FACED with high hospital bills and limited access to psychiatric care, some families in Kano continue to turn to traditional healing homes in desperate attempts to help their loved ones battling mental illness. But families told The ICIR that they are getting little or no solution from the traditional rehabs which have been banned.

THE sun was already blazing in Tassa community in Dawakin Kudu, Kano, but that was the least of Abdulwahab Tsoho Adamu’s worries. His 20-year-old daughter, Summaya, who had been battling a neurological disorder since she was a toddler, was nowhere to be found.

As a toddler, Summaya would put in an unexplained fit of laughter, which according to her father, became an issue after realising that the laughter showed on her face even when she was being hurt. When that persisted overtime, the family began to seek medical attention from professionals and non-professionals.

They sought help at the Dawanau Psychiatric Hospital but said the waiting rooms were often packed with several patients, and the treatment often out of reach. After months of irregular appointments, Summaya’s condition worsened. 

“I took her to Dawanau Psychiatric Hospital,” Adamu told The ICIR, adding: “I spent over Five Hundred Thousand Naira on drugs, but there was no improvement. After a year of back and forth, I brought her home.”

Resort to traditional healers

From there, the family’s search for healing descended into a costly odyssey of dashed hope. Adamu was advised to try a traditional rehabilitation centre in Bunkure Local Government Area. He ferried his daughter there for more than three years, with the hope of getting her mental state back to normal.

“But instead of getting better, she became worse,” he laments.

Again, they had to move. Adamu recalled how he met with another traditional healer who demanded endless sacrifices. The daughter was put through incantations and sorts of rituals, but that also proved to be non-effective.

Mental disorder defined

The World Health Organisation (WHO) describes a mental disorder as a health condition that causes noticeable problems in how a person thinks, feels, or behaves. It often leads to distress or difficulty in handling daily activities. Mental disorders come in different forms and affect people in various ways.

This includes Pseudobulbar Affect (PBA), a neurological condition that causes sudden, uncontrollable series of laughing or crying that don’t match the person’s actual feelings and Gelastic seizures, a rare type of seizure often linked to brain abnormalities, such as hypothalamic hamartoma) where bouts of laughter occur without genuine emotion.

“I later left Bunkure and I was referred to Rano LGA, to one traditionalist who is a spiritual healer. I spent over two years visiting the rehabilitation centre and also invoking some spiritual incantation on her.

“After leaving I noticed my daughter’s condition became even worse. She started walking on the streets, running down to the bush or even walking around and fighting people, eating leaves and others,” Adamu said.

Roaming the streets

Now, Summaya roams the streets from morning till night. In some cases, she chews leaves in the bush. When The ICIR visited her house, it took over three hours to locate her. She was apparently in what her parents described as her usual mentally destabilised state, her clothes dirty, torn and her face pale.

Sumaya also appeared lost in her thoughts, occasionally muttering to herself and tucking at her shirt. However, her father who had trekked for over three hours looking for her, held her hand firmly, as if afraid she might wander off again.

“My worst mistake was taking her to the traditional rehab which has worsened the condition of my daughter. But I had a limited choice due the money demanded at the government hospital. I already spent over N500,000, so I thought I couldn’t afford more.”

He disclosed that he had spent over a million while also touring traditional centres across Kano state. “I can’t estimate the amount I spent in traditional rehabs, because sometimes they request money to buy ram, goat, fowl and others for sacrifice.”

Dearth of government rehab centres

Adamu’s family is not alone. With few official rehabilitation centres, costly treatment, and the absence of immediate support, many families are often forced to patronise unregulated traditional healing homes. Nigeria’s fragile healthcare and welfare systems have left millions without access to proper mental health care or community support. 

The WHO stated that in 2021, nearly 1 in every 7 people (1.1 billion) around the world were living with a mental disorder, with anxiety and depressive disorders the most common. 

Deep-seated stigma and widespread misconceptions, such as the belief that mental illness is caused by evil spirits or supernatural forces, continue to drive families toward religious or traditional healers rather than medical professionals.

For years, Rabiu Musa believed his son’s illness was spiritual. The father of three from Kumbotso, Kano State, had to take her to traditional rehab centres for treatment. While Musa was speaking with The ICIR, his 10-year-old son, Dalhatu was on his laps, as he patted him on his head.

He remembered the pain Dalhatu felt as he glanced through his eyes. He explained that everything seemed normal at first for him when Dalhatu began showing symptoms. 

“My child was born normal. When he was 4-years old, he had a sickness suspected to be malaria and typhoid. I took him to Kumbotso hospital, and he was treated, and he regained his health,” he recalled.

But a few months later, Musa said everything changed for his son as he began to show strange symptoms.

“I took my son to a traditional rehab in Bunkure where he spent about 6 months receiving different kinds of spiritual attention, but I noticed his condition was getting worse and with no improvements.”

The treatments included the use of local perfumes, live hens, and other traditional items. “I spent nearly ₦200,000, buying all kinds of things they requested. But instead of getting better, my son’s condition worsened.”

By the end of those months, Dalhatu’s situation had deteriorated. He began wandering the streets. “So, I decided to take him to  Dawanau Psychiatric hospital, where he was admitted for about a year.

“The hospital rehabilitation is costlier than the local rehab, because I spent over 700k on drugs,” he said.

Children and adolescents are also deeply affected. A recent systematic review of studies conducted between 2010 and 2024, covering over 47,000 young Nigerians, found that about 12 percent suffer from major depression and 9 percent from generalised anxiety disorder.

While nearly 20 million Nigerians, translating to about one in five people, are currently living with one form of mental health condition or another, only about 10 percent of those affected have access to any form of mental health care.

The Pull of Clandestine ‘Rehab’

Faced with soaring costs and inadequate state care, The ICIR gathered that several families turned to unregulated religious and traditional centres that promise spiritual cures at less cost. 

Even though there have been reported crackdowns on the practice and centres across the state following the 2019 official ban on the practice, residents noted that many still could find their way around looking for spiritual help. 

For instance, in October 2021, Kano police command said it arrested operators of an illegal rehabilitation centre in Na’Ibawa Quarters, Tarauni LGA, freeing 47 inmates. Also, in  February 2022, the police arrested six suspects operating an illegal rehabilitation centre in Naibawa ‘Yan Lemo Quarters, Kumbotso LGA. About 113 inmates were rescued.

However, despite periodic crackdowns by authorities, it was gathered that the practice continues to thrive due to several factors, including cost of medical attention, and the state of the rehab centres in the state.

These centres hidden in the outskirts of the main cities, often subject victims to chaining, starvation, and beatings.

Families of patients who spoke with The ICIR described the situation as ‘regrettable,’ explaining how their loved ones were whipped, denied food, and locked in dark rooms. 

During visitation to the federal and state centres, this reporter observed how the dearth of proper facilities could have pushed residents to seek help in other places. While access to the wards were not possible, it was learnt that the patients endured hours without medical care and proper feeding.

Data has shown that Nigeria’s mental-health gap remains a major concern over the years as fewer than 200 psychiatrists serve over 200 million people. In 2024, the Association of Psychiatrists in Nigeria (APN) described the situation as a pressing challenge, attributing it to the worsening mental health crisis to the “Japa syndrome.”

Beyond the dysfunctional facilities as WHO noted that about 80 per cent of the country’s health infrastructures are in a worse state, these facilities in some instances cited by victims, are often overcrowded and medical personnel sometimes get overwhelmed.

Families groan under treatment cost 

The medical cost of mental health problems is immeasurable and can really be daunting, especially in developing countries such as Nigeria where the financial burden of getting proper mental healthcare is high unlike in developed countries, where the burden is significantly mitigated by health insurance.

Families who spoke with The ICIR, noted that they have spent an average of over N500,000 while visiting government hospitals.

It was also gathered that accessing mental health care in Nigeria is largely out of reach for low-income families. Our findings revealed that therapy sessions at public and private facilities cost between an average of ₦50,000-N100,000 per session, held twice monthly, excluding the cost of prescribed medication.

These findings illustrate that for many families, the out-of-pocket costs for mental health care remain prohibitive.

A report revealed that the healthcare costs fall heavily on individuals and out-of-pocket spending accounts for 75 per cent of all health expenditure.

This has left many people more vulnerable. Data from the National Library of Medicine, indicate that people living in low-income households, with little education or unstable jobs, are more likely to experience mental disorders. 

Ironically, these same conditions that heighten their vulnerability also restrict their access to quality mental healthcare. 

According to the WHO, government spending on mental health in Nigeria accounts for barely 4 per cent of all health spending. Psychosis, bipolar illness, and depression treatment are not covered by national health insurance or reimbursement programmes.

More tales of victims’ ordeals

In Sabon Layin Hago, Forty-five-year-old Tukur Liman unlocks a wooden door and stepped into a narrow shed. Inside, his younger brother, Ahmed Nasiru, sits cross-legged, a rope fixed to his ankle. 

“He has been like this for more than six years,” Tukur said, explaining that Ahmed’s ordeal began over eight years ago. “When he first developed the illness, we took him to Dawanau Psychiatric Hospital,” Tukur recounted. 

However, what Tukur described as inability to bear with the cost and effectiveness of the treatment at the centre, led the family to try a traditional rehab centre in Sabon Layin Hago. After some months at the traditional rehab centre, they headed back home when it appeared that Nasiru had regained his mental health. But hope collapsed when Ahmed attacked his elder sister with a machete during a relapse. Since then, the family has shuttled him from one facility to another, back to Dawanau, then to a local spiritual centre called Gidan Manmada, and later to Mallam Dahiru’s rehab centre.

Apparently, his condition has gotten worse. At Mallam Dahiru’s rehab, Ahmed was chained and left without proper care. 

“After spending about two years there (at Gidan Manmada traditional rehab) without any improvement the traditionalist asked us to take him back home. We took him to Dawanau Psychiatric hospital again, he was treated for some months and yet his mental health is not stable.

Although he noted that the family spent heavily at Dawanau, Tukur admitted that the family believed the traditional rehab worked far better than the modern one and was way cheaper.

The ICIR reports that although the Nigerian government has outlawed chaining and other inhumane treatment of people with mental illness, shackling and chaining remains a largely invisible problem as it occurs behind closed doors and concealed from neighbours.

It was gathered that maintaining personal hygiene is nearly impossible for those held in chains, as they are often confined without access to toilets. Many are forced to eat, sleep, urinate, and defecate in the same small area, sometimes within just a meter or two. For women and girls, the situation is even more degrading, as they are often denied basic items like sanitary pads to manage their menstrual hygiene.

The ICIR reports that Nigeria’s journey towards mental health reform has been long. The first law, known as the Lunacy Ordinance of 1916, allowed medical practitioners and judges to detain individuals deemed mentally ill, which is a reflection of colonial-era perceptions that treated mental illness more as a crime than a health condition. 

It was later revised in 1958 as the Lunacy Act, which remained in force for decades without amendment. In 1991, the government introduced the National Mental Health Policy, an effort to modernise mental health governance and align it with global standard. 

In January 2023, Nigeria took a decisive step forward when former President Muhammadu Buhari signed the National Mental Health Act, 2021 into law.

However, while the act replaces the antiquated Lunacy framework and seeks to protect the rights and dignity of persons with mental health conditions, our findings revealed that many citizens are still subjected to inhumane treatment.

Families struggle

In Tassa community, Dawakin Kudu Local Government Area of Kano State, 57-year-old Adamu Zakari sat quietly outside his house. He was watching his son, Ghali, wandering across the small compound. For over fifteen years, Zakari said he has watched his child slip in and out of reality due to his mental illness.

“My son has been like this for more than 15 years,” Zakari said, adding: “People advised me to take him to a local rehabilitation centre, but I refused because many who took their children there ended up worse. I have seen some of those boys now roaming the streets, completely mad.”

But he explained that even though there is an option to take him to the government owned hospital, he could not afford the cost of treatment either.

“I didn’t take my child to the hospital because of how expensive it is. We don’t have that kind of money. So, what I do sometimes, is to meet some medical professional for drug prescription and also get him some local herbs,” he noted.

Just a few kilometres away, in Kumbotso Local Government Area, Hassan Ibrahim, a father of three, shared a similar experience. His 30-year-old brother, Kabiru, had been struggling with mental health challenges for three years. The illness, according to him, was a result of drug abuse.

Hassan said the family initially tried hospital treatment at a psychiatric hospital but could not sustain it.

“We took him to Dawanau for some months, and the drugs helped a bit. But the cost became unbearable. We had to stop going because we couldn’t afford it anymore. Now, we just keep him at home and watch over him.”

Forced treatment

In three traditional rehab centres visited, traditional healers imposed herbal concoctions and other non-medical treatments on individuals with these conditions, often through force.

In one such centre at Unguwar Rimi in Rogo Local Government Area, an 85-year-old Dahiru Abubakar, said he used to “chain his patients, some usually spend 2 to 3 weeks while others above depending on the level and nature of the illness,” after explaining that the rehab he runs was bequeathed to him by his father.

“We used to collect money for that, depending on the level of the patient’s sickness; some we collect N50,000 to N55,000 to sacrifice ram, while some we collect N25,000 if it’s chicken we are to sacrifice to perform the miracle.

“I can’t estimate the number of people that I have kept in this rehab centre, I have kept one patient for over 2 years and later he regained his health,” he said.

Although Dahiru rejected the accusations of mistreatment, he offered explanation for injuries he concedes some patients sustain.

“I don’t harass my rehab patients, but anyone who tries to attack me looks for self-defence, that’s how most patients sustain injuries.

‘Outdated’ state rehab centre

During The ICIR’s visitation to the Dorayi Rehabilitation Centre, owned by the state government, although functioning, the facility appeared visibly neglected and outdated. The buildings, coated in fading yellow paint, showed signs of years of abandonment, with cracked walls and broken windows.

The compound was patched with overgrown grass and was deserted by patients. It was observed that basic and modern medical equipment expected in a government-run mental health or rehabilitation institution were lacking.

Why practice remains popular  

Reacting to The ICIR’s findings, clinical psychologist Chioma described the situation of mental health in Nigeria as deeply concerning, noting that people living with mental illnesses face enormous challenges in accessing care.

“People who live with mental health illnesses face a lot of challenges, some struggle to get their lives functioning properly,” she said. “This stems from limited access to mental health services, stigma at every form, and shortages of trained mental health professionals.”

According to Chioma, the shortage of professionals remains one of the biggest obstacles to effective care. “Trained and licensed psychologists in Nigeria are not up to a thousand, yet Nigeria has a population of over 200 million. The number is not encouraging at all. Nigeria has a lot of groundwork to do when it comes to mental health,” she added.

Chioma also reacted to The ICIR’s discovery that many Nigerians still turn to traditional and religious healing centres for mental illness treatment. She acknowledged that these practices remain popular because they are more accessible and affordable than hospital care.

“It is interesting to find that traditional and religious methods are deployed to treat mental health conditions. People patronize these methods because they are accessible and affordable,” she said.

However, she warned that harmful practices such as flogging, chaining, and forced herbal administration could worsen a person’s condition and violate human rights. “I’m not condemning traditional practices, but when they are combined with harmful acts, they can be dangerous,” she said.

Chioma suggested that both traditional and religious leaders should be trained to recognize symptoms of mental illness and refer patients to qualified professionals.

Government must integrate mental health into primary healthcare

Chioma further acknowledged that the Nigerian government has made progress with the enactment of the National Mental Health Act of 2021, which protects the rights of individuals living with mental illness.

However, she emphasised that more must be done. “The government should integrate mental health services into primary healthcare systems across the country,” she advised, adding that: “This will make mental health services more accessible to the people.”

She also called for increased funding, workforce development, and training, saying these are crucial to ensuring that “people can access quality mental health care at any time.”

State government declines comments

Attempts to speak with state officials proved abortive, as calls made to the Commissioner for Health, Abubakar Labaran Yusuf, were not answered, and text messages sent to his line were not replied to.

Also, the state Director-General of Media and Publicity, Sanusi Bature Dawakin-Tofa, did not pick up calls or respond to WhatsApp messages sent to his line as of the time of filing this report.