Nigeria is sitting on a mental health time bomb. As more citizens battle distress and instability, most resort to self-help, while only a privileged few can access formal care, writes JULIANA UCHE-OKOBI.
At 2 a.m., the reading room on the third floor is still full. Phones are turned face-down but not off. Someone’s playlist leaks through a cracked earbud. A highlighter with no cap lies beside an open economics textbook. On a windowsill near the back, half a strip of tramadol sits next to a bottle of malt drink.
Omawumi Akinsanya, a 300-level Economics undergraduate, did not get the tablets from a doctor. She asked a roommate, who asked a boy in her department, who reportedly buys in bulk from a contact on Instagram and resells individual tablets for a few hundred naira. No prescription. No dosage chart. No doctor. And, among the students, there is no great sense that anything unusual is happening.
Examination week has turned part of the hostel into an informal pharmacy, where students can obtain medicines without anyone keeping track of who is taking what, how much or how often.
For Akinsanya, the pressure is immediate. She has three examinations in four days and is repeating one course for the second time. Her parents call every Sunday to ask how revision is going. She tells them she is fine. What she does not tell them is that she stopped feeling much about the examinations months ago. It is not simply fear or lack of motivation. It is a flat, grinding need to get through them. The tablet, she says, gives her temporary relief from that feeling. There is no hospital record of her distress. There may never be one. If her experience eventually appears in the national health statistics, it could be reduced to a percentage in a survey conducted years from now.
In the meantime, it remains what mental-health problems so often become in Nigeria: something privately endured and publicly unnamed.
Akinsanya’s story is not proof that every student taking tramadol and other stimulants has a mental disorder nor that every person using drugs is self-medicating psychological distress. But it illustrates a troubling overlap between substance use, academic pressure and unmet emotional needs that health professionals and researchers have increasingly had to confront. And outside the university environment, the consequences can become much more visible.
In a Lagos suburb, Frank Umoda, 18, was an active member of his church. He participated in programmes organised by the different societies to which he belonged and was deeply involved in church activities. Then, according to accounts from people who knew him, peer pressure drew him towards smoking and uncontrolled drinking. Within weeks, his life began to unravel.
He became increasingly detached from the community around him and eventually began wandering the streets in dirty and unkempt clothes. Today, the church where he once participated actively has become a place where he is no longer welcome. The last time he wandered into the church, a security officer reportedly bundled him out.
John Iweka, a security official at the church, remembered him differently. “He used to be a strong member of this church,” Iweka recalled, describing how he believed Umoda’s involvement with smoking had contributed to his deterioration.
The episode illustrates another dimension of Nigeria’s mental-health crisis, the point at which a person stops being regarded as someone who needs help and starts being viewed and treated as someone who has become a problem.
For families and communities, the distinction can be difficult. Mental illness may be interpreted as spiritual weakness, bad behaviour, drug abuse, a consequence of disobedience or simply a person’s inability to cope. Substance use can then deepen the problem, while stigma makes seeking professional assistance even more difficult.
By the time a crisis becomes visible, intervention may already be considerably more difficult.
Gerald Badmus was luckier. As a young graduate who could not find paid employment, Badmus turned to tailoring. But he eventually found himself at the Federal Neuro-Psychiatric Hospital, Yaba, popularly known as “Yaba Left,” after consuming large quantities of hard drugs.
His family had the financial means to intervene quickly. They reportedly spent more than N3 million on his treatment and recovery. Today, Badmus has returned to tailoring, putting the pieces of his life back together and doing his utmost to avoid falling back into the grey world of mental imbalance.
His story is a reminder that mental-health treatment in Nigeria is not simply about whether treatment exists. It is also about whether a family can afford to reach it in time.
For families without the financial resources available to Badmus’s relatives, the pathway can be far more uncertain. They may borrow money. They may hide the illness. They may consult a religious leader or traditional healer. They may wait until behaviour becomes impossible to manage. Or they may simply hope that the problem disappears. Sometimes it does. Sometimes it does not. And sometimes the person disappears into the streets, a psychiatric facility, a prison cell or an informal world of substance use.
The scale of Nigeria’s mental-health challenge is difficult to capture precisely because the country still lacks comprehensive, regularly updated national data system that would make the burden easy to measure.
But available evidence is substantial. Recent research on mental, neurological and substance-use disorders in Nigeria continues to cite estimates that 20-30 per cent of the population experiences such conditions annually, while fewer than 10 per cent access any form of treatment and less than 1 per cent receive specialist mental-health care. The same research estimates that Nigeria has only about 300 psychiatrists for a population of more than 200 million.
Those figures should be treated as estimates rather than a newly conducted national survey. A 2025 systematic-review protocol noted that Nigeria’s mental-health prevalence data remain under-researched and under-reported, while continuing to cite the 20–30 per cent estimate. Still, the message is unmistakable. The number of people who may need help is vastly larger than the number who received specialist care.
The World Health Organisation (WHO) maintains that the treatment gap in low- and middle-income countries could range from 65 to 90 per cent, with stigma and discrimination among the major barriers to care. WHO’s Nigeria office has specifically identified stigma as a persistent obstacle to improving mental-health outcomes in the country.
From all indications, the said gap is not merely a statistic. It is the student sitting awake at 2 a.m. It is the young man wandering the streets. It is the family searching for money to pay for treatment. And it is the person who has never had, and may never have, access to medical treatment.
Substance use makes the picture more complicated. Nigeria’s most comprehensive national drug-use survey, conducted in 2018 with the support of the United Nations Office on Drugs and Crime, estimated that 14.4 per cent of Nigerians aged 15 to 64, which is about 14.3 million people, had used drugs other than alcohol and tobacco in the previous year.
The survey estimated 4.6 million past-year users of pharmaceutical opioids, mainly tramadol, representing 4.7 per cent of users aged 15 to 64. It also estimated 2.4 million users of codeine-containing cough syrups. While the survey may be old, the problem has not disappeared.
In November 2025, the National Drug Law Enforcement Agency, NDLEA, said it dismantled an opioid distribution network in Lagos and recovered more than 7.2 million tramadol pills and 53 million millilitres of codeine syrup, with a stated street value exceeding N6.7 billion.
In April 2026, the agency also announced an interim forfeiture order involving 17 containers containing about 19.6 million opioid pills and nearly 2.5 million bottles of codeine syrup, which it valued at more than N33.6 billion.
Though these seizures do not tell how many Nigerians are dependent on opioids or how many are using them to cope with psychological distress, they, however, demonstrate the continued availability and scale of the illicit pharmaceutical-drug market.
The danger is particularly acute when drug use becomes normalised. The 2018 national survey found that nearly 80 per cent of past-year pharmaceutical-opioid users were daily or near-daily users. It also found substantial use of several substances together, including cannabis, pharmaceutical opioids, cough syrups, tranquilizers and alcohol.
For someone already experiencing anxiety, depression, trauma or overwhelming stress, substance use can create another layer of difficulty. It could temporarily alter how a person feels while the underlying problem remains. The problem becomes more worrisome when viewed through the experiences of adolescents and young adults.
Globally, WHO says that mental disorders frequently begin during adolescence and young adulthood, and that most people with mental disorders do not receive effective care. Depression, anxiety and substance-use disorders have the potential to affect education, employment, relationships and social functioning. In Nigeria, the pressures facing young people are hardly insignificant. Such pressures as unemployment, academic competition, family expectations, financial insecurity, social-media pressure, relationship difficulties, violence and insecurity can all intersect with individual vulnerabilities.
For some, the distress is obvious. For others, it is poor academic performance. For another person, it is excessive drinking. For someone else, it may be staying awake all night scrolling through a phone. And for another, it may simply be saying, “I’m fine,” when the opposite is the true situation.
Such a scenario, according to Nneka Edwin, a psychologist, is what makes the silent crisis difficult to measure.
“The people who are most in need of help are not necessarily the people appearing at psychiatric hospitals,” she noted.
Meanwhile, Nigeria has made important changes to its mental-health policy architecture. In 2021, for instance, the country enacted the National Mental Health Act, replacing the colonial-era Lunacy Act framework, while the Federal Government says it has also implemented a revised National Mental Health Policy and the National Suicide Prevention Strategic Framework 2023–2030.
In July 2026, the Federal Ministry of Health and Social Welfare announced plans to establish a Brain Health Desk and develop Nigeria’s first National Brain Health Agenda, with the stated objective of strengthening prevention, diagnosis, treatment and long-term care for neurological disorders.
In addition, government has also been moving towards decriminalising attempted suicide. In September 2026, the Federal Ministry of Health said that the Federal Executive Council approved the ministry’s position on the issue and stated that a task force had undertaken consultations and prepared a white paper.
These developments matter because the law determines how society treats people in crisis. But legislation alone cannot fill a treatment gap.
A recent study of efforts to scale mental-health care in Lagos through WHO’s Mental Health Gap Action Programme highlights one possible direction, that is, training primary healthcare workers to identify and manage common mental-health conditions and refer more complicated cases to specialists.
That approach is important in a country where the specialist workforce is so small. In fact, if every distressed person has to travel to a specialist psychiatric hospital before receiving help, the system will inevitably miss many people. Mental-health care has to move closer to where Nigerians live, study, worship and work.
Perhaps the most difficult barrier is not a shortage of buildings or beds. Rather, it is what happens before someone enters a hospital. In Nigeria, where spirituality is applied to virtually everything, a person experiencing depression may be told to pray harder. Someone experiencing psychosis may be described as possessed. A person struggling with substance dependence may be dismissed as morally weak, while another who admits he is overwhelmed may be told to “man up.”
Again, a student who cannot concentrate may simply be called lazy just as a woman who admits she is struggling emotionally may fear being labelled unstable.
These responses, however, do not necessarily come from cruelty. Oftentimes, they emerge from ignorance, fear or cultural beliefs that have been passed down for generations. But the consequences can be serious.
As WHO states, mental-health stigma and discrimination remain major barriers to care in Nigeria. The result is a peculiar contradiction.
While Nigerians may be willing to talk about cancer, malaria, hypertension or diabetes as medical conditions, mental illness, however, remains a subject of secrecy. The family may conceal it. The individual may deny it because the community may ridicule it. And so the healthcare system may encounter it only after a crisis.
For a family like Badmus’s, early access to treatment may mean an expensive but successful intervention. For another family, the same illness may consume savings over years.The financial burden is one reason access matters.
The Federal Ministry of Health acknowledged in 2025 that most Nigerians currently pay out of pocket for mental-health services and said the government was working towards greater financial protection. That admission points to another uncomfortable question: how many Nigerians who need mental-health treatment cannot afford it? Certainly, the answer is difficult to establish because untreated illness leaves little administrative trace.
A person who never sees a psychiatrist does not appear in a psychiatric hospital’s records. Again, a student buying tablets from another student does not appear in a prescription database, just as a depressed, unemployed graduate, who stays indoors, does not appear in a hospital admission register. The absence of a record can, therefore, create the illusion of an absence of a problem.
At 3 a.m. or later, the reading room will eventually be empty. The textbooks will close. The phones will be picked up. The students will return to their rooms. The tramadol strip may disappear from the windowsill. And by morning, nothing may look wrong.That is precisely the problem.
Nigeria’s mental-health crisis does not always announce itself with a psychiatric admission or a dramatic breakdown. Sometimes it looks like a student trying to survive an examination. Sometimes it looks like a graduate who cannot find work. Sometimes it looks like a young man rejected by the community he once called home. And sometimes, it looks completely ordinary.
Nigeria has laws, policies and programmes. It also has hospitals, psychiatrists, psychologists, counsellors, NGOs, religious organisations and community health workers. There are also growing efforts to move mental-health services into primary healthcare and to address suicide prevention, substance use and stigma.
But between the person who needs help and the service that can provide it lies a wide gap. And millions may be standing in that gap quietly stranded. This is why Edwin says that the real measure of Nigeria’s mental-health response might not be how many people arrived at psychiatric hospitals. Instead, it might be by how many people never have to get that far before somebody notices that they are struggling.
At the time of publication, Mentally Aware Nigeria Initiative (MANI), a youth-based mental health organisation, had not responded to a request for comment on the issues raised in this report. But a report on its website shows that the organisation provided counselling and mental support to over 70,000 persons, 70 per cent of whom are between the ages of 18 and 25.
For Akinsanya, the warning sign may be hidden inside an examination timetable. For Umoda, it became impossible to hide. And for Badmus, he has the last laugh because his family had the resources to intervene. Their stories may be different, but they all point in the same direction, the fact that there are many Nigerians still struggling to keep their sanity intact without a clear knowledge of how long the struggle would last.
