There are wounds that cannot be seen, illnesses that do not always show on the face, and battles that many people fight quietly until they can no longer carry the weight.

Mental health is one of those battles.

Across Nigeria, many people are struggling with depression, anxiety, trauma, substance-use disorders, psychosis and other mental health conditions. Yet, for many Nigerians, seeking help remains difficult because of stigma, inadequate services, financial hardship and a mental healthcare system that is still struggling to reach people where they live.

For me, this is no longer just a subject for discussion.

It has become personal.

Recently, a young woman I knew died by suicide after reportedly battling serious mental health difficulties for years. She was a mother of four.

I will not reveal her identity because her family deserves privacy and dignity as they mourn their loss.

But I believe her story must not disappear in silence.

She reportedly knew that something was wrong. She sought medical attention on occasions because she experienced voices that she said were telling her to take her own life. She was aware that she needed help.

Yet, somehow, the help she desperately needed was not enough or was not consistently accessible.

Eventually, she died by suicide.

Four children were left behind. A husband was left to mourn. A family was left to ask questions that may never have satisfactory answers.

And those of us who knew her are left wondering whether something more could have been done.

When mental illness becomes invisible

One of the biggest problems with mental health in Nigeria is that many people still associate mental illness only with the most severe cases.

When people hear the words “mental health hospital,” they may immediately picture institutions where people with severe psychiatric conditions are treated.

That perception is part of the problem.

Mental healthcare should not begin only when someone reaches a crisis point.

People should be able to seek help when they first notice persistent changes in their mood, behaviour, thoughts, sleep, emotions or ability to function.

A person experiencing depression should not have to wait until they are suicidal before receiving care.

Someone experiencing hallucinations or hearing voices should not have to struggle until they become a danger to themselves or others before accessing psychiatric support.

And a young person battling overwhelming anxiety should not be dismissed as simply being “too sensitive.”

Mental illness is a health issue.

It deserves the same seriousness we give physical illness.

The World Health Organization says more than one billion people globally live with a mental health condition, while most do not receive adequate care. WHO also estimates that more than 720,000 people die by suicide globally every year.

Nigeria is part of this global crisis, but its circumstances make the problem even more complicated.

The treatment gap is a national concern

Nigeria has made important steps in recent years.

The country enacted the National Mental Health Act in 2021, which received presidential assent in December 2022. Nigeria also introduced a National Mental Health Policy in 2023 and developed its first National Suicide Prevention Strategic Framework.

These are important developments.

But policies alone cannot save lives.

They must be properly funded, implemented and made accessible to ordinary Nigerians.

A Nigeria-specific health-sector document notes an 85% treatment gap for severe mental disorders, linking the problem to inaccessible quality services, the concentration of treatment in specialist and tertiary institutions, shortages of mental-health professionals and inadequate financing.

WHO; Nigeria also reports that fewer than 3% of people with mental health conditions are covered by health insurance, meaning many people are still forced to pay out of pocket for treatment.

For a poor family struggling to put food on the table, the cost of psychiatric consultations, medication and follow-up care can become another barrier.

And this is where mental health intersects with Nigeria’s wider economic crisis.

A nation under economic pressure

It is impossible to discuss mental health in Nigeria without discussing the conditions under which Nigerians are living.

Food is expensive.

Rent is expensive.

Transportation is expensive.

School fees are rising.

Healthcare costs are increasing.

Many families are struggling to maintain basic standards of living, while unemployment and insecurity continue to create uncertainty about the future.

For many people, the question is no longer simply, “How do I achieve my dreams?”

It is, “How do I survive?”

Economic hardship does not automatically cause suicide or mental illness, and it would be wrong to reduce every suicide to poverty. WHO stresses that suicide is influenced by multiple social, cultural, biological, psychological and environmental factors. (World Health Organization)

But financial stress, unemployment, insecurity, social isolation and other pressures can worsen psychological distress, particularly when people have little access to support.

This is why improving mental health in Nigeria requires more than building psychiatric hospitals.

Government must also address the social conditions that contribute to psychological distress.

Mental healthcare must move into communities

Nigeria needs to rethink how mental healthcare is delivered.

The answer cannot be to wait for people to become severely ill and then send them to specialist hospitals.

Mental health services should become part of primary healthcare, so that people can seek help closer to home.

WHO recommends integrated, community-based mental health and social care rather than relying exclusively on institutions.

This means training doctors, nurses, community health workers and other frontline healthcare providers to identify mental health problems early and refer patients when specialist treatment is required.

It means expanding access to psychiatrists, psychologists, psychiatric nurses, counsellors and social workers.

It means making essential psychiatric medicines available and affordable.

It means incorporating mental health into health insurance.

It means establishing credible crisis-response and suicide-prevention systems.

And importantly, it means creating a system where people can seek help before they reach the point of crisis.

Government must do more

The Nigerian government has already acknowledged the need for reform. The country’s mental health authorities have said their goal is to achieve universal health coverage that genuinely includes mental healthcare and to develop a funded national mental health action plan.

That ambition must become reality.

The government should:

• Increase funding for mental healthcare and ensure allocated funds are actually used effectively.
• Integrate mental health into primary healthcare, particularly in rural and underserved communities.
• Expand the mental health workforce by training and employing more psychiatrists, psychologists, psychiatric nurses, counsellors and social workers.
• Make essential psychiatric medicines affordable and accessible.
• Include mental healthcare in health insurance coverage so that treatment does not become a privilege for those who can afford it.
• Strengthen suicide prevention and crisis-response services.
• Establish accessible mental health helplines and referral systems.
• Train teachers and healthcare workers to recognise early warning signs.
• Introduce mental health programmes in schools and universities.
• Create workplace mental-health programmes that allow employees to seek help without fear of losing their jobs or being labelled.
• Fight stigma through sustained public education.
• Improve data collection on suicide, attempted suicide and mental health conditions so that policies are based on evidence.

WHO’s recent guidance similarly emphasises stronger leadership, financing, integration of mental health into health systems, workforce development and reducing stigma. (World Health Organization)

Society also has a role

Government cannot do this alone.

Families must learn to listen.

Friends must learn to recognise when someone is struggling.

Religious leaders must understand that mental illness is not necessarily a sign of spiritual failure.

Communities must stop humiliating people who seek psychiatric or psychological help.

And we must stop using words such as “mad,” “crazy” or “possessed” to ridicule people experiencing mental health difficulties.

Sometimes, the person laughing with you may be fighting a battle you know nothing about.

Sometimes, the person who has stopped answering calls is not being rude.

Sometimes, the friend who constantly says “I am tired” may be asking for help without knowing how to say it.

We need to learn to ask one another a simple question:

“Are you really okay?”

And when someone says no, we need to listen.

The woman we lost must not become another statistic

I keep thinking about the young woman whose death inspired me to write this.

She knew she needed help.

She reportedly sought help.

She tried to fight.

But she eventually lost that battle.

I cannot bring her back.

I cannot erase the pain her husband and four children are experiencing.

I cannot answer all the questions her family may be asking.

But perhaps her story can help us ask a bigger question:

How many more people must die before mental health becomes a genuine national priority?

Her death should not simply be another tragic story that disappears from public conversation after a few days.

It should remind us that behind every suicide statistic is a human being — someone’s child, someone’s spouse, someone’s parent, someone’s friend.

There are families living with the pain of losing loved ones who may have been saved if timely and appropriate care had been available.

It is time to take mental health seriously

Mental health should not be treated as an afterthought in Nigeria.

We need a country where someone experiencing depression can walk into a health centre without shame.

A country where a person hearing voices can receive psychiatric care without being abandoned or stigmatised.

A country where a suicidal person can reach a trained professional immediately.

A country where families do not have to choose between buying food and paying for mental healthcare.

And a country where seeking psychological or psychiatric help is seen as an act of courage rather than weakness.

Nigeria has policies. It has laws. It has professionals working tirelessly in the field.

What is needed now is implementation, funding, political commitment and compassion.

As individuals, we must also take responsibility for our own mental wellbeing and that of the people around us.

Check on your friends.

Check on your children.

Check on your parents.

Check on your colleagues.

And check on yourself.

If you are struggling, please seek professional help rather than suffering alone. If you believe you or someone else is in immediate danger of suicide or self-harm, contact local emergency services or get the person to the nearest emergency department or qualified mental-health professional immediately.

There is no shame in asking for help.

There is no shame in seeing a psychologist.

There is no shame in seeing a psychiatrist.

There is no shame in taking prescribed medication.

There is no shame in saying, “I am not okay.”

The real shame would be knowing that people are suffering and choosing to look away.

Nigeria must do better. And we must start now.