Sociology of Mental Illness: the Study of the Un-institutionalized Mentally Challenged in Abeokuta, Ogun State. Nigeria
misalignment with the social system. Thus the illness is seen as punishment from the gods or supernatural beings, witches and evil people. In the ancient times, the mentally ill, when not ignored, were usually taken care of (sheltered or exorcised) by traditional medicine men, priests and spiritual healers. The etiology of mental illness for the Nigerian can be summarized as: evil spells and witches, failure to adhere to the cultural taboo, action or inaction of the person if considered offensive by the gods, inheritance, natural causes or physical illness, drugs e.g. marijuana or Indian hemp and environmental factor e.g. adversity.
According to Sow (1980), fewer cases of chronic mental disorder occur in the rural-non-literate group than among the urban-literate group. This is attributed to the fact that family/kinship bond which serves as an important ameliorator of socioeconomic and psychological conditions of rural Nigerians is weaker or impossible in the urban areas (Sow, 1980; Asuni, 1968).
Two different approaches, the traditional and the orthodox (western), are used to control mental illness in Nigeria. The choice of approach depends on the belief system of the users. The major difference between these approaches lies in their belief as to the etiology of mental illnesses and diseases in general. The traditional approach is the “medical” practice which existed among the people of Nigeria before they had European contact. Some form of spiritual healing can also be grouped under this approach. Common to virtually all the religions is the power of the spoken words whether in form of incantations, orders to the spirit to leave their patients, spells, exorcism, prayers or penitential formulas asking the forgiveness of the offended deity. Often this is accompanied by rituals, ritualistic movements and dances. Other therapeutic measures include application of drugs of plant or animal origin (as it is believed that they work in accord) often prepared according to secret formulas to cure the patients. Some traditional healers restrain their patients by tying them with ropes or chains in extremely unhealthy conditions. The orthodox (western) approach to mental illness in Nigeria follows the western medical model by locating the causes of mental illness in natural factors such as somatic organs, nervous systems or stressful situations (Erinosho, 1979). The early belief that some people develop psychological problems due to the use of Indian hemp and other psychoactive drugs (Lambo, 1981), is still being strongly adhered to. The method of treatment employed today has tilted more toward psychotherapy and drug therapy while shock treatment and psychosurgery seem to be of the past. There are evidences to show that asylums existed in Nigeria, wherein psychoanalytically-oriented methods were used (Erinosho, 1979; Laosebikan, 1973; Lambo, 1963; Shopeju, 1983). However, the general types of care facilities available today are located in the neuro-psychiatric hospitals, with both in and outpatient facilities. In addition, psychiatric facilities are also available in various university teaching hospitals throughout the nation.
In recent years, medicine has succeeded in bracketing mental illness into one of its areas of specialization — psychiatry (Szasz, 1961; Conrad and Schneider, 1980; Henslin; 2002). Unfortunately, while there is no doubt that some behavioural disorders can be controlled with drugs (Lickey and Gordon, 1983:75-104) psychiatry has not been able to come up with unquestionable definitions, and very successful methods/cure to prove its expertise on this subject (Szasz, 1961; Scheff 1974; Henslin, 2002). The mystery which mental illness presents is further revealed by the fact that mental health professionals do not always agree as to what the definition is. For example, the psychiatrist, psychiatric social worker, clinical psychologist, and other mental health professionals define it differently. While not denying the fact that some iota of consensus occurs across some professions (for example, there is an approved and certified diagnostic manual for mental illness), the idea is that one would have felt more convinced if the difference in diagnosis can be narrower. Further flaws in psychiatric definitions were revealed by the Rosenhan experiment. The experimenter had referred some sane people to mental health experts for diagnosis, they were all diagnosed “insane” (Rosenhan, 1973). Another concern is in the area of over-diagnosis and consequently over-prescription of drugs (Diller, 2006; Eisenberg, 2007). In fact, some psychiatrists admit that little is known about mental illness and some like Szasz (1961; 1996; 1998) do not agree that it exists. Rather it is believed that there are some people who have difficulty in living and that such behaviour should be called “problem behaviour” not mental illness, insanity or other self serving labels. The