Educating Communities of Lagos, Nigeria About Mental Health to Reduce Stigma Through Visual Storytelling

Committee: John Daugherty, MS Biomedical Visualization, University of Illinois at Chicago

Sam Bond, MS Biomedical Visualization, University of Illinois at Chicago

Leah Lebowicz, MS Biomedical Visualization, University of Illinois at Chicago

Northwestern University’s Access to Health Project (ATH) is a partnership with the Justice and Empowerment Initiatives (JEI) and the Nigerian Federation of Slums and Informal Settlements. The project’s goal is to equip the health educators living in Lagos, Nigeria with the tools they need to educate the population about basic health topics. A Community Health Educator (CHE) is a person from the community who is trained to raise awareness about health needs and deliver health education to the general population. The curriculum was designed specifically for the needs of the informal communities in Lagos to provide information on germs, anatomy, disease, family planning, and sexual health. The University of Illinois at Chicago’s Biomedical Visualization graduate program joined this collaboration in 2018 to help engage the Lagos population by creating visuals for this curriculum.

Currently ATH does not have a mental health curriculum. My research focused on helping create this curriculum and create a visual story about depression to reduce stigma.

Mental Health History of Nigeria

Nigeria has a long history of mental health stigma and this stigma was enforced under the Lunacy act established in 1916 and last modified in 1958. The Lunacy Act enforced a system of westernized psychiatric medicine in Nigeria that was at odds with the traditional practices that had been used to treat mental illness in Nigeria. Those with mental illness were known as “lunatics” and seen as weak because they were not able to assimilate into British Culture. They were sent back home and were isolated from both cultures resulting in a high number of mentally ill people living on the streets of Nigeria with no support or treatment. Stigma can result from faulty beliefs that mental illness is a result of religious or pseudoscience practices like mesmerism and this stigma is damaging socially, politically, economically, and psychologically. The Lunacy Act defines a “lunatic” as an idiot and any other person of unsound mind.

Mental Health Curriculum and Visuals

Currently, there is minimal research on implementing mental health curriculums in sub-Saharan Africa. There are limited mental health resources and it is most commonly believed that mental health disorders are associated with religious and spiritual factors. A lot of the literature focuses on implementing mental health curriculums by teaching primary care providers which is not the right audience for this project. The studies that did focus on patient education for a lay audience found that having people interact with people who have a mental illness helps to reduce stigma. On a conference call with Northwestern we identified that the main focus of mental health curriculum should be focused on reducing stigma by associating positive images with mental health, emphasizing that mental illnesses can be cured and they are not related to spiritual factors. A lot of the stigma stems from religious beliefs that people with mental illnesses did something bad to end up this way. By building trust and making people understand that it is okay to get help and mental health is not related to spiritual factors mental health can begin to be seen in a better light.

How can visual storytelling be designed to decrease mental health stigma and promote active engagement in health education for a low health literacy community in Lagos, Nigeria?

Storytelling has been useful in teaching health information to communities that have a strong culture in storytelling. Research has shown that hearing stories from people with a mental illness and interacting with them can reduce stigma. By creating a visual story about depression that is personalized and culturally relevant, hopefully, mental health stigma can be reduced.