Many countries have not addressed mental health law reform for a woeful number of years. In Nigeria, where I live, the ‘Lunacy Act’ is the central Federal law governing mental health. Its origins lie in the Lunacy Ordinance of 1916 which underwent only minimal reform in 1958; it is a legal framework that is effectively 100 years out-of-date.
The Lunacy Act applies federally, and across the vast majority of States. It does not once mention treatment and uses pejorative words like ‘lunatic’ and ‘idiot’. It also permits magistrates to order the detention of the mentally ill, including those who attempt suicide or engage in self-harm.
Without legal protections, the twin forces of stigma and superstition strip those living with mental health problems of their dignity. Access to essential services, including education, health, and employment, are denied. Mental illnesses are then construed as spiritual problems which result in sufferers being detained in so-called ‘spiritual healing homes’ and other mental health facilities. Recent reports by Human Rights Watch and others indicate that shackling, chaining, starvation and flogging are rife.
Those who are driven to the edge of despair and attempt unsuccessfully to take their own life are shown little mercy. Attempted suicide is an offence in Nigeria under the Criminal and Penal Codes. When charges are brought against a person, time spent in prison and severe bail conditions are virtually guaranteed, even where magistrates are willing to discharge.
This lamentable situation points to a clear need for law reform. Nationwide legislation must be established to recognise and uphold the rights of persons with mental health conditions. I’ve been proud to provide technical support for a new Mental Health Bill which is currently being considered by the Nigerian National Assembly. But I am also aware that new legislation and the drafting process that precedes it, must be carefully designed if people living with mental health problems are to have their rights fully realised.
In this task, we can learn from other Commonwealth countries. The Seychelles stands as a shining example. The Government of the Seychelles, working closely with health professionals and advocates, undertook a careful process of reform that paid close attention to international human rights standards including the International Convention on Persons with Disabilities, to which Nigeria is also a party. The principles of dignity and quality of life were at the forefront. They ensured that persons living with mental health conditions were part of the law reform process and that their views were heard and understood.
A Mental Health Bill was presented in Nigeria in 2002, almost twenty years ago. The Bill died after many years of advocacy simply because legislators didn’t demonstrate enough interest. It is now time for them to take up the mantle of human rights and human dignity and ensure this new bill sees the light of day.
Dr Cheluchi Onyemelukwe is Associate Professor of Law at Babcock University and Executive Director at the Centre for Health Ethics Law and Development. She facilitated the Foundation’s Health Rights Learning Exchange in 2019.