Living with mental illness is a major challenge in Nigeria, where access to treatment is limited and discrimination is common. Patients with schizophrenia, in particular, find it especially hard to cope, not only because of stigma but also because daily medication is difficult to maintain.
Anthony Ademiluyi, who recently visited the outpatient clinic of the Federal Neuropsychiatric Hospital in Yaba, Lagos, described a patient he called George Okoye (a pseudonym to protect his identity). Okoye was well‑dressed in a starched white shirt and black jeans, clutching a conspicuously large Bible. At first glance, he appears to be a cheerful young man pursuing his dreams. Yet, he confides that life has been tough since his schizophrenia diagnosis. Schizophrenia is a chronic, severe mental disorder that disrupts thinking, behavior, emotional expression, and perception of reality. Although its exact cause is unknown, experts point to a mix of genetic, environmental, and neurochemical factors. The illness often involves delusions, impaired concentration, and memory problems, and treatment is typically lifelong, combining psychotherapy, medication, and specialized care.
Okoye’s symptoms began during his undergraduate years. He recalled returning home during an Academic Staff Union of Universities strike, watching a sitcom with his siblings when he suddenly ran into a room, screamed loudly, and began stripping off his clothes. His older siblings restrained him from going outside and creating a public scene. Because public hospitals were also on strike, he was rushed to a private psychiatric facility. Speaking to HealthWise, he expressed bewilderment at his condition: “I have never used hard drugs, smoked cigarettes, or even tasted alcohol. Sometimes I wonder whether God is punishing me for my sins or those of my ancestors.” He believes his great‑grandfather’s involvement in the slave trade may have brought karmic retribution.
The illness has taken a heavy toll. Okoye spent an extra year in school but eventually graduated with a Second Class Upper degree. He has been admitted repeatedly to both public and private psychiatric hospitals. Romantic relationships have suffered; several women rejected him after he disclosed his condition. He left the United States and dropped out of a master’s program after six months because the illness made it impossible to adapt to the new environment. “I feel less of a man,” he said, “and I believe my life would have been better without this condition.” Taking antipsychotic medication twice daily is another major challenge. The drugs cause severe side effects, including daytime sleepiness, and his appointments—often scheduled on Mondays—conflict with work meetings, leading to missed doses and relapses.
Despite fighting back tears, Okoye remains optimistic and plans to relocate abroad for better health management and a brighter future. He intends to pursue a master’s degree in Canada, citing lower healthcare costs and a welfare system that would allow him to function more effectively. He also wants to combine his project‑management studies with mental‑health activism, hoping to become a voice for the mentally challenged. His parents initially opposed activism in Nigeria due to stigma, but they eventually agreed to his plan to work and advocate simultaneously in Canada.
Okoye urges the Nigerian government to adopt policies that enable people with mental health challenges to work and contribute to the economy while managing their conditions. He suggests scheduling hospital appointments on weekends to reduce the need for employees to disclose their health status and to avoid stigma. He also calls for free or heavily subsidized mental‑health medication, similar to HIV drugs, noting that many out‑patients struggle to afford their prescriptions. “I am lucky that my parents can finance my treatment, but I still feel like an economic burden at over 30,” he said. This financial strain drives his desire to move to Canada, where he hopes to become self‑sufficient.
Another outpatient, who requested anonymity, echoed the difficulties of living with schizophrenia. Raised by housemaids while his parents pursued careers, he began showing bizarre behavior after secondary school despite never using hard drugs. Diagnosed at a public psychiatric hospital, he has been in and out of care ever since. He spent an extra three years completing university and was redeployed from his National Youth Service Corps posting in the north back to Lagos for health reasons. During his NYSC, he relapsed and spent half the year in the hospital, missing a prestigious teaching opportunity.
Since completing NYSC seven years ago, he has been unable to secure stable employment; most employers are reluctant to hire a nearly‑40‑year‑old with no work experience. An internship at a large firm failed because he lacked basic workplace skills. He fears for his future as his parents approach 70. Family relations are strained: his siblings view him as a failure and a liability. One sibling threatened to sell the family home and leave him homeless after their parents die; another said he would confine him to an institution because he refuses to work. He stresses that his inability to work is not laziness but the result of his illness, medication, and monthly injections.
When asked about entrepreneurship, he expressed interest but noted a lack of unique ideas. He considered opening a provisions shop near his family home, but the market is already saturated with more than five similar stores on his street. He has even contemplated fleeing to Europe by road, but fears a relapse that could leave him injured or dead.
Guardians of patients also shared their hidden pains. One mother, caring for a daughter in her twenties who recently relapsed, described the severe financial strain. With her husband deceased, she relies on borrowing and using her pension to pay for daily medication and monthly injections, supervising each dose to prevent her daughter from discarding the drugs. The daughter, a creative fashion‑design student, lacks time‑management skills and has been unable to complete her course. The mother urges her daughter to develop discipline and a service mindset, emphasizing that “nobody owes you anything.”
Another guardian, a woman buying medication for her son, lamented his wasted brilliance. Her son, the youngest of five, earned a first‑class degree from a Russell Group university in the UK and secured a fully funded doctorate at an Ivy League university in the US. His career derailed after experiencing brutal racism at a Big Tech firm in the UK, leading to a mental‑health decline. Despite holding a patent after just two years—a feat that funded his treatment—he has been unable to maintain employment. The mother hopes he can return to work so she can rest and enjoy time with her grandchildren. She has sought spiritual help without success, placing her faith in science and hoping her son will eventually become self‑sufficient.
The World Health Organization’s Special Initiative for Mental Health (2019‑2023) aims to provide universal health coverage for mental health in twelve countries, reaching about 100 million people. However, Nigeria has yet to implement universal health insurance or subsidized medication for mental‑health patients. Most individuals still pay out‑of‑pocket for treatment, relying on family support for both medical and basic living needs.
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