Abuse in mental health institutions is not a new phenomenon. Reports of abuse emanate from care institutions nationwide. This is worsened by the fact that there are thousands of unregistered mental health institutions which often use unorthodox methods in the treatment of patients. The case isn’t any different in government-run institutions where practitioners operate unsupervised and unchecked, leading to several instances of human rights abuses.
To commemorate Mental Health Awareness Month, I spoke to Remi, a former patient of the psychiatric ward at the Lagos University Teaching Hospital, Idi-Araba as part of a four-part series in partnership with She Writes Woman Mental Health Initiative highlighting human right abuses of people with mental health conditions in Nigeria.
My name is Remi, and I’m a student at the Lagos State University Teaching Hospital. In 2019, I was diagnosed with depression and suicide ideation. I went to see a doctor after seeing symptoms of what I assumed was Attention Deficit Hyperactive Disorder (ADHD).
What were the symptoms?
I was unable to focus on things. In class, I always zoned out or fell asleep. I had to cram to pass exams and I’d forget everything I read right after.
I also had problems socially. I always preferred to keep to myself, and didn’t have any friends. My roommates tried to make friends with me but I always rejected them. My temperament also estranged people from me. I got severely angry at the slightest trigger so people generally stayed away. On the inside, I was always angry, sad or just numb.
So what did the doctor do?
She wasn’t convinced that I had ADHD. She chalked all my symptoms to just being stressed. I was certain I had ADHD and I was determined to make her see. I mentioned in passing that I sometimes think about killing myself and she immediately referred me to LUTH’s Psychiatric ward to see a specialist.
At the psychiatric ward, I was diagnosed with severe depression with suicidal ideation and they refused to let me leave unless I called a relative. I refused. They called their intervention personnel — big, heavily-built men who they said would restrain me if I tried to make a scene. They threatened me to call my relatives or risk spending the weekend chained to a bed till Monday — it was a Friday.
Woah. Why didn’t you want to call a family member?
The only relatives I could call were my parents and I didn’t want them to think I had mental health issues. An uncle of mine lives with schizophrenia and I’ve always heard of them speak with him with a certain stigma. I didn’t want my parents to think I also had a mental health condition.
So, who did you call?
I called a doctor who worked at the NGO I volunteered for but unfortunately, she wasn’t in Lagos so I had to call my mom who called my dad. When they arrived, the nurses said I’ll need to be admitted. I lied to my parents that depression had to do with a gastrointestinal issue I had and told them I didn’t want to be admitted.
My parents told the nurses that I would not be getting admitted. They were made to sign a document in which they undertook to ensure I came for my clinic appointments.
I was prescribed some drugs for my depression and assigned to a psychologist. I used the drugs religiously and faithfully attended my appointments but my mental health worsened.
What happened next?
I was told I had to be admitted. They said I would be admitted for a period of two weeks. I knew that my condition was worsening but I was worried about missing school. My depressive episode had been triggered because I performed poorly in school and missing weeks of classes could make me carry some courses over into the next semester.
I eventually agreed to be admitted, thinking two weeks wasn’t so bad. I was promised that I would get help from a team of psychiatrists and psychologists who would see me every day. I knew I needed help so I agreed.
After I was admitted, a nurse told me that it was impossible for me to be admitted for just two weeks. She stated that the minimum time spent admitted was six weeks, and even that was a minimum. With severe depression, it was unlikely I’d even get out after six weeks. I hated the fact that I was lied to. Why did they have to? I would have agreed to be admitted, without needing to be lied to.
Wow. Did you at least get the help you were promised?
I was assigned a bed in an open ward filled with patients in varying severity of mental health conditions. I found it hard to sleep because there were no fans in the wards. There were also mosquitoes and the patient adjacent to my bed snored terribly loud.
Day after day, I waited to see a psychiatrist or psychologist but none came around. I was just given drugs and food every day. I was losing my mind in boredom because my phone and laptops were taken away. I had nothing else to do but eat and sleep. The medication they gave me made me very drowsy all the time, so I was taking a lot of naps. I was also not allowed to read because they said I have something called Brain Fog Syndrome. I was bored and fed up. On top of that, I wasn’t getting the treatment I was promised.
My mom came to visit daily with my favourite foods because I’m a picky eater. She’d also bring along my phone so I could text and watch movies while she was around. One time, she had a run-in with a nurse who was angry I didn’t eat hospital food. The nurse continued to be rude to my mother without provocation every day of my stay.
By the fifth day, a Friday, I could no longer take it. I demanded to be discharged from the hospital because I felt I was just wasting away, doing nothing but eating and sleeping while my mates were studying. I didn’t want to risk carrying a course over at school so I asked my mom to ask for my discharge. I explained everything to her and she agreed.
My mom asked for advice from a family friend who was a psychologist and she was told that I could go home as long as I attended my clinic days religiously. The nurses tried to discourage my mom from checking me out but she was determined. They threatened that if my mother took me home and I harmed myself, the blame would be on my mother. My mother and I insisted that I was lucid and was fit to attend the clinic from home.
She signed the required Discharge Against Medical Advice (DAMA) form and spoke to a resident doctor who impressed on her the implications of me going home before the conclusion of my treatment. The doctor reluctantly signed my release form and said I was good to go.
We handed the DAMA form to the nurses. They then refused to let me go because my dad was listed as my next-of-kin but it was my mother who came to request my discharge. The resident doctor said it was a tiny matter that could be overlooked but the nurses refused, saying my dad had to come in person. We begged and pleaded with them, stating that my dad was at work and wouldn’t be able to arrive till way past 6 pm, the closing time. That would have meant I’d have to spend the weekend at the facility since it was a Friday. They refused and insisted my dad come all the way to sign the form.
Against all odds, my dad made it there before six pm that evening. The nurses tried to discourage him as well, to the point of aggression but my dad had spoken to our psychologist friend who had told him there was no harm in me going home. I had a feeling the nurses were trying to delay till closing time in order to keep me there for the weekend.
Whew. So you went home, right?
Unfortunately, the officer to sign my final release papers had already gone home that evening. I was told I’d have to wait till the next morning before I could go home.
My mother and younger brother begged and fought and pleaded for me to be released that night to be allowed home but the nurses disagreed. I told my parents to go home and come the next morning. My father did but my mother said it was already too late to go home and make the long trip back to the hospital again in the morning. She and my brother would sleep somewhere on the LUTH campus till it was time to fetch me. I tried to discourage her but she refused. She snuck me my phone to call her in case anything was wrong because she didn’t trust the nurses.
Wow. What happened next?
Miserably, I went back to my bed. Shortly after, one of the nurses came to me and said she suspected my mom had given me a phone. I denied it several times. She threatened to search my things, which she did. I had anticipated this so I had hidden the phone in my shirt. She continued to insist that she was sure I had a phone on me and would search my body. I pointedly refused, telling her she had no right to touch me. I anticipated that she would be back so I hid the phone in my panties.
She left and returned a moment later with one of the heavily-built crisis intervention personnel whom she ordered to handcuff me to the bed and restrain my legs while she searched me. I was screaming at her not to touch me but she did anyway. When she didn’t find it, she said she would have to search my privates and I screamed at her not to do it. She ordered the guard to hold my hands and legs while she stripped my pants off, in the full view of the male guard and the rest of the patients in the ward. She took my phone and left me on the ground, naked and screaming. I felt so violated that I didn’t know what to do but to keep screaming.
Oh my God. I’m so sorry.
Apparently, my screams were so loud that my mother and brother heard where they were and came running back to see what was wrong. They peered through the window and saw me handcuffed to the bed, screaming, naked and jerking at the cuffs violently. Their pleas to tell them what was wrong was left unanswered, as I could not just stop screaming for minutes on end. The nurses threatened to inject me with a sedative if I didn’t keep quiet.
My mother and brother tried to get into the ward but the nurses refused to let them in. They told them nothing and the nurses threatened to have my mother thrown out. She was heartbroken seeing me in that state.
Did no one try to intervene?
Eventually, a senior nurse from a different ward came to find out what was wrong. She spoke to my mom, went inside to see me and calmed the situation. My mom asked her to let us go home but the nurse said she could only help if she was given a bribe. My mom pleaded and said she would bring something for her the next day as she had no money on her. The nurse agreed and directed the junior nurses to let us go.
Did you try to report this incidence?
Report? What’s the point? This was something the nurses did regularly without consequences. My reporting wouldn’t have made any difference, especially as my family doesn’t “know anybody.”
How did you continue treatment?
I opted to continue treatment privately, which I found to be very expensive.
Remi is currently receiving private treatment, however expensive. She is continuing her education and finds joy volunteering as an advocate for mental health issues in Nigeria.
People living with mental health conditions and psychosocial disabilities in Nigeria continue to be subjected to varying levels of human rights abuses across state-owned and otherwise owned facilities. She Writes Woman and Zikoko continue to document and amplify the lived experiences of these victims in a bid to hold the Nigerian government accountable to ensuring human rights-respecting mental health legislation in Nigeria.
Do you have a story of abuse in state-owned, religious or traditional facilities? Reach out to @shewriteswoman across social media.
If you’ll like to get confidential support for your mental health, call the 24/7 toll-free helpline – 0800 800 2000.