Nigeria Must Address Moral Injury Among Security Personnel, Says US-Based Expert

A United States-based behavioural health expert, John Smart Mgbakor, has urged the Federal Government to incorporate clinical care for moral injury into the mental health support provided to Nigeria’s security personnel.

Mgbakor, founder and board president of Wholeward Health LLC, a New York-based behavioural health organisation, said personnel returning from prolonged security operations could experience psychological and moral distress that may not always be captured by conventional mental health diagnoses.

He made the call against the backdrop of Nigeria’s ongoing security challenges and concerns over the country’s capacity to provide adequate mental healthcare.

“Our soldiers, police and civil defence personnel have held the North East for more than a decade,” Mgbakor said. “They come back carrying something our hospitals have no name for. It is not fear. It is conscience: the wound left when a man must do, witness or fail to prevent what violates everything he believes about himself.”

He explained that moral injury differs from post-traumatic stress disorder (PTSD), although the two conditions can occur together.

“PTSD is the body remembering danger. Moral injury is the conscience remembering what it did, saw or could not stop. A soldier can be safe and still not be at peace,” he said.

Mgbakor, who spent 12 years as a military chaplain officer before receiving clinical training at Fordham University and the Bronx Addiction Treatment Center, said the mental health needs of security personnel should be addressed as part of the country’s broader healthcare response.

His comments come at a time Nigeria is reviewing its approach to mental healthcare. In September, the Federal Government said the Federal Executive Council had approved the Federal Ministry of Health and Social Welfare’s position on decriminalising attempted suicide, with the proposal to proceed to the National Assembly for legislative consideration.

Nigeria’s mental health system, however, continues to face a shortage of specialists. A 2026 study published in BMC Psychiatry reported that fewer than 300 psychiatrists serve a population exceeding 234 million people.

The shortage has also been highlighted by the Association of Psychiatrists in Nigeria, which said in 2024 that fewer than 200 psychiatrists were available to serve more than 200 million Nigerians.

Mgbakor said the consequences of untreated psychological distress could extend beyond the individual to families and communities, particularly where substance use becomes part of the coping mechanism.

“Many of these men are not using to get high. They are using to get quiet,” he said. “The substance becomes the medicine nobody prescribed, and the family becomes the ward nobody staffed.”

Nigeria’s 2018 National Drug Use Survey estimated that 14.3 million people aged 15 to 64 had used psychoactive substances in the previous year, while nearly three million were estimated to have drug dependence. The survey was conducted by the National Bureau of Statistics and the United Nations Office on Drugs and Crime.

Mgbakor proposed greater collaboration between military chaplains, faith leaders and clinical mental health professionals to identify personnel experiencing psychological distress and ensure timely referral for treatment.

“Military chaplains and imams sit with these men every day. Train them clinically. Fund mental health and addiction as one service, not two,” he said.

He advocated starting with a pilot programme in one military command, with trained chaplains and imams equipped to identify signs of mental health challenges and refer personnel to clinicians.

“Start small and measure it,” he said. “One command, one year, chaplains and imams trained to screen, and a clinician they can refer to that same week. If it works, scale it. If it doesn’t, we will know why.”

Mgbakor said his organisation, Wholeward Health LLC, was prepared to offer its integrated approach to Nigerian institutions willing to pilot such a programme.