It's been five years since Victor Ugo founded Mentally Aware Nigeria Initiative (MANI), a youth-led and youth-focused non-governmental organisation working to end the stigma and discrimination attached to mental health in Nigeria and the rest of Africa.

Today, the organisation has become a household name when it comes to mental health care and awareness in Nigeria, especially among young people. Across social media and offline, MANI has become a go-to source for mental health support.

With over 130 million unique social media users reached every year, and more than 30,000 people who have received crisis support via MANI in the last four years, the nonprofit’s impact is evident.

Ugo, who is also a medical doctor, was inspired to establish MANI after he was diagnosed with depression in 2014. It could be easy to think that as a doctor, the signs would have been clear to him, but they weren’t and that was a shocking realisation for him.

“That was when it dawned on me that there were so many people, and especially without the medical background, who would find it even more difficult and almost impossible to recognise mental health difficulties in themselves and in their close relatives,” he told BellaNaija in a 2018 interview.

As part of the BellaNaija x Global Citizen content series IMPACTER, which works to shine a light on Nigerians making a difference for their communities, we sat down with Ugo to learn more about MANI's important work.

How MANI Works

What MANI does is offer “mental health first aid and crisis support for people with mental health needs,” says Ugo. He notes that most people who call their support lines simply need someone to talk to and often people feel better afterwards. 

But it doesn't stop there, Ugo and his team also provide referral services so people can speak with qualified psychiatrists and psychologists if they need to.

MANI serves as "that stranger that you can reach out to to talk about your mental health," he says, adding that the organisation’s recruitment process is quite strict "because we know that we're dealing with people's mental health." 

Even after volunteers are recruited, they still undergo training and are supervised by experts. They undergo psycho-education, active listening, suicide counselling, safety training, and refresher trainings monthly. They also have an outlet where they receive counselling from an expert on the team. So volunteers are not only adequately trained, they are also mentored.

MANI also says that 98.5% of the people they have provided crisis support to have said they would refer their services to their friends.

What Is the State of Mental Health in Nigeria?

"Naturally, you'd want to go with the data, but we don't have data. However, going by what we're seeing on social media and communities across the country, it's not in a very good place," Ugo tells IMPACTER.

"And with constant exposure to traumatic situations in the past year, it's definitely gotten worse and the pandemic has increased risk factors to mental illness,” he adds. “The pandemic, based on research from other countries, has led to an increase in predisposing factors to mental illness. And then in Nigeria, the #EndSARS protests have led to an increase in stress and anxiety."

Image: Victor Ugo/MANI

But this is not the only problem. There are only a couple hundred psychiatrists in Nigeria [300, according to this 2020 Lancet report] and this poses a major mental health challenge in the country, according to Ugo. Furthermore, he adds, people do not know where or how to seek help when they have mental health challenges.

How Can This Problem Be Solved?

For MANI, part of the work is educating people on how to seek help and interact with doctors, as well as how to identify one that's good for them.

Secondly, MANI is involved in policy advocacy, Ugo notes. The organisation is working hard to change Nigeria's Lunacy Act from 1958, which gives medical practitioners and magistrates the power to detain an individual experiencing mental illness.

"One thing that's evident is that we can't actually solve this problem in the next 10 years. We can't have as many psychiatrists as we need," Ugo says, highlighting a system that the World Health Organisation (WHO) is implementing in some countries.

It's called the Mental Health GAP Programme (mhGAP) and it is a system where non-mental health specialists are trained to care for people with mental health conditions. This is important because people with mental health conditions that are not severe cases can be supported very well by these non-health specialists who are well trained. 

For Nigeria, the current health care system is perfect for implementing mhGAP in Nigeria. Ugo says if health care workers in Primary Healthcare Centres (PHCs) located in all communities across Nigeria are trained to attend to mental health conditions, it will reduce the burden on the small number of practicing psychiatrists Nigeria has. 

Ugo adds that certain cases that are not acute but more severe than mild, can be referred to Secondary Healthcare Centres (like general hospitals), which have doctors that are general practitioners but not mental health specialists. 

This has been piloted in Cross River, Benue, and Enugu states, says Ugo, and Lagos has also trained community health centres in managing postpartum depression. "So it works and we need to nationalise this," he adds.

What Are Some of the Barriers to Accessing Mental Health?

According to Ugo, there are barriers in:

  • Knowledge: Lack of information and awareness around mental health.
  • Access: Most people do not know where or how to access mental health care, and there aren’t a lot of available options.
  • Capacity: Lack of professionals who can actually provide mental care and support with the right mindset. Ugo shares that in Nigeria, it's common for staff of mental health care centres to tell people with mental health challenges to go to religious houses for help.
  • Resources: There aren’t enough people with the resources and know-how to provide a listening ear and mental health first aid.

In Nigeria, the majority of the population are located in rural areas with little or no internet access and MANI is working to provide its services in more languages so they can meet the mental health needs of people across many more communities. 

This is in addition to establishing partnerships across Africa, as well as developing a platform where people can connect with counsellors across the continent.

"For now, MANI is meeting the needs of people where our resources can cater to and do not want to go unprepared to communities — which is a form of neglect," Ugo says.

What Was MANI’s Impact During COVID-19?

Between March and May 2020, MANI recorded a more than 300% increase in the number of people reaching out to them. The number of visitors to their website also increased to the point where the team had to set up a “Stranger Support System”, where people volunteer to receive calls every month and just listen to the caller. In less than a year, more than 2,000 people have benefited from the program.

The pandemic also took its toll on MANI's volunteers because the organisation was receiving more than 4,000 cases a month. MANI’s partnerships with different organisations across the world came in handy at this time and counsellors received the needed support to continue their good work.

What Mental Health Practices Can Any Nigerian Practice in Their Daily Lives?

"I'll not speak from an expert's point of view, but from the view of someone who's had a tough 2020 and ‘21," Ugo says, before laying out his five personal tips:

  • I take stock. I write down my thoughts and daily activities. I voice journal to make it easy.
  • I have a gratitude pot where I note the good things that happen in my life. It can also be a gratitude album (with pictures of where I go, food to eat, etc)
  • Have a therapist if you can. We are constantly being hit with reasons to be angry.
  • I listen to music and meditate
  • I maintain sleep hygiene. I put off the light, don't go to bed before I'm sleepy, and don’t use my phone past a particular time.

Image: Victor Ugo/MANI

How Can Individuals Help Increase Mental Health Awareness in Their Communities?

"It starts with us recognising that we don't have to aim for the national or state level,” says Ugo. “It just starts with us doing the little we can within our families, street, workplace, etc. The first part is assessing what you know and educating yourself, then move on to learning with — not educating — others and ensuring people around you are mentally aware."

Which of MANI's Successes Would You Like to Share with Global Citizens?

“Apart from reaching about 130 million people globally every year and providing crisis support to more than 30,000 people in four years, MANI has, between 2019 and 2020, reached more than 8,000 students and 3,000 teachers as part of its 6-month programme in schools,” says Ugo.

He added that “more than 15,000 students have also been directly impacted by MANI and over 5,000 people in workspaces have been impacted” by the organisation’s work.

MANI has also provided more than 6 million minutes of counselling support for more than 30,000 people, according to Ugo, with each person receiving an average of four to five sessions.

How Do You Reach Out to People Who Don’t Want Mental Help?

"You can't actually help anyone that doesn't want help. Just wait (watchful waiting) and be kind in the way you encourage them to seek help,” says Ugo. “Sometimes it's fine to let people deal with their mental health challenges because it helps to build resilience."

From the impact of climate change on our environment and the people, to extreme poverty, insecurity, inaccessible health care, gender inequality, poor education, COVID-19, and many more, the world seems to be fraught with disasters. 

IMPACTER by Global Citizen x BellaNaija is throwing the spotlight on Africans making an impact in their countries and beyond. From mitigating the effects of climate change, to providing mental care, building innovative solutions to COVID-19, fighting global poverty, and providing education for all, these impacters are building smart solutions to creating a world that is safe, healthy and equal for all. 

As the world strives to recover from the impact of COVID-19, IMPACTER will follow the journey of these changemakers whose projects are not just changing the lives of people, but are also creating a world of equity and equality. Learn more about the series here.

Global Citizen Asks

Defeat Poverty

Meet Activist Victor Ugo, Who’s Changing the Narrative Around Mental Health in Nigeria

By Akindare Lewis