Nigeria’s latest mental health announcement is no cause for celebration, argues AG AHMED
The Federal Government’s announcement that President Bola Ahmed Tinubu has approved a proposed amendment to the National Mental Health Act to decriminalise attempted suicide would ordinarily deserve applause. Treating a person in suicidal crisis as a criminal is cruel, medically indefensible and incompatible with a modern understanding of mental illness.
But Nigeria must resist celebrating another announcement while the government continues to disregard the mental health law already in force.
The proposal approved by the Federal Executive Council is not yet law. It is an executive bill that must still be transmitted to, debated and enacted by the National Assembly. More importantly, it comes from a government that has failed, for almost four years, to activate some of the most important institutions mandated by the existing National Mental Health Act.
This is not reform. At best, it is the renovation of a building the government has refused to open. At worst, it is another exercise in legislative theatre._
Nigeria’s journey to this point was painfully slow. The colonial Lunacy Ordinance of 1916, later incorporated as the Lunacy Act of 1958, governed mental healthcare for more than six decades. It was custodial, discriminatory and concerned principally with confinement rather than treatment, autonomy or recovery. Its deficiencies and the repeated efforts to replace it have been extensively documented in the academic literature (Ozota et al., 2024).
An initial Mental Health Bill introduced in 2003 did not become law. Further legislative efforts followed, including the Mental Health and Substance Abuse Bill introduced in the Senate in January 2020. The National Assembly eventually passed the National Mental Health Bill in 2021. It was enacted as Act No. 46, with a commencement date of December 28, 2022, and presidential assent was publicly announced on January 5, 2023 (National Mental Health Act 2021; Nigeria Health Watch, 2023.
The new law was rightly celebrated as a historic break with colonial thinking. It promised protection from discrimination, degrading treatment, arbitrary detention and abuse. It recognised informed consent, community-based care, access to treatment, confidentiality, legal representation and independent review (Akanni et al., 2024.
Most importantly, section 2 did not merely suggest the creation of an administrative body. It expressly declared: “There is established a Department of Mental Health Services in the Federal Ministry responsible for Health.”
That Department was not an optional aspiration. It was intended to be the principal mechanism through which the Act would be administered. It was assigned responsibility for coordinating mental health services, developing national programmes, protecting the rights of people with mental health conditions, monitoring implementation and facilitating a national suicide-prevention strategy (National Mental Health Act 2021.
The Act also established a Mental Health Assessment Committee to protect people receiving care, review involuntary and long-term admissions, investigate complaints and guard against arbitrary detention. It provided for a Mental Health Fund and contemplated the integration of mental healthcare into primary, secondary and tertiary health services (Nigeria Health Watch, 2023.
Nearly three years and eight months after the Act commenced, where are these institutions?
Where is the visibly operational Department of Mental Health Services, with a director, staff, office, budget, implementation programme and publicly accessible reporting system?
Where is the Mental Health Assessment Committee hearing complaints, reviewing involuntary detention and inspecting facilities?
Where is the Mental Health Fund? Where are the regulations, national implementation timetable, minimum standards, enforcement reports and state-level structures?
As early as May 2024, the Centre for Health Ethics Law and Development issued an urgent call for the establishment of the Department and constitution of the Mental Health Assessment Committee (CHELD, 2024.
A 2026 academic review of Nigeria’s mental health-policy implementation found that progress between 2023 and 2025 remained limited, with no operational budget, minimal state adoption, weak or non-functional state structures and no robust national implementation plan. The review contrasted Nigeria’s approach with countries that followed legislation with defined implementation roadmaps and timelines (Damul et al., 2026).
The government’s failure is not merely administrative incompetence. It is a continuing violation of its own law.
When legislation says that a department “is established,” the executive cannot treat its operationalisation as a matter of political discretion. The Federal Ministry of Health is not free to obey the sections it finds convenient and ignore the institutional obligations upon which the entire Act depends. A government that refuses to establish and operationalise a body expressly created by statute undermines the rule of law.
This is the central deception of Nigeria’s mental health reform. The country possesses a shiny law but has withheld the machinery required to make it work.
A law without an implementing institution is a press release. A right without a remedy is a slogan. An independent review mechanism that does not sit cannot protect anyone. A mental health fund that contains no identifiable resources cannot purchase medication, employ professionals or establish community services. A prohibition against degrading treatment means little if no authority regularly inspects the places where people are detained.
The consequences are not abstract.
Before the Act was enacted, Human Rights Watch documented people with mental health conditions being chained in state institutions, psychiatric facilities, rehabilitation centres and traditional and religious establishments across Nigeria. Some were reportedly restrained for weeks, months or years and subjected to forced treatment, seclusion, beatings and unsanitary conditions (Human Rights Watch, 2019.
A subsequent international investigation described people with psychosocial disabilities being locked in confined spaces, forced to eat, sleep, urinate and defecate in the same small areas, and exposed to involuntary fasting, forced medication and physical or sexual violence (Human Rights Watch, 2020).
The National Mental Health Act was supposed to end this national disgrace. Yet people with mental illness are still reportedly found in chains and shackles. Distressed prisoners remain in correctional institutions without adequate psychiatric assessment, psychologists, medication or meaningful rehabilitation. Families without accessible services continue to surrender relatives to unregulated facilities where restraint may be presented as treatment and abuse disguised as spiritual intervention.
The Lunacy Act may have been repealed from the statute book, but its philosophy survives wherever a mentally ill Nigerian is chained, hidden, beaten, abandoned or detained without independent review.
That is why the announcement on attempted suicide cannot be received as an unqualified achievement.
Decriminalisation is necessary. Section 327 of the Criminal Code and section 231 of the Penal Code retain colonial provisions under which a survivor of a suicide attempt may be arrested and prosecuted. Such punishment discourages disclosure and help-seeking, intensifies stigma and converts psychological distress into criminal liability.
Minister of Health and Social Welfare Muhammad Ali Pate is correct that a suicidal person needs care and support rather than prosecution. The Federal Executive Council’s recognition of this principle is welcome.
But the proposed legislation must be legally precise. Amending the National Mental Health Act alone will not necessarily eliminate offences contained in the Criminal Code, Penal Code and relevant state legislation. The executive bill must expressly repeal or amend every applicable criminal provision and ensure harmonisation across federal and state jurisdictions. Otherwise, Nigeria may produce yet another contradiction in which one law promises care while another authorises arrest.
More fundamentally, what care will the government offer the person it says should no longer be prosecuted?
Where is the national crisis line?
Where is the properly staffed emergency mental health service? Where are the community crisis teams, suicide-prevention programmes, psychological services and accessible treatment centres?
Where are the trained personnel to assess the person after a suicide attempt?
Where is the follow-up care after discharge?
Where is the national suicide surveillance system?
Decriminalisation without services may remove the police cell, but it does not create a hospital bed, psychiatric nurse, psychologist, social worker or community support programme. A suicidal Nigerian who is no longer prosecuted but is discharged into the same conditions of poverty, stigma, family exhaustion and unavailable treatment has been spared punishment but has not been provided care.
The government cannot continue manufacturing laws as substitutes for governance. It cannot announce a new amendment while refusing to explain why the Department mandated by the existing Act remains invisible or non-operational. It cannot proclaim compassion for suicidal people while mentally ill citizens remain shackled. It cannot promise treatment while failing to fund the structures that would provide it.
There should therefore be no presidential self-congratulation, ceremonial fanfare or victory parade over this proposal. The government should immediately publish the full amendment bill and a comprehensive implementation report on the National Mental Health Act. The report should identify the leadership, staffing, office, budget and activities of the Department of Mental Health Services; the membership and proceedings of the Mental Health Assessment Committee; the amount appropriated and disbursed to the Mental Health Fund; the regulations issued under the Act; the number of facilities inspected; the complaints investigated; and the steps taken to end chaining and unlawful detention.
The National Assembly must refuse to treat the executive bill as an isolated amendment. Its public hearings should examine the government’s failure to implement the parent Act. Ministers and responsible officials should be required to account for every neglected statutory obligation. The legislature should attach definite timelines, budgetary duties, annual reporting requirements and enforceable consequences for non-compliance.
Civil-society organisations, professional associations, service-user groups, families, disability-rights advocates and public-interest lawyers should also consider coordinated legal action. The courts should be asked to determine whether the government’s prolonged failure to operationalise institutions expressly established by law constitutes an unlawful refusal to perform statutory duties.
Applications for mandamus and other public-law remedies should be considered to compel the responsible authorities to operationalise the Department, constitute the Assessment Committee, activate the Fund and publish implementation standards. Fundamental-rights actions should challenge chaining, degrading treatment, arbitrary confinement and denial of essential care. Strategic cases should seek structural orders requiring inspections, public reporting and continuing judicial supervision, not merely compensation after another person has suffered.
Nigeria does not need another beautiful mental health law displayed before the international community. It needs the government to obey the one it already has.
Decriminalising attempted suicide is morally right and long overdue. But it must not become a convenient public-relations shield for nearly four years of executive neglect. The true measure of reform is not the number of bills announced at the State House. It is whether a Nigerian in psychological crisis encounters care instead of punishment, treatment instead of abandonment and dignity instead of chains.
Until the Department exists in more than statutory language, until the Assessment Committee sits, until the Fund functions, until community services are available and until the last chain is removed from the ankle of a person with mental illness, there is no victory to celebrate.
There is only another promise resting upon an earlier promise that the government has refused to keep.
Ahmed, MD, LLM is a Forensic Psychiatrist, Professor and Chair of Psychiatry, College of Medicine, University of Saskatchewan, Canada
