“Emmanuel had a name. The 2023 Act gave him rights. But rights without implementation are chains of a different kind—padlocked by bureaucracy, rusted by indifference.”

The Chain Was Padlocked To His Ankle

Emmanuel had been there for three months—chained to a wall in a church in rural Ogun State, fed once daily, beaten when he screamed. His family brought him for “prayer and deliverance.” The pastor said he was possessed.

Human Rights Watch documented this reality in 2019. Investigators visited 28 facilities across Nigeria—state-run centres, psychiatric hospitals, and faith-based healing homes.

In 27 of them, they found people chained. Children as young as 10. An 86-year-old man with visual disability. All unlawfully detained. All unable to leave.

This was not 1958.

In January 2023, Nigeria passed the National Mental Act—a landmark law that promised transformation.

Section 5 established a Department of Mental Health Services. Section 6 created a Mental Health Fund.

Section 9 constituted a Mental Health Assessment Committee to review involuntary admissions and protect rights. For the first time since independence, we had a law that spoke of dignity, not lunacy.

But Emmanuel has not heard of this law. The chain on his ankle has not heard of this law.

To Understand Why The Chains, We Must Go Back To 1958

The Lunacy Act was enacted two years before independence, carrying colonial violence in every clause. It used words like “lunatic” and “insane” as legal categories.

It authorised magistrates and doctors to detain people without clear criteria—no definition of “proper subject for confinement,” no right to appeal, no requirement for least restrictive care.

The Act built asylums in Yaba, Lantoro, Calabar—warehouses for the unwanted. You went there to be forgotten.

Sixty-five years later, that law still governs mental health in most of Nigeria. The 2023 Act was meant to replace it. But replacement requires implementation—and implementation requires structures that have not arrived.

Senator Ibrahim Oloriegbe, who spearheaded the Mental Health Act, confirmed in August 2025 that the law is “yet to be fully implemented.”

His prescription was urgent: establish the Mental Health Department, create the dedicated Fund, allocate, at least, ₦4 billion in the 2026 budget. “These steps will ensure that services are accessible, particularly to vulnerable groups,” he said.

In May 2025, the Minister of State for Health announced that the Federal Government had “begun implementing” the Act, with the goal of “integrating mental health services into primary health cares across the country.”

Implementation, it seems, has begun—at least in official statements. But Emmanuel remains in chains. And the Mental Health Assessment Committee—the body designed to protect people like him—has still not been constituted.

Here is what the 2023 Act promised: prohibition of discrimination in housing, employment, and medical care.

Guaranteed informed consent.

Confidentiality.

Legal representation. Section 54 expressly criminalises violations—up to one year imprisonment or ₦500,000 fine for discrimination or unauthorised disclosure.

These are revolutionary promises. But here is the reality: The Mental Health Fund has not been established. No state beyond Lagos has passed enabling legislation. The Act exists on paper, not in practice.

The gap is widest in “spiritual homes”—churches and traditional centres where thousands are detained, not treated.

Lagos State recognised this in 2018, giving police power to enter and rescue abused patients.

But nationally? The Act is conspicuously silent on enforcement powers against abusive detention in religious settings.

Police cannot intervene where a man is chained, because the law does not empower them. The pastor’s authority is protected; the patient’s dignity is not.

This is the chasm: a law that speaks of rights, and a reality where rights have no teeth.

The 2023 Act provides for involuntary admission, but the procedure is burdensome. A relative must submit written application stating specific grounds—serious likelihood of imminent harm, or serious deterioration—supported by two independent doctors, reviewed by the MHAC.

But the MHAC does not exist. And in a country where millions of adults cannot read or write, how many families can navigate such applications?

The Act limits involuntary admission to 28 days, extendable. Critics say this is too short. But the deeper problem is access—the National Coordinator of the National Mental Health Programme confirmed in 2026 that the treatment gap is about 90 percent.

Nine out of 10 Nigerians who need mental health care receive none. The rest? They go to pastors. They go to traditional healers. They go to chains.

We Must Ask The Dignity Question Directly

Is it dignified to pass a law and ignore it? To celebrate legislative progress while Emmanuel remains padlocked?

The 2023 Act’s penalties have never been enforced. Not once. Who will bring the case when the victim is chained in a room with no phone, no lawyer, no voice?

And What Of The Family’s Dignity?

They are not cruel. They are desperate. They have watched Emmanuel talk to voices no one else hears, wander into traffic, refuse food.

They love him. They fear him. They have no money for a psychiatrist, no community health centre, no knowledge that the 2023 Act gives them rights to demand care.

The pastor promises healing. The chain promises safety. The state promises nothing they can touch.

Whose dignity prevails? The family’s right to choose care? The chained man’s right to medical treatment? Health law must answer. In Nigeria today, it whispers.

Nigeria Does Not Need New Laws

We need the law we passed to breathe.

First, constitute the Mental Health Assessment Committee immediately. Fund the Mental Health Fund. Pass state enabling legislation without delay.

Second, amend the 2023 Act to give police clear power to enter “spiritual homes” where abuse is reported—following Lagos State’s 2018 model, but with national reach.

Third, accredit and regulate all mental health facilities—medical, traditional, religious. Registration must mean inspection. Inspection must mean enforcement.

Fourth, educate. Rights mean nothing if families do not know they exist.

Community health workers must reach rural areas with information about the 2023 Act, about free treatment options, about alternatives to chains.

Emmanuel had a name. The 2023 Act gave him rights. But rights without implementation are chains of a different kind—padlocked by bureaucracy, rusted by indifference.

We passed a law that speaks of dignity. But until that law touches the ground where Emmanuel is chained, Nigeria remains a country where freedom is promised in statutes—and denied in practice.

The law must find its voice. For the chained. For the desperate families. For the dignity we promised but have not yet delivered.