Mental Health Awareness

for Tax Professionals

By:
George Usman Kato
RN, RPN, DNE, B.Sc., M.Ed.
INTRODUCTION

• Victims of mental health disorders do lack mental health awareness

• They do not know the:
 causes
Signs and symptoms
Treatment services, or where to get help, and
Prevention principles
INTRODUCTION CONT.
This paper will discuss:
• Global mental health situation
• Concept of mental health awareness
• Mental health and awareness in Nigeria
• Economic implications of mental health issues
• Improving mental health
Update on Global Mental Health
• Nature is theme of 2021 Mental Health Awareness Week

• Observed from May 10 – 16, 2021

• Nature has a positive impact on mental health

• It has the ability to bring consolation during stress and increase our
creativity (Rowland, 2021).
Update Cont.
• Nearly 1 billion people live with a mental disorder
• 75% of people with mental health disorders do not receive treatment
• 3 million people die yearly due to substance abuse
• Every 40 minutes, a person dies of suicide
Update Cont.
• 50% of mental disorders begin at the age of 14 years
• Depression, anxiety, substance-related disorders disable people more
than AIDS, heart disease, accidents, and wars combined.
• Why then is mental health not given the urgent attention it deserves?
• CITN must be commended here for creating awareness about mental
health issues.
Concept of Mental Health Awareness

• Mental health awareness and literacy virtually have the same

meaning. They are two sides of the same coin.
• Mental health awareness is the ability to:
recognize, and
understand characteristics of mental health disorders
Concept Cont.
• Examples of the characteristics are:
Risks
Causes
When and how to obtain resources, and
Services
Concept Cont.
• The foundation for increased mental health awareness are the ability
to:
evaluate and
communicate
Key Factors
• The key factors or components of mental health awareness are:
1. The ability to recognize specific disorders or different types of
psychological distress
2. Knowledge and beliefs about risk factors and causes
3. Knowledge and beliefs about self-help interventions
4. Knowledge on beliefs about professional help available
5. Attitudes which facilitate recognition and appropriate help-seeking
6. Knowledge of how to seek mental health information (Jorm et al.,
1997).
• Alter Ty (2019) introduced a process approach to mental health
awareness:
• He developed a tool: Mental Health Awareness Advocacy and
assessment tool (MHAA-AT).
Ty Tool
• His tool has three progressive domains:
1. The ability to identify signs and symptoms of mental health issues
(Identifying Domain);
2. The ability to identify and access evidence-based mental health
resources (Locating Domain); and
3. Ability to effectively and appropriately respond to mental health
issues (Responding Domain) (Alter, 2019).
• Low mental health awareness
- decreases perception of need, and
- utilization rates of mental health services (Gagnon et al., 2015)
• Delay and failure to seek treatment for mental health issues has
adverse effects such as bad prognosis.
• Successful management, however, leads to reduction in disabling
symptoms (Eisenberg, et al. 2012; Jorm, 2000).
Mental Health and Awareness in Nigeria

• Mental health does not mean absence of disorder or illness

• It is an important component of health
• WHO defines mental health as:
• “a state of well-being in which an individual realizes his or her own
abilities, can cope with normal stresses of life, can work productively,
and is able to contribute to his or her community.”
• In Nigeria there is
- general neglect of mental health and
- stigmatization of mentally ill persons
• There is poor knowledge of:
- mental health
- Mental health disorders
- causes and characteristics
• All these are identified as major hurdles to improving mental health in
Nigeria (API & EpiAFRIC, 2020).
• An estimated 20% - 30% of the about 200 million Nigerians suffer
from mental health disorders,
• Ugochukwu and colleagues (2020) report Federal Ministry of Health
statistic of at least 1 in 8 Nigerians suffering with mental health
disorders.
• These figures suggest economic hardship, negative environmental
problems, the rising cost of decent living in Nigeria.
• Less than 16% of Nigerians actually access mental health services
(Gureje, et al. 2006).
• Only a small proportion of the people receive appropriate care due to
low level of mental health awareness.
• Many Nigerians attribute mental health disorders to:
- misuse of drugs and psychoactive substances
- possessions by evil spirits
- divine punishment (Gureje, et al. 2005)
• The implication of these findings is that people with mental health
disorders deserve their problem.
• This has ramifications for seeking medical care for individuals affected
• It implies that orthodox medical care would be futile, with Nigerians
obtaining help from spiritualists and traditional healers.
• This view about supernatural as cause of mental problems is shared
by many Nigerians (Gureje et al. 1996).
• Due to negative attitude, you would find someone, unintentionally or
in a subtle manner, avoid the victim because he or she assume that
that person is unstable, violent, or dangerous.
• The Mental Health Law (Lunacy Ordinance) of 2016, amended into
The Lunacy Act of 1958, since the Colonial era, is the official law
recognized for Nigeria today.
• To improve on the Lunacy Act of 1958, a new Mental health Bill was
introduced at the Nigerian Senate in 2003, but has not been passed
into law.
• Nigeria now faces a global emergency in mental health, underpinned
by poor societal attitude (or is it poor mental health awareness?)
towards mental health disorders (Ugochukwu et al, 2020).
Economic Implications of Mental Health
Issues
• The impact of mental health is strongly attached to the
socioeconomic agenda of the country.

• Tax is a fundamental issue for health; it presupposes that the tax

professional has an important role regarding our collective health.
Economic Implications Cont.
• A tax professional is the individual who has attained special
knowledge, standards, skills, and experience required, and licensed to
practice.

• The most obvious link between tax and health is in financing health
systems.

• Strong health systems would require predictable and sustainable

financing.
Economic Implications Cont.
• Expanding health coverage to the entire population requires
substantial funding from general tax revenues.

• It is estimated that low income countries including Nigeria, need to

spend $86 per person, per year to fund primary health care services
(WHO, 2010).
Economic Implications Cont.
• Currently, among adults employed, anxiety, depression, and
substance use disorders are the most common mental health
disorders (Hedden, 2015).

• These disorders constitute a direct cost on the individual worker.

Indirect costs
• Indirect costs include:
- increased rates of short-term disability,
- safety incidents
Indirect costs cont.
- absenteeism and presenteeism (working while sick)
- underperformance and unrealized output
- stress imposed on team members
- overtime and overstaffing to cover sick day absences, and
- hiring costs related to recruitment and retention (Goetzel et al. 2009;
Kowlessar et al. 2011).
Improving Mental Health Awareness

• The WHO suggests an expanded community-wide approach to mental

health issues.

• This is in line with prevention strategies to prevent mental health

disorders from reaching crisis point (WHO, 2004).

• Such interventions are often offered in educational conferences like

the CITN conference.
• A tax professional conference can target members by helping to:
- educate them to identify at-risk colleagues
- encourage such individuals through referrals to treatment

• These awareness programmes aid in recognition of mental health

disorders, management and prevention (Jorm, 2000; Jorm et al.
1997).
Conclusion

• The low level of mental health awareness worldwide, including

Nigeria, is worrisome.

• Studies conducted in Nigeria indicate poor knowledge of knowledge

of causes and characteristics of mental health disorders.

• It is commendable that organizers of this important CITN conference

would include the subject of creating mental health awareness among
its members and the public.
THANK
YOU.