Addressing the Needs of Neuropsychiatric Patients

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Sunday Okobi writes on how best to address the needs of Neuropsychiatric patients with mental disorders, through quality mental health services delivery and easy access to infrastructure

The Federal Neuropsychiatric Hospital Uselu, Benin City in Edo State is a foremost mental health institution established by the federal government to essentially provide mental health services to all Nigerians, but for many years, it had constraints providing the required services for which it was established.

However, in a space of one year, the new administration of the hospital led by its Medical Director/Chief Executive Officer, Dr. Imafidon Agbonile, has taken it to a new height by providing professional and quick services, training workers, building major health facilities in the hospital, and ultimately helping the government to curb the spread of the COVID-19 pandemic. The hospital has continued to render services to Nigerians mostly those in its catchment area, as its scope covers the South-south geo-political zone of the country because of its location.

Apart from being renowned for providing excellent services like Child and Adolescent Psychiatry, Community Psychiatry, Consultation-Liaison Psychiatry, Drug Addiction Treatment, Education and Research, Psychiatry, Emergency and Assessment Psychiatry, Psychotherapy, Forensic Psychiatry and Geriatric Psychiatry, Agbonile, told THISDAY recently that the hospital services have been expanded to include general medical services, dialysis, ultrasound, and digital X-ray services.

In its efforts to key into the federal and state government strict policy to control the pandemic from spreading further, he disclosed that with the support of the federal government, the current administration has built the intensive care unit, isolation centre, and Molecular Laboratory to handle patients with COVID-19 complications. It is worthy of note here that these laudable projects were part of the proactive steps that the federal government has taken to contain the Coronavirus pandemic.

“With our new Molecular Laboratory, we will be able to provide virtually all relevant laboratory services such as testing for all Viral Hemorrhagic Fevers, HBV/HCV Viral Load, HIV Viral Load, Medical Micro-biology, all Chemistry Analysis, and Hematology services,” he said.

While reeling out the achievements of the federal health agency, Agbonile, who was appointed the substantive Medical Director/CEO on October 1, 2020, sounded out without any atom of immodesty that since his assumption of office, “the hospital has made phenomenal progress in several areas. It is worthy of note that the state of infrastructure that I met before I took charge of affairs of the hospital was really not complimentary so to speak. I will not close this chapter without mentioning some of these areas we have affected to improve services in the hospital”.

Building Projects

We have been able to construct from scratch some building projects and also completed others that were commenced by my predecessors. These buildings include the Clinical Science Building, Molecular Laboratory, Intensive Care Unit, Isolation Ward, New Male Ward II Storey building, reconstruction/tarring of the internal road network within the two sites of the hospital and the School of O.T Building (70 percent). All these were done within one year in office, Agbonile said, adding: “We have been able to do a new roof for the School of Psychiatric Nursing, and also did complete re-plumbing in the hostels, wards, and many of the offices.”

Aesthetics

According to him, the hospital was able to change the aesthetic view of our hospital from its deplorable state to something that is more welcoming and this has earned us some commendation from visiting guests and clients. One of the visions I had before I assumed office was to change the outlook of the hospital to something more positive and inspiring, to me, the former look was not only old but also depressing.

So, we thus commenced the repainting of some of the buildings including the offices, such as: the perimeter fence, Outpatient department block, administrative building, Dater Unit, and the School of Psychiatric Nursing building.

Owing to the deplorable power situation in the country, we procured diesel generators 250KVA, 100KVA, and 50KVA to support the existing diesel generators in the hospital. In addition, we purchased smaller petrol generators of 5.5kVA-6.5KVA for some critical service points and offices. Solar inverters were installed in all the wards but one, both at our new site at Idunmwunowina, and Uselu site in Benin-city.

Training

He said within one year of assumption of duty, the hospital was able to organise numerous in-house training for our staff and sponsored several others to different training programmes, workshops, conferences, and seminars. Also, through the support of the NCDC and FMOH, we were able to train our frontline health workers and doctors on COVID-19 safety protocols and IPC measures.

Vaccination Centre

Our hospital is one of the screening/sample collection points in Edo State. During the COVID-19 lockdown, our hospital was able to partner with the state government to handle the psycho-social aspect of COVID-19 patients, who were in isolation centres, especially those at Stella Obasanjo Hospital, Benin-city. Also, our hospital is one of the COVID-19 vaccination centers where many citizens in the state have been vaccinated against the deadly virus, Agbonile said.

In view of the ongoing brain drain of health workers in the country, we have been able to obtain a waiver from the federal government to carry out replacement recruitment of staff to mitigate the effect of personnel shortages, he added.

Staff Welfare

According to him, when he assumed office, staff members were being owed four years promotion salary arrears, but within months of coming on board, we were able to pay three years of the arrears and are currently working on the fourth year which we intend to offset in the next few weeks. Promotion exercises were carried out across cadres with the consequently increased motivation of our staff. Their offices have been made more conducive for them by providing the conveniences and tools to make their work a delight. Also, we upgraded and converted deserving staff who had acquired relevant higher qualifications, some of whom had been stagnated for over 10 years prior to my assumption of office.

He further explained that the Federal Neuropsychiatric Hospital in Benin-City is a foremost institution for the training of Psychiatrists, Psychiatric Nurses as well as Medical and Nursing students in mental health. “We train students in mental health in partnership with both public and private institutions such as Wellspring University, Benson Idahosa University, Igbinedion University, Ambrose Alli University (AAU), DELSU, University of Benin, as well as various schools and Colleges of Nursing and Health Technology. Our hospital currently collaborates with three local government areas in the state (Oredo, Egor, and Ikpoba-Okha) on mental health enlightenment, ”Agbonile said.

Medical Equipment

In a bid to reposition the hospital for best global practice, the hospital acquired state-of-the-art medical equipment and accessories. These include a Digital X-Ray suite, Dialysis Machines, 4D Ultrasound, Ventilators, Automated Nucleic acid extractor, Blood Bank Ultra Low Freezer, Digital Autoclaves, Blood Culture System, Patient Drug Trolleys, Lab. Vortex Mixer, Automated External De-fabricators, Multi-parameter monitors, Blood Gas Analyzer, Haematology Analyzer, Chemistry Analyzer, Incubators, Nasopharyngeal Swab, Micro Plate Readers, Sample Transport Bags, Water Treatment Machine, Refrigerated Centrifuge, Microplate washer, Laboratory Oven, Ultrasound accessories, Anaesthetic Machine, Automated ICU Beds and patients’ beds and mattresses, EEG and ECT machines among others.
“We have equipped all the offices in the hospital with desk computers, laptops, printers, photocopiers, internet service, modern chairs, office chairs, purchase and installation of air conditioners in all offices to enhance quality services,” Agbonile further said.

Building Internal Roads

Giving details of internal road construction, Agbonile said the hospital administration was able to reconstruct the entire internal road network in the hospital with an improved drainage system to befit the status of the tertiary health institution.
Meanwhile, Agbonile noted that all the achievements recorded by his administration did not come seamlessly without surmountable hiccups. He disclosed that the major challenges his administration had encountered included inadequate funding, uncompleted capital projects at their new (permanent) site, inadequate power supply from BEDC with the consequent drain on their meager resources.

According to him, “Staff motivation, the inadequacy of equipment, dilapidated infrastructure due to age in the various departments of the hospital and deplorable access road to our new site were also some of the challenges they had to conquer to move the health agency forward.

“First and foremost, the issue of funding is not restricted to only this hospital. We intend to tackle this issue headlong by increasing or expanding our services to other areas besides psychiatry. This is why we have planned to establish dialysis services, and ultrasound, as well as expand general medical services, CSSD, molecular laboratory just to mention a few. With the services, we will double our revenue in a short while. On staff motivation, we have been able to increase the morale of staff through training and recognition of their efforts, payment of promotion arrears, payment of uniform allowance to nurses as at when due, having regular meetings with unions, conversion/upgrading of staff members that were hitherto stagnated but have gone to school to upgrade their career. The last challenge that I have just mentioned has been a reoccurring decimal in that it has lingered for well over 10 years.”
He, therefore, appealed to the Federal and State Ministry of Works and Housing to assist in constructing the access road to the hospital’s new site.

The hospital boss further hinted of a particular challenge, which is the high rate of abandonment of mentally ill patients in the hospital by relatives leading to a very high debt burden on the hospital.