It is a common saying that Nigeria has been blessed with good plans but has poor implementation.
I do not know how we came about this conclusion; but I think it is very wrong, since no human being succeeds anywhere in the world through wishful thinking without putting in place workable and achievable goals that can be practically operated in the journey towards accomplishment.
Every nation sets goals and formulates road maps towards achievement of those goals, but not every nation succeeds. I want to believe that one of the means through which Nigeria has been brutally and recklessly raped and plundered is through ineffective policy formulation. There is no basis for separating formulation of policy from its implementation. Too much money is spent on understudying other countries and how they formulate polices but without regard for our peculiar circumstances, feedbacks from stakeholders and our culture. Our policy statements appear to have been plagiarised from foreign countries to be implemented unprocessed in this country.
The elite class, leveraging on our rulership cultural software, implement their campaign of looting and plundering by adopting policy frameworks that have loopholes and not easily adaptable as a deliberate strategy for personal enrichment, to the detriment of the society at large.
A sound policy is a deliberate system of principles to guide decision and achieve rational outcomes. Policies are generally adopted by the highest decision-making body in an organisation or government; whereas procedures or protocols emanating from policies are developed by the mid level officers.
Polices assist in subjective and objective decision making in such a way that results can be objectively assessed. Policy differs from rules or law. While law can compel or prohibit behavior, policy merely guides actions toward those that are most likely to achieve a desired outcome. Policies can therefore be understood as political, management, financial and administrative mechanisms arranged to reach explicit goals.
Mental health policy, in context, defines the vision for the future of mental health of the population, specifying the framework which will be put in place to manage and prevent mental and neurological disorders. When clearly conceptualised, a mental health policy can coordinate essential services and activities to ensure that care is delivered to those in need, while at the same time preventing inefficiencies in the health system, according to a World Health Organisation document.
A mental health plan is a preformulated detailed scheme to implement the vision and objectives defined in the policy. The plan should include concrete strategies that will be implemented to tackle mental disorders and associated disability, as well as specifying the targets to be achieved by the government. It should also clarify the roles of the different stakeholders in implementing the plan. It is therefore not a private document.
Our nation still operates by the lunatic ordinance of the pre-colonial years, yet with so much mental health burden. The Nigeria population is exploding with potent factors that impact negatively on our mental health. The recent experience of terrorism that leave many people homeless and traumatised prescribes that mental health should assume a status of full-fledged department, rather than a desk in all tiers of government. On this page, we have raised several issues beyond the narrow clinical paradigm of mental illness and mental health.
Developed countries are adopting concepts of mental capital development where mental well-being is viewed as a prime resource for national development. Unemployment, homelessness, dysfunctional family, terrorism, socio-economic challenges, education, reproductive health, gender issues, culture, religion, political instability, stigma, alternative practitioners and many more are crucial issues that a strong mental health policy should address.
The mental health situational analysis and needs assessment must be broad enough to explore these issues. There should be a facilitation of inputs from the stakeholders, rather than just consulting the experts.
Efforts should be directed at improving the capacity of mental health systems and services to ensure their effective utilisation.
The current paradigm of viewing health as a crucial component of development agenda holds that development is not only infrastructural but crafting of programmes and strategies that enhance utilisation of available effective services such that the people can take ownership. Intervening between the teeming population and the services is our culture which must be thoroughly interrogated and adapted as vehicle for policy formulation and implementation. Embedded in our culture are certain liabilities that can frustrate the western orthodox approaches but paradoxically offers unique opportunities for intervention.
Policy should construct pathways of care, based on synergy worked out by the major stakeholders. It is disturbing that our health insurance scheme has not made generous accommodation for the care of the mental ill, which is a violation of a major principle of setting up the scheme designed to get the rich to pay for the health care of the vulnerable poor.