Stigmatization of Mental Illness in Nigerian Home Videos

To the Editor: Stigmatization of individuals with mental illness has been identified as a major hindrance to better care and improvement of their quality of life (1). Awareness of the need to develop long-term strategies to combat stigma is increasing, and a current area of emphasis is on improved efforts to promote “mental health literacy” (2).

As psychiatrists improve mental health literacy through direct public education, they should also make efforts to reduce misinformation. Media depictions of people with mental illness are a widely viewed source of stigmatization. The Nigerian home video industry is ranked second largest in the world (3), and studies have found stigmatizing themes in Nigerian films. In an analysis of 163 Nigerian films, Aina (4) found that 25 (15%) contained scenes portraying psychiatric illness. Mental illness was depicted largely as originating from supernatural or preternatural forces, and effective treatment was portrayed as arising through magical means or from traditional care.

To counter stigma it is important to understand how these videos portray mental illness and how often Nigerians are exposed to such scenes. This information can help to determine whether these videos contribute significantly to perpetrating negative views of mental illness and to what extent this medium could be used for promoting mental health literacy. In an effort to answer these questions, community dwellers participating in a 2009 public health campaign in Ibadan, Nigeria, were asked via in-person interviews how often they see scenes depicting “madness” in Nigerian films and about their views of the accuracy of such depictions. In addition, a sample of current Nigerian home videos from three randomly selected video rental shops in three neighborhoods in Ibadan were rented for viewing and content analysis. All Yoruba films on display were sampled, yielding a total of 103.

All 676 respondents had seen a Nigerian film in the preceding 30 days, and 528 respondents (78%) reported that at least one of the videos contained a scene depicting “mad persons.” A total of 472 (70%) reported that the films accurately portrayed mental illness on the basis of the respondent's understanding of its cause and treatment. However, of the 103 videos that were subjected to content analysis, 21 (20%) depicted mental illness as arising mostly from sorcery and enchantment by witches and wizards and as mostly amenable to magical and spiritual healing.

This study provides evidence that Nigerian films are popular among community dwellers in Nigeria and that Nigerians view scenes depicting mental illness regularly. The finding that most respondents reported a congruence between their conceptions of mental illness and its treatment and the video portrayals raises concern about the influence that Nigerian films may be having on mental health literacy, if we assume that respondents were likely to have seen the films that were in the content analysis sample.

The World Psychiatry Association had advised that national psychiatric societies should combat stigma by fostering good working relationships with the media, engaging them in locally appropriate ways (5). The Association of Psychiatrists in Nigeria needs to develop strategies for large-scale promotion of mental health literacy by taking advantage of the popularity of Nigerian films.