By Adedapo Adesanya and Noah Aderoju
For Kemi*, the eight-month period back in 2022, when students in Nigeria were home due to a strike by university staff was a tedious affair. A feeling of hopelessness, of uncertainty, gripped her. As the last child in her family, her older siblings were married, her parents were aged, and her friends were mostly in Ilorin all dealing with their fair share of life. “I needed a community,” she said.
Kemi is not alone. The numbers note that even before COVID-19, children and young people carried the burden of mental health conditions without significant investment in addressing them. According to available data, more than 1 in 7 adolescents aged 10–19 are estimated to live with a diagnosed mental health problem globally. About 46,000 of these adolescents die from suicide each year, being one of the top five causes of death for their age group. As is the case of Nigeria which only recently signed its first mental health Act, wide gaps still exist between the mental health needs of people and its actual provision.
A 2021 UNICEF comprehensive report on mental health finds that only about 2 percent of government health budgets are allocated to mental health spending globally. This is not enough to cover the lacuna that exists in this very important space and in Nigeria where the implementation of the new policy has not been demonstrated the pressure on the people can only be imagined. With this in mind, Modupe Olatunji, a Psychology undergraduate at the University of Lagos came up with The Mind Clinic in January 2019, a virtual mental awareness and counseling initiative. Although many initiatives like this exist, what makes this initiative stand out is that it is run by relatable practitioners with assistance from trained, experienced, and certified professionals.
Initially, the platform started as a community for victims of sexual assault to get their voices heard but for Olatunji, the issue was beyond that, and it needed to enter a different realm.
“It was difficult for me to live past being assaulted and after near suicide attempts, I realized there were people out there like me too and I thought we could find strength together,” she said.
TMC, as it is stylised, “started as The Fighters’ League. After a while, we received messages from men/boys who were assaulted too. It took a lot of deliberation to accept male members because we had built this safe space for women and most of these women felt a deep kind of hate towards men, but we did it. Our pains birthed new and beautiful emotions and we learned how to channel hurt the right way,” Olatunji noted.
TMC is primarily powered by a team of volunteers manning the different arms of the organisation. Many of these volunteers are youths, mostly undergraduates in various campuses like the University of Lagos, University of Ibadan, Covenant University, University of Jos, Baze University, University of Benin, Obafemi Awolowo University, University of Ilorin, Lagos University, University of Osun, Yaba College of Technology, and Nigerian Institute of Journalism. Other volunteers are young professionals who are either in the mental health profession or are enthusiastic about the provision of mental health care.
Kemi, a student at Unilorin noted that she has been able to find meaning in her life with the support supplied by TMC, adding that this could present itself further, with the appropriate recognition and backing.
Responding to mental health needs
Through this network of campus volunteers in addition to its online campaigns, people seeking help can be linked to prompt help and support. Olatunji noted that the misconception with the platform was that people thought the students are all counselors, but they are not because the “heavy duty is carried by our psychologists who are approved and deliver the needed help”.
Primarily, the campus network only creates a pipeline for students seeking assistance to get the needed help.
These volunteers through personal engagements or on their WhatsApp status share the social media contents of the TMC and or link to their page which includes a link to an online form that anybody who needs help can fill out to request the service of the initiative. On submitting this form, the TMC team gets the request and shares it on their closed WhatsApp group for listeners and counselors. An available volunteer who is interested in the case will then signify to take it up and then reach out to the client on WhatsApp after being approved to do so.
Clients’ first point of contact after filling an online request is a listener who has been trained to attentively and without bias and judgment listen to the challenge of the client first and make decisions on the way forward based on the information provided.
Akanmu Oluwabukola, a final year Guidance and Counselling student of the University of Ibadan and a trained listener and in-house counselor of the TMC noted that most of the clients at the point of complaints don’t have a clear picture of what is wrong with them, they just fill the online form with basic information about what they think is wrong with them.
“It is after the listening session that we know what exactly the case is. some fill things like depression, anxiety, bipolar syndrome, and other known mental ailments, it is at the end of the session, [that] it may be discovered that they are overwhelmed, stressed, or have what they say they have. And some just needed to be listened to, an avenue to vent is just what some of these clients need” Akanmu said: “Most times people fill out forms and tell us nothing is wrong with them, they want someone to listen to them rant without judging them. they just have a lot of things bottled up that want to be able to tell someone willing to listen”.
According to her, in that situation, they just need to be listened to and reassured that their feelings are valid. To other people, it might be unimportant but as a counselor trained in this aspect, she knows how critical the task is and how important it is for the client.
On occasions when clients need more service or expertise that is beyond the capacity of the first point of contact, the client is then transferred to a higher person who can adequately attend to the need of the client. The campus communities only serve as funnels for the counselors who eventually attend to the needs of the people.
Rubaia Khatun, the Lead Counselling and Listening of TMC explained that there are trained counselors and listeners who attend to the needs of the people who seek mental health support from the TMC. The listeners and counselors are all volunteers, as is everyone in the organisation.
Khatun who is based and volunteers from India noted that many TMC clients that have been helped are mostly between 20 and 30 years. They are evenly spread between males and females who face issues bordering on stress and pressure from work or school resulting in different mental ailments. she explained that her team of counselors and listeners with members across Nigeria and even some other countries help manage the conditions of these clients adequately, mostly through virtual consultations, on WhatsApp mostly. And in cases where there is a need for physical care, which is not often, they leverage their resources to provide adequate help.
She also noted that some clients also face issues emanating from their family, like family pressure, inability to open up to other family members, or pregnancy traumas. And in a quite rare scenario around last year November to December there was a sudden influx of suicidal cases, about 3 to 4 clients were confirmed to have suicidal thoughts but they were all adequately managed by the team.
Favour Odimnfe, a volunteer from the Nigerian Institute of Journalism who joined the team last year doted on the community and what it does to help people faced with the challenge of getting access to mental well-being.
“I never knew that this could be an experience like no other. I have had to understand the many levels that come with understanding how this works. There are so many problems in the world and with The Mind Clinic, we are trying to play our role.”
Another volunteer, Oresanya Pelumi, described the community as a necessity since the issue of mental health is not treated with the level of importance it should be.
“We cannot continue to toughen up in this generation. We are faced with the decisions that they’ve made, and we are still facing them. Since we cannot help that, we can help ourselves,” she said, noting that the previous generation only made up the government and decision-makers.
The cost of negligence
In the last seven years, many Nigerian youths including students have committed suicide and it seems not to be stopping. Their reasons range between financial, emotional, and social factors.
The Suicide Research and Prevention Initiative (SURPIN) in Nigeria revealed that people aged between 13 and 19 years account for one in every five suicide cases in the country and that over 50 percent of crisis calls received via its hotlines are from people aged between 13 and 29 years and that 27.8 percent of them were students.
The impact of living a healthy life is incalculable, but a new analysis by the London School of Economics indicates that lost contribution to economies due to mental health problems that lead to disability or death among young people is estimated at nearly $390 billion a year.
Dealing with the costs
Being an intervention premised on online interactions and virtual facilities it costs every volunteer and the TMC a lot of resources for maintaining a constant online presence like electricity, mobile data, and a lot of extra night hours for team engagement and volunteer training, client servicing and online/social media campaigning and advocacy.
Some challenges faced by TMC border on manpower, capacity building for the volunteers, and availability of the counselors. Sometimes unresponsiveness of clients or their hesitancy to provide adequate information for the counselor pose a challenge to providing adequate help.
As Akanmu pointed out, it doesn’t matter if these clients are the ones who initiated the request for help, sometimes in the middle of the engagement they become unresponsive, and this hinders progress. She also noted that sometimes due to the need for empathy in her line of work, at the end of her session with some clients, it feels like they had unburdened their issues on her, and she starts to feel part of what the client feels.
Khatun stressed that the difference in time zones of the countries of the counselors and volunteers and the difference in accent can serve as a challenge to effective delivery. Especially for her who supports from India, a country with about 5 hours difference in time from Nigeria. The team had to strike a balance in time for meetings which they do frequently to review performance, train new volunteers or attend to clients. To achieve this, the team meets late at night time in Nigeria to accommodate the time difference.
Rubaia also noted that she needs to pay extra attention to her team members and vice versa when they communicate due to the difference in their English accents. However, she hopes to increase the volunteers’ capacity to work more efficiently and independently through more training, which she is currently finding hard to create time for due to her other commitments.
There remain many other challenges for initiatives like The Mind Clinic providing mental health care services for people. Although many initiatives like the Mentally Aware Nigeria Initiative, Chop and Chat Community, Toosdei Space, and others have continued to spring up where they matter the most.
This story was produced in partnership with Nigeria Health Watch through the Solutions Journalism Network, a nonprofit organisation dedicated to rigorous and compelling reporting about responses to social problems.