Mental Health Knowledge and Attitudes of Community Health Workers in Northern Nigeria Thirty Years After Mental Health Was Integrated into Primary Healthcare Settings
Abstract
Yusufu Maigari Taru, Pracious Akinnusi, Friday Tungchama Philip, Aishatu YushaâÂÂu ArmiyaâÂÂu, Charles Nwoga Nnaemeka, Dung Ezekiel Jidong, Margaret Isioma Ojeahere and Binuga Boyiga Boyiga
Background: The knowledge and attitudes of community health workers are essential in expanding mental health services, particularly in countries like Nigeria. Despite over thirty years of attempts to integrate mental health into primary healthcare, challenges remain. Many community health workers lack sufficient mental health training and harbor negative, stigmatizing attitudes towards mental health. Additionally, Nigeria’s mental health policies often lack adequate implementation strategies, further complicating efforts to meet the mental health needs of the population.
Objective: The aim of this study was to assess the knowledge and attitudes of Community Health Extension Workers (CHEWs) towards mental health, thirty years after its integration into primary healthcare in Nigeria.
Methods: This study evaluated the mental health knowledge and attitudes of 130 Community Health Extension Workers in northern Nigeria. A cross-sectional survey design was employed, with data collected using a consecutive sampling method and a self-administered questionnaire adapted from a previous study conducted in Nigeria.
Results: Analysis revealed that 49.2% of respondents had inadequate knowledge of mental health, and 48.5% held negative attitudes towards mental health. Respondents from the northeastern region exhibited significantly lower knowledge of mental health compared to those from the north-central region (mean difference = 2.12, p = 0.007), and the north-western region (mean difference = 1.91, p = 0.030). A statistically significant association was observed between knowledge and attitudes (p < 0.001).
Conclusion: Despite over three decades of efforts to integrate mental health into primary healthcare settings in Nigeria, progress remains limited in both knowledge and attitudes toward mental health among community health workers, especially in Northern Nigeria, with particular challenges in the northeastern region. This highlights the critical need to revisit and actively advance the integration of mental health services into primary healthcare systems.