I know I haven't updated in a long time but want to say that my two week trip to Nigeria was a success. I am so humbled and blessed to be able to do what I do! While in Nigeria I was able to do so many things, work on projects anD really make a difference.

I had an opportunity to meet with Newly appointed Commandant General of Nigeria Security and Civil Defense Corp. NSCDC, Abdullahi Muhammadu in Abuja Nigeria. We discussed the important of EAP and drug policy in the work place and schools. Things are moving in a positive direction for Nigeria and we are tackling the stigma about mental health and substances abuse in the society. This was an amazing and enlightening experience.

I had an opportunity to fly to Lagos, Nigeria to Lagos University for the Association of Psychiatrist Nigeria for their 4th annual scientific conference. During our stay their promoting our NGO Reconnect HDI and Synapse Services an old patient of mine Majek Fashek a famous reggae artist came to support our efforts. He spoke to the individuals at the conference and gave a surprise performance.

I also was able to travel to Suleja in Tafa Niger state, Nigeria for our first company team bonding day. It was a blast and had a lot of fun. It was amazing to see everyone coming together and working as a team.

I also had time to follow up with all of my current patients and 3 patients who had been discharged from our program. It was amazing to see my past patients still coming for groups weekly and participating in the program and doing well. One patient has been now drug free 7 months. I am so very proud of them.

Till the next visit. ....

Journey of Recovery

When you’re struggling with drug addiction, sobriety can seem like an impossible goal. But recovery is never out of reach, no matter how hopeless your situation seems. Change is possible with the right treatment and support, and by addressing the root cause of your addiction. Don’t give up—even if you’ve tried and failed before. The road to recovery often involves bumps, pitfalls, and setbacks. But by examining the problem and thinking about change, you’re already on your way.

Drug addiction treatment and recovery 1: Decide to make a change

For many people struggling with addiction, the biggest and toughest step toward recovery is the very first one: deciding to make a change. It’s normal to feel conflicted about giving up your drug of choice, even when you realize it’s causing problems in your life. Change is never easy—and committing to sobriety involves changing many things, including:

• the way you deal with stress
• who you allow in your life
• what you do in your free time
• how you think about yourself

You may wonder if you’re really ready for all that change or if you have what it takes to quit. It’s okay if you’re torn. Recovering from addiction is a long process, one that requires time, commitment, motivation, and support. As you contemplate your situation, the following tips can help you make the decision.

Thinking about change

• Keep track of your drug use, including when and how much you use. This will give you a better sense of the role the addiction is playing in your life.
• List the pros and cons of quitting, as well as the costs and benefits of continuing your drug abuse.
• Consider the things that are important to you, such as your partner, your kids, your career, or your health. How does your drug use affect those things?
• Talk it over with someone you trust. Ask the person how he or she feels about your drug use.
• Ask yourself if there’s anything preventing you from changing. What are some things that could help you make the change?

Preparing for change: 5 key steps to addiction recovery

1. Remind yourself of the reasons you want to change.
2. Think about your past attempts at quitting, if any. What worked? What didn’t?
3. Set specific, measurable goals, such as a quit date or limits on your drug use.
4. Remove reminders of your addiction from your home and workplace.
5. Tell friends and family that you’re quitting and ask for their support.

Drug addiction treatment and recovery 2: Explore your treatment options

Once you’ve made the decision to challenge your drug addiction, it’s time to explore your treatment choices. As you consider the options, keep the following in mind:

• There’s no magic bullet or single treatment that works for everyone. When considering a program, remember that everyone’s needs are different. Drug addiction treatment should be customized to your unique problems and situation. It’s important that you find a program that feels right.
• Treatment should address more than just your drug abuse. Addiction affects your whole life, including relationships, career, health, and psychological well-being. Treatment success depends on developing a new way of living and addressing the reasons why you turned to drugs in the first place. It may have been because of an inability to manage stress, in which case you’ll need to find healthy ways to handle stressful situations.
• Commitment and follow-through are key. Drug addiction treatment is not a quick and easy process. In general, the longer and more intense the drug use, the longer and more intense the treatment you’ll need. But regardless of the treatment program’s length in weeks or months, long-term follow-up care is crucial to recovery.
• There are many places to turn for help. Not everybody requires medically supervised detox or an extended stint in rehab. The level of care you need depends on your age, drug use history, and other medical or psychiatric conditions. In addition to doctors and psychologists, many clergy members, social workers, and counselors offer addiction treatment services.

As you seek help for drug addiction, it’s also important to get treatment for any other medical or psychological issues you’re experiencing. Your best chance of recovery is through integrated treatment for both the substance abuse problem and the mental health problem. This means getting combined mental health and addiction treatment from the same treatment provider or team.

Drug addiction treatment and recovery 3: Reach out for support

Don’t try to go it alone. Whatever treatment approach you choose, having a solid support system is essential. The more positive influences you have in your life, the better your chances for recovery. Recovering from drug addiction isn’t easy, but with people you can turn to for encouragement, guidance, and a listening ear, it’s a little less tough.

• Lean on close friends and family – Having the support of friends and family members is an invaluable asset in recovery. If you’re reluctant to turn to your loved ones because you’ve let them down before, consider going to couples counseling or family therapy.
• Build a sober social network – If your previous social life revolved around drugs, you may need to make some new connections. It’s important to have sober friends who will support your recovery. Try taking a class, joining a church or a civic group, volunteering, or attending events in your community.
• Consider moving in to a sober living home – Sober living homes provide a safe, supportive place to live while you’re recovering from drug addiction. They are a good option if you don’t have a stable home or a drug-free living environment to go to.
• Make meetings a priority – Join a recovery support group and attend meetings regularly. Spending time with people who understand exactly what you’re going through can be very healing. You can also benefit from the shared experiences of the group members and learn what others have done to stay sober.

Drug addiction treatment and recovery 4: Learn healthy ways to cope with stress

Even once you’ve recovered from drug addiction, you’ll still have to face the problems that led to your drug problems in the first place. Did you start using drugs to numb painful emotions, calm yourself down after an argument, unwind after a bad day, or forget about your problems? After you become sober, the negative feelings that you used to dampen with drugs will resurface. For treatment to be successful, and to remain sober in the long term, you’ll need to resolve these underlying issues as well.
Conditions such as stress, loneliness, frustration, anger, shame, anxiety, and hopelessness will remain in your life even when you’re no longer using drugs to cover them up. But you will be in a healthier position to finally address them and seek the help you need.

  Relieving stress without drugs

Drug abuse often stems from misguided attempts to manage stress. Many people turn to alcohol or recreational drugs to unwind and relax after a stressful day, or to cover up painful memories and emotions that cause us to feel stressed and out of balance. But there are healthier ways to keep your stress level in check, including exercising, meditating, using sensory strategies to relax, practicing simple breathing exercises, and challenging self-defeating thoughts.

Strategies for quickly relieving stress without drugs

You may feel like doing drugs is the only way to handle unpleasant feelings, but it’s not. You can learn to get through difficulties without falling back on your addiction. Differentquick stress relief strategies work better for some people than others. The key is to find the one that works best for you, and helps you calm down when you’re feeling stressed and overwhelmed. When you’re confident in your ability to quickly de-stress, facing strong feelings isn’t as intimidating or overwhelming.

• Exercise releases endorphins, relieves stress, and promotes emotional well-being. Try running in place, jumping rope, or walking around the block.
• Step outside and savor the warm sun and fresh air. Enjoy a beautiful view or landscape.
• Yoga and meditation are excellent ways to bust stress and find balance.
• Play with your dog or cat, enjoying the relaxing touch of your pet’s fur.
• Put on some calming music.
• Light a scented candle.
• Breathe in the scent of fresh flowers or coffee beans, or savor a scent that reminds you of a favorite vacation, such as sunscreen or a seashell.
• Close your eyes and picture a peaceful place, such as a sandy beach. Or think of a fond memory, such as your child’s first steps or time spent with friends. 
• Make yourself a steaming cup of tea.
• Look at favorite family photos.
• Give yourself a neck or shoulder massage.
• Soak in a hot bath or shower.

Drug addiction treatment and recovery 5: Keep triggers and cravings in check

While getting sober from drugs is an important first step, it’s only the beginning of the recovery process. Once sober, the brain needs time to recover and rebuild connections that have changed while addicted. During this time, drug cravings can be intense. You can support your continued sobriety by making a conscious effort to avoid people, places, and situations that trigger the urge to use:

• Make a break from old drug buddies. Don’t make the mistake of hanging out with old friends who are still doing drugs. Surround yourself with people who support your sobriety, not those who tempt you to slip back into old, destructive habits.
• Avoid bars and clubs, even if you don’t have a problem with alcohol. Drinking lowers inhibitions and impairs judgment, which can easily lead to relapse. Drugs are often readily available and the temptation to use can be overpowering. Also avoid any other environments and situations that you associate with drug use.
• Be up front about your history of drug use when seeking medical treatment. If you need a medical or dental procedure done, be up front about your history and find a provider who will work with you in either prescribing alternatives or the absolute minimum medication necessary. You should never feel ashamed or humiliated about previous drug use or be denied medication for pain; if that happens, find another provider.
• Use caution with prescription drugs. Stay away from prescription drugs with the potential for abuse or use only when necessary and with extreme caution. Drugs with a high abuse potential include painkillers, sleeping pills, and anti-anxiety medication.

Coping with drug cravings

Sometimes craving cannot be avoided, and it is necessary to find a way to cope:

• Get involved in some distracting activity. Reading, a hobby, going to a movie, exercising (jogging, biking) are good examples of distracting activities. Once you get interested in something else, you’ll find the urges go away. Another effective response to a drug craving is eating (but be careful what you eat, as eating junk will only add stress and inches to your waistline).
• Talk it through. Talk to friends or family members about craving when it occurs. Talking about cravings and urges can be very helpful in pinpointing the source of the craving. Also, talking about craving often helps to discharge and relieve the feeling and will help restore honesty in your relationship. Craving is nothing to feel bad about.
• Urge surf. Many people try to cope with their urges by gritting their teeth and toughing it out. But some are just too strong to ignore. When this happens, it can be useful to stay with the urge until it passes. This technique is called urge surfing.Imagine yourself as a surfer who will ride the wave of your drug craving, staying on top of it until it crests, breaks, and turns into less powerful, foamy surf.
• Challenge and change your thoughts. When experiencing a craving, many people have a tendency to remember only the positive effects of the drug and forget the negative consequences. Therefore, you may find it helpful to remind yourself that you really won’t feel better if you use and that you stand to lose a lot. Sometimes it is helpful to have these benefits and consequences listed on a small card that you keep with you.

Adapted from: The National Institute on Alcohol Abuse and Alcoholism

Drug addiction treatment and recovery 6: Build a meaningful drug-free life

You can support your drug treatment and protect yourself from relapse by having activities and interests that provide meaning to your life. It’s important to be involved in things that you enjoy and make you feel needed. When your life is filled with rewarding activities and a sense of purpose, your addiction will lose its appeal.

• Pick up a new hobby. Do things that challenge your creativity and spark your imagination—something you’ve always wanted to try.
• Adopt a pet. Yes, pets are a responsibility, but caring for an animal makes you feel loved and needed. Pets can also get you out of the house for exercise.
• Get involved in your community. Replace your addiction with drug-free groups and activities. Volunteer, become active in your church or faith community, or join a local club or neighborhood group.
• Set meaningful goals. Having goals to work toward and something to look forward to can be powerful antidotes to drug addiction. It doesn’t matter what the goals are—whether they involve your career, your personal life, or your health—just that they are important to you.
• Look after your health. Regular exercise, adequate sleep, and healthy eating habitshelp you keep your energy levels up and your stress levels down. When you feel good, drugs are much less of a temptation. The more you can do to stay healthy, the easier it will be to stay sober.

Drug addiction treatment and recovery 7: Don’t let relapse keep you down

Relapse is a common part of the recovery process from drug addiction. While relapse is understandably frustrating and discouraging, it can also be an opportunity to learn from your mistakes and correct your treatment course.

What causes relapse?

Various “triggers” can put people at risk of relapsing into old patterns of substance use. Causes of relapse can differ for each person. Some common ones include:

• negative emotional states (such as anger, sadness, trauma or stress)
• physical discomfort (such as withdrawal symptoms or physical pain)
• positive emotional states (wanting to feel even better)
• testing personal control (“I can have just one drink”)
• strong temptations or urges (cravings to use)
• conflict with others (such as an argument with a spouse or partner)
• social pressures to use (situations where it seems as though everyone else is drinking or using other drugs)
• good times with others (such as having fun with friends or family)

Source: Centre for Addiction and Mental Health

The important thing to remember is that relapse doesn’t mean treatment failure. Rather than giving up, get back on the wagon as quickly as you can. Call your sponsor, talk to your therapist, go to a meeting, or schedule an appointment with your doctor. When you’re sober again and out of danger, look at what triggered the relapse, what went wrong, and what you could have done differently. You can choose to get back on the path to recovery and use the experience to strengthen your commitment.

Resources

Simple ways of coping with stress

SIMPLE WAYS OF COPING WITH STRESS 

Modern life is full of demands, deadlines and frustrations.  Stress has become a way of life for many people. Stress is simply a reaction to a stimulus that disturbs our physical or mental equilibrium.  It describes how our bodies respond to the demands placed on them. Our bodies may respond physically, emotionally or psychologically. The demands or (stressors) may be external such as work and relationships, or internal such as thoughts about ourselves and expectations we place upon ourselves.  Stress is not always bad.A little bit of stress, known as “acute stress,” can be exciting—it keeps us active and alert. But long-term, or “chronic stress,” can have detrimental effects on health. We can protect ourselves by recognizing the signs and symptoms of stress and taking steps to reduce its harmful effects. 

Why do we experience stress?

When we are under stress our bodies produce a chemical called adrenaline. This prepares the body for what is known as ‘fight or flight ‘response. The body is ready to fight if it is faced with real physical danger or run away from the danger or stand and fight. There is no immediate danger to ourselves when we feel stressed but the adrenaline is still released into the blood stream and gears us up for immediate action. It stimulates the heart to beat faster and re-directs blood to the brain, heart and muscle. As the blood is rapidly pumped around the body, our blood pressure rises. It causes the liver to release sugar and fat into the blood stream and gives us instant energy.

Causes of Stress

• Job: overworking, colleagues, meeting deadlines
• Family changes: birth, death, marriage, divorce, relationship breakdown
• Family Life: relationship problems, children, elderly relatives, financial worries
• Environment: noise, pollution, overcrowding, bad working conditions, relocation
• Nutrition: unbalanced diet, too much caffeine, excessive alcohol/tobacco
• Social factors: unemployment, racism, bullying, discrimination

Symptoms of Stress

If we have too much stress, we feel distressed and may develop a number of symptoms or stress indicators. There may be some warning signs, such as: 

Cognitive Symptoms Memory problems Inability to concentrate Poor judgment Seeing only the negative Anxious or racing thoughts Constant worrying   Physical Symptoms Aches and pains Diarrhea or constipation Nausea, dizziness Chest pain, rapid heartbeat Loss of sex drive Frequent colds

Emotional Symptoms Moodiness Irritability or short temper Agitation, inability to relax Feeling overwhelmed Sense of loneliness and isolation Depression or general unhappiness  Behavioral Symptoms Eating more or less Sleeping too much or too little Isolating yourself from others Procrastination Using alcohol, cigarettes, or drugs to relax Nervous habits (e.g. nail biting, pacing)

We begin to experience other indicators of stress as the stress continues e.g.

• Irritability/impatience
• Headaches/backache
• Fatigue/tiredness
• Tearfulness
• Forgetfulness
• Social withdrawal
• Stomach upset/weight gain

Our general health can be affected if we continue to feel distress over a long period of time.  We can develop problems such as:

• Depression
• Heart disease/High blood pressure
• Anxiety
• Psychosomatic problems (Physical problems with the body) 

1. General Principles of managing stress

Keep fit, happy and well. A healthy body makes it much easier to cope with stress.

• Take regular exercise
• Eat a balanced, healthy diet
• Get enough sleep

Reduce artificial stimulation

• Limit your intake of tea/coffee/caffeinated drinks
• Don’t overeat-especially on chocolate
• Reduce intake of alcohol and tobacco
• Avoid street drugs, sleeping tablets or ‘tranquillizers’

Know yourself

• Recognize your limits
• Avoid doing several things at a time
• Avoid taking on more tasks
• Have the courage to say ‘no’ when things are too much

Find ways to enjoy yourself. We all need variety and changes from the routine to make life more interesting.

• Be kind to yourself. Treat yourself to extra-long bath/massage
• Pursues hobbies and leisure activities
• Relaxation: get time to unwind and relax

2. Identify Stressors

• Write down the things that cause you stress or the things you are worried about
• Look at each one and consider if there something you can do to change the stressor or change the amount of stress it causes you
• Where possible get away from the situation that causes you stress
• If you cannot change the situation, try the following techniques

3. Specific Techniques

• Breathing: Start by breathing slowly and deeply. Breathe in through your nose for count of three, allowing your lungs to fill up your tummy to rise. Then breathe out through your mouth for the count of three
• Relaxation: Muscle relaxation - tense and relax various muscle groups. Try your neck/shoulders and foreheads/eyes. Combine with deep breathing so that you inhale when you tense your muscles and exhale when you relax them. Take deep slow breaths. Throughout the day become aware of how tense your body is and try this exercise

     Routines

• Become used to going to places or doing things that make you feel anxious. The body   and mind will gradually adapt as you become familiar with the activity or place and the level of anxiety will reduce  

Visualization

Imagine a peaceful scene such as lying on beach, walking in the forest, sitting by a river, Try to use all your senses-imagine what you can see/hear/smell/touch/taste

Setting priorities

Make a list of the things you have to do. Decide which ones are most important and which are less important. Work out how much time you have and decide what you can realistically do in the allotted time. Leave the other tasks to another day. Try to manage your time/work realistically.

                                                                                         OLATUNDE IBIRONKE

                                                                                          & JOHN IKOT  

Drawing Mental Illness: A Visual Diary by Bobby Baker

Mental illness is still very much a taboo subject; in part, this is because the experience of it can be very challenging to articulate. For performance artist Bobby Baker, when she was diagnosed with borderline personality disorder in 1996, she set out to capture her experience and her journey to recovery in 711 drawings that would serve as her private catharsis over the course of more than a decade. 

 

Some of her work can be seen by clicking on this link. 

What can you do to make a difference

What can you do to make the difference?

If your friend had a broken leg, or he or she had just come out of hospital after an operation, you probably wouldn't think twice about asking how they were. Anyone can experience a mental health problem, so being able to talk about it is important to us all.

You don't need to be an expert about mental health though. Sometimes, just doing the little things, like asking someone how they are, is all it takes to let someone know you're still thinking about them and make a big difference to how they're feeling.

If someone you know has experience of mental illness, these are some of the things you can do to support them:

• Carry on as normal – just be the family member, friend or colleague you’ve always been and stay in touch.
• Offer practical support, help and understanding.
• Educate yourself about mental health and wellbeing.
• Use positive and encouraging language when talking about mental illness.
• Value and respect the person’s decisions about his or her mental wellbeing.
• Talk about the future, make plans to do things together.
• And speak up if your family member, friend or anyone you see is being treated unfairly.

For Nigeria's mentally ill, the cure can be worst than the disease

In Nigeria, the mentally ill have little more than faith on their side.

Original article on Slate and on Roads+Kingdoms

By Rowan Moore Gerety

Nigerian spiritual healer Al-Hajji Mojeed with a patient at the offices of his Olaiya Naturalist Hospital in Ibadan, Nigeria.

Photo by Rowan Moore Gerety

IBADAN, Nigeria—Al-Hajji Mojeed thinks of himself as a reformer. After he welcomed me to the offices of his Olaiya Naturalist Hospital in Ibadan, Nigeria, he led me to a small, windowless room where a patient was shackled to a rusty engine block, recovering, as Mojeed put it, from “head surgery.” Three days earlier, Mojeed had used a razor blade to make a long incision in the patient’s scalp, then filled the gash with herbs in order to allow malevolent spirits to escape through the wound.

The room was the last in a row of cubbyhole-like shops that sit in front of Mojeed’s house, concrete painted sea-green, with double doors cut from the walls of shipping containers. Mojeed’s wife operates a hair salon in one of the rooms, small general stores rent two rooms in the middle, and at the other end of the row, Mojeed keeps a small office lined with shelves of herbal concoctions in recycled plastic water bottles.

Back in his room, Mojeed’s patient was sprawled out on a mat across the entrance, using his arms to shield his head as he slept. A chain around both ankles left him enough slack to sit up and face the street or to turn and lean against the wall. Beside him, his mother sat silently, smiling. She planned to stay with her son at Mojeed’s hospital for the next two months.

According to Mojeed, spirits had haunted the man periodically for 12 years. Before the surgery, he was hostile and violent. When his family delivered him into Mojeed’s care, they brought him with his hands and feet bound with rope. The patient had been cursed by debtors in a business deal gone bad, Mojeed said, and his family had taken him to a series of spiritual healers with no change for the better. Standing in the doorway, Mojeed was ready to declare the surgery a success. “That is why he is sleeping,” Mojeed said. “The medicine is taking effect.”

A mentally ill patient shackled to an engine block at the Olaiya Naturalist Hospital in Ibadan, Nigeria.

Photo by Rowan Moore Gerety

Professional psychiatric care is basically inaccessible for most Nigerians with psychosis, a term used to describe a broad range of conditions that involve some disconnect from reality, including schizophrenia and bipolar disorder. Fewer than 200 psychiatrists work in a country of 168 million, and since Nigerians usually consider psychosis a supernatural affliction, psychiatrists are rarely seen first, if at all.

Increase Adeosun, a psychiatrist who manages intake at Nigeria’s largest psychiatric hospital, says patients usually only turn up there when the symptoms have reached a “melting point, when every other [option] has failed.” Most have already put in long stints at churches and mosques—where they are often subjected to fasting and periods of isolation—or in centers run by traditional healers. Flogging and shackling patients is sometimes practiced at all three. The clinical rule of thumb for psychotic disorders, meanwhile, is “the shorter the onset, the better the prognosis,” Adeosun says. As a result, psychiatrists typically find themselves treating the “treatment” as well as the illness, with many patients suffering from symptoms that have been exacerbated by the work of other healers.

But spiritualists like Mojeed represent the only consistent frontline psychiatric care in Nigeria. Whether they’re Christians, Muslims, or animist complementary providers (medical jargon for traditional and faith healers), they are present in nearly every community in the country. In Ibadan, Nigeria’s second-largest city, a single Muslim healer operates a facility that houses twice as many patients as the only psychiatric ward in town. For Nigeria’s medical professionals, the trick is to convince spiritual healers to modify their treatments and even refer some cases to clinical doctors. If that type of collaboration happened on a large scale, it could transform the prognosis for thousands of people suffering from acute mental illnesses.

That’s exactly the cooperation that Ibadan psychiatrist Oye Gureje is hoping to encourage. He’s the principal investigator of a six-country research project called the Partnership for Mental Health Development in Sub-Saharan Africa. Gureje says that the goal of the program, which is funded by the U.S.-based National Institutes of Health, is to design a collaborative “shared care” program between professional psychiatrists and traditional healers. The hope is to spare patients from the most harmful practices, and ideally have some referred to specialists for treatment sooner rather than later. African medical literature is rich with studies on how both patients and practitioners view mental illness and its causes, but this is the first research project devoted to evaluating the feasibility and benefits of psychiatrists and traditional healers practicing in tandem. “We don’t really know how it will work,” says Gureje. “We just have to wait and see.”

It’s clear that Gureje would like to see the traditional healers phased out immediately. But he has to be more pragmatic. “It will be decades before we have enough psychiatrists in Nigeria to meet the need. Until we’re able to convince people that their worldview is wrong, that there is no supernatural causation of mental illness, these people are going to be patronized,” says Gureje. “If that is the case, what can we do to make their practice less harmful, to make it beneficial to patients?”

For his part, Mojeed seems like an unlikely candidate for compromise. Although the head surgeries he performs are technically illegal, he believes in the procedure and views Western medicine as ineffective against psychosis. There may be physical causes for anxiety and depression, but psychosis, Mojeed explained using a Quranic term for spirits, is caused by “djinns taking over a person’s mind.”

He used a razor blade to make a long incision in the patient’s scalp, then filled the gash with herbs so malevolent spirits could escape the wound.

Where psychiatrists see cycles of remission and relapse, traditional healers see the failure of Western medicine. “The treatment at UCH doesn’t reach the brain,” Mojeed said, referring to the University College Hospital of Ibadan. “It only manages, never heals.” His consultation room is decorated with local news clippings heralding outright cures against the odds: “Madwoman completely healed after 21 years,” one reads. Since 1997, Mojeed has run an association called Atorise—in Yoruba, the name means “repairer of heads”—organizing the ranks of Ibadan’s traditional mental health practitioners with an eye toward proving their legitimacy to the Nigerian medical establishment. Last year, Mojeed suggested that the university hospital should refer patients to him they are unable to cure, a proposition he says they rejected out of hand.

As horrifying as Mojeed’s methods may sound, he is considered more progressive than most. Wole Adejayan, a researcher at UCH, says Mojeed stands out among dozens of traditional healers for his efforts to temper the methods used by his colleagues. Through Atorise, Adejayan says Mojeed has argued against beating or withholding food from patients. His facility is one of only a handful that requires the presence of a caretaker alongside the patient for the duration of the treatment.

Indeed, a few decades ago, techniques performed in U.S. asylums were every bit as cruel. A 1946 article in Life describes life-threatening beatings routinely visited on inmates of psychiatric hospitals by their attendants, as well as long periods of confinement in dank cells where patients slept on the ground and wore thick leather handcuffs. Three years later, in 1949, a Portuguese neurologist won the Nobel Prize for developing the lobotomy—a procedure no doctor today would recommend. Insulin shock therapy, designed to induce a comalike state in schizophrenic patients, was common in the United States through the 1950s.

Most Nigerians have little choice but to visit a spiritual healer for psychiatric care.

Photo by Rowan Moore Gerety

Mojeed remains leery of participating in collaborative treatment for psychosis. His concern is actually based on medicine; he’s worried about the possibility of negative interactions between pharmaceutical drugs and the sedative, plant-based concoctions he gives his patients. Unless, that is, it could be done sequentially by making referrals when one form of treatment proves ineffective. In that case, he said, “If the government will provide shelter and food for patients, members of Atorise will provide our services for free.”

Other faith healers are similarly open-minded. In Ibadan, I spoke to a pharmacist who says he periodically sells Largactil—the anti-psychotic chlorpromazine—to robe-wearing pastors who administer the drugs dissolved as a cocktail in a glass of holy water.

One problem, as with so much in Nigeria, is money. Psychiatric treatment is expensive, and even the government can’t always pay its hospital bills. In July, when Ogun State’s funds were tight, officials stopped sending homeless patients with severe mental illness to a more expensive government-run psychiatric hospital, instead opting for Ademola Mental Hospital. Ademola is a traditional healing center that practices diagnosis by incantation, reciting verses to invoke the presence of gods responsible for mental illness. When I visited in the middle of October, two patients were chained to pillars on the front porch.

It’s hard not to see psychiatric hospitals and traditional healers remaining in direct competition. For now, though, it’s the psychiatrists whose livelihood seems most uncertain. Last month, residents in Nigeria’s public hospitals went on strike for more than three weeks; some doctors hadn’t been paid in more than four months. Most patients were left to look elsewhere for treatment.

This story was made possible by a grant from the International Reporting Project (IRP).