Boko Haram Insurgency and Nigeria’s Mental Health Response

Abstract

The Boko Haram insurgency, which has raged across the northeast region of Nigeria since 2009, has been the deadliest and most protracted outbreak of violence since the country’s civil war from 1967 to 1970. Rejection of western education and civilization sits at the heart of the insurgency, whose end goal is to overthrow the government and replace it with Islamic rule. The group took up arms against the state in 2009, but they were defeated, and their leader was killed. Surviving members subsequently adopted guerrilla warfare tactics and started attacking towns and villages in rural communities. Schools and school children became targets of Boko Haram’s attacks in their bid to discourage western education. Hundreds of students were killed or abducted, including female students at the Government Secondary School in Chibok, Borno State. The consequences have been dire for the region with more than 20,000 fatalities and 3.6 million persons displaced from their homes and forced to find shelter elsewhere in Nigeria or in neighbouring West African countries. Children in the region have been severely traumatized by the violence. Several of them have lost their parents and other family members, others experienced kidnappings and forced marriages (for abducted girls), and across the board, many children have experienced severe food shortages and malnutrition. Response efforts to support the mental health of insurgency victims were initially hampered by the paucity of mental health professionals in the region, insecurity leading to the closure of several health facilities, and poor coordination of different civil society organizations, resulting in chaotic interventions and duplication of efforts. With better coordination, several innovative responses have evolved with good effect. These include adopting a task-sharing approach to train non-specialists using the World Health Organization’s Mental Health Gap Action Programme Intervention Guide (mhGAP-IG), collaboration with development partners to “Build Back Better,” and developing and utilizing group-based psycho-educational interventions for managing post-traumatic stress disorder (PTSD).