Pathways to psychiatric care for children and adolescents at tertiary facility in northern Nigeria

ABSTRACT

There is limited availability of mental health services in Nigeria; and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence; therefore; is a long and tedious pathway to care for the mentally ill; especially children and adolescents. This was a study of all new patients; aged 18 years and below; presenting over a 6 month period in 2009 (January - June) at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized; along with a record of the clinician's assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school; or any previously engaged-in activity for longer than 4 weeks on account of the illness; were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2) with males accounting for 51.7 (125) while 14.5 of the females (n=117) were married. Two thirds (64.5) of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5) had received no care at all; while 36.4 had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80); mental retardation (77.8); epilepsy (64.1) and psychotic disorders (50). There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments