The Mental Health System in North-Eastern Nigeria: A WHO-AIMS Generated Assessment of the State of Mental Health in a Sub-Saharan African Region.

Background: Mental health care is considered an important subsystem of health care and, consists of all the activities whose primary purpose is to promote, restore, or maintain mental health. Regional disparities in socio-economic indices may lead to failures in implementing policies based on data generated at the national scale. The definition of a detailed description of the mental health system of the north-eastern region is critical to the understanding of the essential weaknesses in its health care delivery process, allowing for the formulation of appropriate intervention plan to strengthen the system. The aims and objectives include provision of a comprehensive analysis of the mental health system in north-eastern Nigeria and baseline data for regional mental health Gap action Plan (mhGAP) policy formulation and implementation.Methods: The mental health system of the north-eastern region was defined using a WHO tool, World Health Organization Assessment instrument for mental health system WHO-AIMS version 2.2,.The instrument which is composed of six domains that collects comprehensive information on the mental health system of a country or region.Results: The regional expenditure towards mental health is 1% of the total health budget, with 76% of this directed at curative measures in the region’s mental hospital. There is a ratio of 0.52 beds per 10000 people with 61% of available hospital beds being located within the mental hospital in Maiduguri. In terms of human resources, the region has 13 Psychiatrists (0.069 per 100,000) Vs (1.44 per 100,000) on the national scale and 2 Psychologists (0.01 per 100,000) Vs (0.11 per 100,000) on the national level.Discussion: The health systems in most of the developing countries including Nigeria are weak. However the situation in the north east is relatively worse as demonstrated across all the WHO-AIMS domains. There is about a hundred fold difference in the available mental health personnel in the Egyptian mental health service compared to the north-east of Nigeria.Conclusion: This report has clearly defined what must be done to achieve a particular target of improvement in mental health service at the regional level. A separate policy implications document of the findings of this study including a SWOT analysis may be possible to generate. This may be relevant to spur the political will necessary for the improvement of the situation as suggested by this study