There can be little doubt that, at the current time, one of the key objectives of many agencies working within mental health is to ‘prove the case’ largely in terms of, (i) prevalence and impact, and, (ii) developing ways in which mental health screening, treatment and referral skills can be integrated into existing health platforms. While these objectives are absolutely worthy and essential (and might also result in insights into other non communicable diseases in particular), there are increasing calls to ensure that ‘the voices’ of those suffering from (and affected by) mental health conditions do not get lost in the research and policy evolution ‘din’. Indeed, it is difficult to see how any real progress can be made either in research and/or policy formulation without their voices being ‘front and centre’ – as they have been within HIV-AIDS.
This opens up a sometimes uncomfortable debate within NGOs regarding the use of ‘shock tactics’ to gain the attention of the reading public and decision makers. How long will it be until mental health user groups emerge which espouse a radical agenda, forcing the policy and resource allocation ‘debate’ to pay attention to them through their ability to shock their audience into ‘submission’? Reflecting on the lessons from HIV-AIDS support groups, is this inevitable and, indeed, even desirable for the longer term benefit of users? At what point will mental health support groups morph into protest movements and demand equal rights to health for all of their members? Is there even any case from around the world in which ‘rights’ have been won without a ‘fight’ involving the ability to shock decision makers in particular into action? If not, what does this say for the rights of people living with and affected by mental health in Nigeria?