From criminalisation to care: Nigeria’s next mental health challenge

The Nigerian Federal Executive Council's decision to decriminalise attempted suicide marks a significant shift in the country's approach to mental health. This move acknowledges that people who survive suicide attempts are not merely offenders, but individuals in distress who require compassionate care. However, mere legal changes do not constitute a solution; they must be accompanied by a robust health system capable of providing effective care and support.

The true extent of Nigeria's mental health challenge extends beyond reported suicides. A 2026 study estimated that 7.9% of Nigerians experience suicidal ideation, 1.9% plan suicide, and 1.3% attempt it. Yet, the country currently lacks a robust national suicide surveillance system, making it difficult to accurately gauge the true burden of the problem. This gap in data poses a significant public-health concern, as it hinders the design of effective interventions, resource allocation, and progress measurement.

Suicide is often a final symptom of an ongoing journey involving depression, substance abuse, trauma, violence, social isolation, financial distress, relationship breakdown, displacement, chronic illness, and other social determinants of mental health. Therefore, suicide prevention cannot solely focus on psychiatric treatment; it must address these underlying issues. This requires a shift in focus from treating people after they reach a crisis point to identifying risk factors earlier and providing care proactively.

Integrating mental health services into primary healthcare (PHC) is crucial. Primary healthcare workers, such as midwives, nurses, and community health workers, are often the first point of contact for individuals experiencing psychological distress. Nigeria should design its health system to recognise and respond to psychological distress at these initial contact points, ensuring that appropriate pathways to care are available.

However, integrating mental health services into PHC requires more than simply adding another task to an already overwhelmed health worker's plate. It necessitates training, supportive supervision, access to appropriate medications, functional referral pathways, specialist support, and continuity of care. Moreover, it demands adequate financing to support these comprehensive care models.

Strengthening Nigeria's health information systems is also essential. The country cannot effectively prevent suicide if it cannot accurately measure its prevalence. Suicide and suicide attempts should be included in robust public-health surveillance systems, with safeguards for confidentiality, dignity, and data protection. Improved data collection would enable governments to design evidence-based, population-level prevention strategies, rather than reacting to individual tragedies.

Addressing the stigma surrounding mental illness is another critical component of effective suicide prevention. In many Nigerian communities, mental illness remains a source of shame and isolation, discouraging individuals from seeking help. Public awareness campaigns, education initiatives, and community engagement efforts are necessary to challenge these negative attitudes and create a more supportive environment for those struggling with mental health issues.