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Hospital Pioneers Research on Biological Psychiatry

On Wednesday, 28th September, 2011, the hospital hosted a seminar titled “Building capacity for Neurobiological research: Endophenotype-based genetic dissection of schizophrenia”.

The seminar was to pave the way for a pioneering collaborative research on biological psychiatry between the hospital and the University of Maryland School of Medicine, Baltimore, United States of America.

The Research, the first of its kind in West Africa, is designed to improve on the diagnosis and treatment of psychiatric disorders in the country.

The resource person for the seminar, Dr. Ikwunga Wonodi, Associate Professor of Psychiatry, Schizophrenia-Related Disorders Program, MPRC Neuro-genetics Laboratory, and Director of the First Episode Psychosis Clinic, Maryland Psychiatric Research Centre, University of Maryland School of Medicine, Baltimore, informed that he was in Nigeria to help set up the biological psychiatry research laboratory. The seminar was therefore, to prepare the staff for the actualaisation of the laboratory.

Disclosing the essence of the research to newsmen during the seminar, the Medical Director, Dr. R.A. Lawal said “we are trying to couple practice with research to improve quality of service to our clients. The end point is that we are entering into a new age of psychiatry in Nigeria and we are proud of this achievement. With the causes of psychiatric disorders being identified, psychiatry is going the way of becoming an illness that can be diagnosed just like malaria, hypertension or diabetes. This is known as biological psychiatry, where biological markers are identified to explain possible cause or causes of psychiatric ailments”.

The Medical Director also informed that with the assistance of Dr. Wonodi, the hospital had already obtained a small grant to build the laboratory and begin research into biological psychiatry. According to him, “this is the best thing that can happen to any psychiatric hospital in this area”.

Participants at the seminar included Consultant Psychiatrists, Resident Doctors, Laboratory Scientists, Radiologists, Clinical Psychologists, Health Record Officers, EEG Specialists, Social Welfare Officers, Nurses and other research assistants.

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Mental Spirituality

Dr H.T.O Ladapo-Former Medical Director, Neuro Psychiatric Hospital Yaba speaks to Adebayo Waheed on the hospital, treatment of mental disorder and the need for the establishment of a Psychiatric Nursing school Yaba.

What is the relevance of occupation therapy to the treatment of mental disorder?

When you talk of mental health, you are talking of psychiatrist, who is the head of the team, psychiatric nurse, social worker, clinical psychologist, and occupational therapist. But for some time in Nigeria, the team has never been complete because of the dearth of occupational therapist. In the last 15, 20 years, there had been no instructing programme and facility in the country to train them. So, it was as a result of this that the Federal Neuro-Psychiatric Hospital Yaba, Lagos, and the board, two years ago, decided to set up a school that will award diploma in Occupation Therapy.

In the past, the work of an occupational therapist was being done by psychiatric nurse. An occupational therapist assists more or les in the rehabilitation of not only psychiatric patients but other patients who are disabled in one in one way or the other. They do this by creating vocational training programme, planning daily activities for people with stroke, or with disability, those who have difficulty in using their hands, or people who are victims of trauma, people who are recovering from drug addition or people recovering from psychiatric condition. The assist these people in rehabilitation homes.

The requirement for the school is five credits, including English and Mathematics and three science subjects (Physics; Chemistry and Biology.)

But we have problems with some of the retired occupational therapists who were demanding for a higher institution, like a university. They wanted a degree awarding institution and we believe that we must fill the middle level class, hence, the introduction of a two-year diploma programme. We have produced three sets. Some of them are on attachment with the school. They wanted accreditation with a university. Fortunately the school management and Medical Rehabilitation Board have agreed to affiliate the school with the Obafemi Awolowo University (OAU) Ile-Ife, so that they will have the opportunity of having a higher degree.

They will continue with their degree programme from 200 level which I believe is appropriate. We are also working with some establishments and ministries so that they will be able to work with them. As they will start with HATISS 7 and from there they can move to HATISS 14 but those of them from graduated from the university can now get to directorship level. Very soon, the school will move to its permanent site. We have completed the construction of the administrative block, the hostel, (female and male), the laboratory and warehouse, where every equipment is kept. New set of students are expected to resume for lectures in January.

Why has is it taken the hospital so long to establish such school?

Well, it has taken so long because of no money syndrome to send our experts to United Kingdom (UK) for the training. It was very expensive. So anytime we make proposal to the government it was turned down and that is why we said we have to look inward, we have the experts, the capability, the facility and that is why the board and the management of the hospital decided to establish the school and it is now function.

Do you think the products of the school will meet the market demand, considering the number of psychiatric hospitals we have in Nigeria?

I am not sure. It will be in the short-term but in the long-term, with expansion, other schools can also recruit from foreign countries occupational therapist to work for them. What we have done is to create awareness in our environment and that awareness is making other hospitals to look inwards as they realize that they need such professionals. Many of our graduates have been going abroad for employment. We don t a situation whereby we will be producing our people and they will be subjected to brain drain at the end of the day. So we need to ensure that the graduates are given the opportunities to stay on ground.

Now that the hospital is trying to establish a school of nursing, what impact do you think that will have on the healthcare system?

The impact is enormous, considering the population in Lagos which can be put at 15 million with only one psychiatric hospital. You can imagine that majority of people with mental problem are not coming to the hospital due to ignorance. They will be visiting spiritual homes, where they are subjected to inhuman forms of treatment. They tie them to the wall, bed, and beat them. Our people from this part of the world believe that mental problem is due to spiritual issues, spiritual attack, somebody is behind it, the second or third wife of the family is the one responsible, all sorts of ignorant ideas. This is compound again by the spiritualists, who instead of advising them that this is a medical problem, compound the problem by saying it is spiritual attack and that what they need is prayer and fasting.

These spiritualists are educated, yet they subject our patients to inhuman forms of treatment under the pretence of spiritual attack and increase in membership of their spiritual group. I advise on the need to seek treatment of mental sickness at psychiatric hospitals. People should not be afraid of the word psychiatric.