental Health Services and prompt constitution of the Mental Health Assessment Committee. Urgent action is crucial to address the delay. The Department administers the Act and promotes mental wellness, while the Committee safeguards individuals’ rights. The timely formation of these bodies is vital to protect the well-being of those with mental health conditions. Collaboration among stakeholders, policymakers, and advocates is essential to expedite their establishment, ensuring dignity, equity, and access to mental health services for all Nigerians.
Authors: Prof Cheluchi Onyemelukwe (Centre for Health Ethics Law and Development) and Peace Folorunsho (Centre for Health Ethics Law and Development)
