The focus of this discourse is that the human mind, with its limited coping facilities, is at the center of all these challenges. In Africa, we mourn the dead and even mount big ceremonies in their memories, but no care is instituted for the mental health challenges of survivors of road and air accidents as well as suicide bomb attacks.
Nigeria has one of the largest and gallant army of soldiers who have fought to keep our nation together but with no adequate care for the attendant mental distress they live with, consequent of combat experiences. Survivors of armed robbery attacks have considerable mental distress which has made some families to abandon their new buildings for rented apartments.
There is a whole family of psychiatric disorders traceable to exceptionally stressful life events; and, depending on the duration and peculiarity of symptom, there is the acute stress disorder and post traumatic stress disorder. Basic symptoms include disturbed concentration, disorientation, emotional numbness, anger, panic anxiety and despair, among others.
Post traumatic stress disorder has the listed symptoms but in addition has emotional numbness and blunting, detachment from others, re-experiencing symptoms when such persons involuntarily relive aspects of the traumatic experience in a very vivid and distressing way as flashbacks in which the person acts or feels as if the events were reoccurring, nightmares and intrusive images from the traumatic event, just as some actually avoid activities and situations reminiscent of the event.
Men experience more traumatic events than women, but the women experience higher impact events. The critical challenge in recognising this disorder is that the clinical picture is often marked by substance abuse and depressive illness. The view of a layman is that traumatic events cannot fully explain this abnormal mental state, but literature and clinical practice have established a spatial relationship between these events and the occurrence of these disorders. The experience for those directly involved or witnesses carry a possibility of actual or threatening death or serious injury or threats to the physical integrity of the self and others. We should realise that survivors of traumatic events require mental health management and should be appropriately referred.
Our culture and religious orientation encourage the suppression of the emotional experience, thereby militating against a speedy recovery. Untrained counsellors get them to deny the reality of their feelings which impairs the principle of “working through” the trauma. The Federal Government needs to urgently incorporate mental health programme in the rehabilitation of the survivors of suicide bomb attacks, in addition to economic empowerment and social repositioning for those who have suffered significant handicaps as a result of the crisis.
This is important because economic deprivation and loss of social role functioning are potent factors of poor recovery. The amnesty programme being proposed cannot be successfully implemented unless a preliminary rehabilitation of survivors of the attacks is undertaken.
The ministry of defence should have a strong mental health programme to cater for soldiers, both serving and those retiring. Cases of rape should be promptly reported, not just for prosecution but for timely rehabilitation.
Our state ministries of health should be at the center of public health campaigns in managing survivors of disasters, as they have input in disaster management effort.
In conclusion, the relevance of the mental health professionals in primary health care is undisputable, especially for public enlightenment.