MENTAL ILLNESS AND CRIME: THE GORDIAN KNOT

A wreath is laid in memoriam to victims of the Washington Navy Yard shooting. (credit:
modification of work by D. Myles Cullen, US Department of Defence)[1]

On Monday, September 16, 2013, a gunman killed 12 people as the workday began at the
Washington Navy Yard in Washington, DC. Aaron Alexis, 34, had a troubled history: he thought
that he was being controlled by radio waves, and a month earlier, he had complained of noises
coming from the linen closet in his military housing. He called the police to complain about
voices in his head and being under surveillance by “shadowy forces”.

While Alexis’s actions cannot be excused, it is clear that he had some form of mental illness.
Mental illness is not necessarily a cause of violence; it is far more likely that the mentally ill will
be victims rather than perpetrators of violence. If, however, Alexis had received the help he
needed, this tragedy might have been averted. [1]

“Man killed wife and children in Niger,” “Man jumps over the third mainland bridge in Lagos,”
“Woman caught in Abeokuta burying her child alive,” “ Twenty one year old man charged to
court for raping grandmother,” “man rapes twelve year old to death…”

These are startling news that features in indigenous Nigerian Newspapers. And to some of us,
each story gets less touching and disheartening as they kept piling in the ignored dump we call
statistics, hedged round by the cliché “we’ve heard such before.”
In light of recent statistics, this is not getting better, and ignoring the remote possibility that some
of this crimes may be due to mental illness would only make things worse and the future, bleak.

This article seeks to address the issue of mental health in Nigeria, and how it had affected Crime
rates in the country; plus, measures that can be taken to minimize crime rates due to mental
health.

WHAT IS MENTAL ILLNESS?

The world health organization explained that, Mental disorders comprise of a broad range of
problems with different symptoms. However, they are generally characterized by some
combination of abnormal thought, emotions, behaviour and relationship with others. Examples
are schizophrenia, depression, intellectual disabilities and disorders due to drug abuse. Most of
these disorders can be successfully treated. [2]

HOW PREVALENT IS MENTAL ILLNESS IN NIGERIA?

Nigeria has a population of about 180 million people. It is estimated that about 20 per cent of
this population suffers some form of mental health challenge. [3] Yet other reports place the
figures at about 30 per cent.[4]

Simply put, about two to three out of ten people you know suffer from mental illness.

This claim might be founded on the 2006 research by the WHO. A report based on data collected
from six states: Lagos (south-west), Calabar (south south),Enugu (south-east), Kaduna (north-
central), Maiduguri (north-east), and Sokoto(north-west). These states represent about 17% of
the total Nigerian population. This doesn’t goes without saying that this report estimated that
about 20 per cent of this population suffers some form of mental health challenge. Has the values
spiked since 2006, we might want to read the news pattern of suicide, rape, homicide and the
increased general crime rate to confirm.

Have you ever wonder if that paedophile in police custody, or that commercial health worker
standing trial for arson, or the fetishist caught with body parts are alright mentally? Does the
statistic above seek to suggest that about 20% of trials regard criminals that had psychiatry
explanation for their crimes? Well, we should begin to ask questions and treating the cause,
instead of concentrating only on the effect.

WHAT FACTORS CONTRIBUTES TO MENTAL ILLNES?

A complex interaction between genetic and environmental factors contributes to mental illness.
Extrinsic factors include:
 Severe physiological trauma suffered as a child,
 Such as emotional or physical or sexual abuse
 An important early loss such as loss of parent
 Neglect
  Dysfunctional family,
 Substance abuse by the person or the person’s parent. The list continues.

You will agree with me that these above factors are at all time high in recent times, not to
mention the goading economic situation; the recent insurgence in the country left thousands
displaced, unemployment and underemployment. Does this not predispose even more to mental
disorders?

WHAT CONNECTS CRIME WITH MENTAL ILLNESS.

Aside the obvious reasoning that anyone warped off the rail psychologically may certainly takes
the train to crazy town. Here are statistics.

Nigeria has one of the highest crime rates in the world. Murder often accompanies minor
burglaries, rich Nigerians live in high-security compounds and police in some state are
empowered to ‘shoot on sight’ violent criminals.[5]

According to JO Abdulmalik et. al. (2014), “Prevalence of mental health problems are frequently
higher within the prison population than the general population. Previous study of prison mental
health had focused on convict populations whereas, the awaiting trial segment of the prison
population in Nigeria gradually become the majority of total lock-up.” Among the awaiting trials
inmates in a prison facility in Ibadan, it was found that “the prevalence of mental illness was
56.6% with the commonest condition being depression (20.8%), alcohol dependence (20.6%),
substance dependence (20.1%), suicidality (19.8%) and antisocial personality disorder (18%). It
is also worthy of not that in the study site, 764 of the total lock-up of 834 are awaiting trials at
January 2013.” [6]

Adding more details to the paralytic judicial system, “some of these individuals may spend
upwards of 10yeaars awaiting trial’ due to their inability to afford lawyers, non-appearance of
witnesses and the slow pace of court hearing.”[7]

Some of these may eventually be freed to roam society, or served a jail term. Does this
eventually proffer cure for their psychological issues or does it aggravates them?

WHAT HAS BEEN DONE SO FAR?

According to the 2006 WHO-AIMS report on mental health system in Nigeria,

“There is considerable neglect of mental health issues in the country. The existing Mental
Health Policy document in Nigeria was formulated in 1991.It was the first policy addressing
mental health issues and its components include advocacy, promotion, prevention, treatment and
rehabilitation. Since its formulation, no revision has taken place and no formal assessment of
how much it has been implemented has been conducted. Though a list of essential medicines
exists, they are not always available at the health centres. No desk exists in the ministries at any
level for mental health issues and only four per cent of government expenditures on health is
earmarked for mental health.”

Other issues such as unavailability of essential medicine at health centres, unavailability of

physicians to run primary health care centres and the lack of prescriptions of psychotropic
medications were identified.

“There is no coordinating body to oversee public education and awareness campaigns on mental
health and mental disorders. There are no formal structures or provisions for interaction between
mental health providers and primary healthcare staff. Also no systematic reporting of
information exists for mental health.”

It concluded that “In general terms, several countries in Africa are better resourced in regard to
mental health personnel. Countries such as South Africa, Egypt, and Kenya have more
psychiatrists per 100,000 persons and also higher proportions of psychiatric beds. Many
countries in Africa also give better official attention to mental health issues. More recent mental
health legislations exist in several and mental health issues are specifically addressed by
designated senior bureaucrats. Nigeria could use a few more governmental organization involved
in individual assistance activities such as counselling housing and support.”[8]

LEGISLATION FOR MENTAL HEALTH

According to WHO-AIMS (2006) “The existing Mental Health Policy document in Nigeria was
formulated in 1991.It was the first policy addressing mental health issues and its components
include advocacy, promotion, prevention, treatment and rehabilitation. Since its formulation, no
revision has taken place and no formal assessment of how much it has been implemented has
been conducted.

“Though a list of essential medicines exists, they are not always available at the health centres.
No desk exists in the ministries at any level for mental health issues and only four per cent of
government expenditures on health is earmarked for mental health.”[8]

THE LAW AND MENTAL HEALTH STIGMA

It’s no news that the issue of mental health is least addressed in the country. According to
Cheluchi, (2016) “Stigma remains a major factor that needs to be addressed if the issue of mental
health is to be properly solved.”

Stigma is rife in the country as far as mental disorder is concerned; we still cling to primitive
views. Not many feel safe to admit to depression in a typical Nigerian society because of the
stigma attached to anything that concerns psychological disorder. Children considered abnormal
are ostracized from the community and seen as cursed or demonic.

“The law has not been helpful to stigma reduction and may even be argued to have exacerbated it
by its no recognition of stigma and its adverse effects on mental health and the rights of the
mentally ill. Indeed, when mental health is mentioned in our legislation, generally speaking, it is
not to provide for human rights coverage, it is generally to exclude on the grounds of “insanity.”
“Some of the rights violations that mentally ill people suffer from the most are equality rights
and right to freedom from discrimination. At the present time, discrimination is not specifically
addressed in law since there is currently no legislation on mental health. However, the
Constitution of the Federal Republic of Nigeria,1999 prohibits discrimination.1 It does not
specifically identify health status as one of the grounds on which discrimination is prohibited,
however. Perhaps in recognition of this, the law has specifically addressed discrimination against
persons living with HIV/AIDS and disabilities.”[9]

In his defence of the slow education of the populace he stated, “ Increasingly, more awareness is
being created, particularly in social media circles like Facebook and Twitter, but also in the e-
health
realm. Persons are sharing personal experiences with mental illness, thus humanising it and
potentially changing existing narratives.”

Above all these development there is advocation for a law reform approach. Such reform as will
affect both delivery of justice and health care for the mentally ill.

WHAT IS THE WAY FORWARD?

If Nigeria is to expect better days ahead, we must begin working even today. It’s time we stop
shying away and take responsibility for this pandemic. It’s time to increase manpower supply to
the public, we must train more professionals in mental health and ensure that every school, every
hospital even religious organization has a train personnel waiting to render services.

It would be great to have more nongovernmental organization taking the issue of mental health
to the forefront.

We must stop stigmatization against anyone showing signs of mental health issues. Our
collective support and voice can change their situation. A law reform is necessary alongside
more financial focus on mental health in the yearly budget.

It must be noted that a large spectrum of mental illness can be cured, imagine what would
happen if the said 20-30% Nigerian get the medical attention needed. The world would be better
for it!

REFERENCES
1 OpenStax College, Psychology. OpenStax College. 8 December 2014.
<http://cnx.org/content/col11629/latest/>.
2 The World Health Organization. (2018) Genva.
www.who.int/mental_health/managment/en
3 WHO-AIMS Report on Mental Health System in Nigeria, WHO and Ministry of Health,
Ibadan, Nigeria, 2006
4 MHLAP, Mental Health Situation Analysis in Nigeria, 2012 at 4.
5 Essay, UK. (November 2013). Statistical analysis on crime rate in Nigeria.
6 Abdulmalik JO, Adedokun BO, Biyewu OO, PREVALENCE AND CORRELATES OF
MENTAL HEALTH PROBLEMS AMONG AWAITING TRIAL INMATE IN A
PRISON FACILITY IN IBADAN, NIGERIA. Afr J Med Med Sci. 2014
Sep;43(Suppl1):193-199
7 Amnesty International. Nigeria: Human Rights Agenda 2011-2015 Report. AFR/01/2011.
2011:6
8 WHO-AIMS Report on Mental Health System in Nigeria, WHO and Ministry of Health,
Ibadan, Nigeria, 2006.
9 Cheluchi O (2016). Stigma and Mental Health in Nigeria: Some Suggestions for Law
Reform. Journal of Law, Policy and Globalization. Vol.55, 2016. www.iiste.org ISSN
2224-3240