“On 5 January 2023, President Muhammadu Buhari signed the National Mental Health Act into law. It repealed the Lunacy Act of 1958, a colonial relic that treated mental illness as grounds for indefinite detention without rights or dignity.”
In June 2026, a government panel found mentally-ill inmates at Aba Correctional Centre and Kano Central Custodial Centre chained, shackled, and isolated without treatment. No psychologists were present. No medications were available.
The panel concluded these practices violate Section 34 of the Constitution — the right to dignity — as well as the UN Convention Against Torture.
Three years earlier, on 5 January 2023, President Muhammadu Buhari signed the National Mental Health Act into law. It repealed the Lunacy Act of 1958, a colonial relic that treated mental illness as grounds for indefinite detention without rights or dignity.
Lunacy and failure of Nigeria’s Mental Health Law
The new Act promised community-based care, informed consent, a Mental Health Assessment Committee, a Department of Mental Health Services, and a Mental Health Fund.
Yet in Aba and Kano, the chains remain.
This column applies a lens I developed in my MSc dissertation — therapeutic jurisprudence — to ask: can a law heal if nobody enforces it?
What Therapeutic Jurisprudence Demands
Therapeutic jurisprudence evaluates law by its consequences for human wellbeing. A therapeutic law reduces stigma, restores autonomy, and promotes recovery. An anti-therapeutic law raises expectations it cannot fulfil, deepening helplessness.
The Mental Health Act 2023 is profoundly therapeutic on paper. It replaces “lunatic” with “person with mental health conditions.”
It mandates respect for inherent dignity. It requires informed consent. It prohibits forced treatment and restraint by faith-based institutions except under strict medical certification. It creates appeal mechanisms. It integrates mental health into primary healthcare.
These are dignity-restoration mechanisms. They recognise that mental health is not the absence of chains in an asylum, but the presence of voice, choice, and care in the community.
But therapeutic jurisprudence measures law by its operation, not its text. In operation, the Act produces therapeutic betrayal — the harm that occurs when a legal system promises dignity and delivers neglect.
The Missing Institutions
The Act establishes a Department of Mental Health Services within the Federal Ministry of Health. As of mid-2026, it does not exist.
The Act creates a Mental Health Assessment Committee to review involuntary admissions and safeguard against arbitrary detention. It has never been constituted.
The Act establishes a Mental Health Fund. It remains a concept on paper. Nigeria spends approximately $1.50 per capita annually on mental health — 120th of South Africa’s spending.
Mental health receives about 3.3 per cent of the total health budget, below the WHO benchmark. And 90 per cent of that allocation goes to six federal neuropsychiatric hospitals, leaving primary care integration unfunded.
Only three of 36 states have recognised the Act. Only Lagos and Ekiti have adopted it locally. The other 34 states operate under pre-Act frameworks, or none at all.
This is implementation collapse. From a therapeutic jurisprudence perspective, it is worse than having no law.
A person chained in a church “treatment centre” in 2010 knew the state did not care. A person chained there in 2026 knows the state promised to care, and broke its promise.
The Workforce Crisis
No law can be therapeutic without human hands to administer it. Nigeria has approximately 250 psychiatrists for over 200 million people — one per 800,000 citizens. Since 2010, Nigeria-trained psychiatrists abroad have outnumbered those at home. Psychiatric nurses are “gradually becoming extinct.”
In January 2026, resident doctors at the Neuropsychiatric Hospital, Aro, Abeokuta joined an indefinite nationwide strike over welfare. If doctors treating the mentally-ill must strike for their own dignity, what does that say about patient dignity?
Therapeutic jurisprudence teaches that the law’s healing power depends on the wellbeing of all participants. A framework that degrades mental health professionals is anti-therapeutic. It asks the wounded to heal the wounded.
The Constitutional Paradox
Section 17 of the Constitution directs the state to ensure adequate medical facilities. But Section 6(6)(c) makes Chapter II non-justiciable. A citizen cannot sue the government merely for failing to build clinics or fund the Mental Health Fund.
Sections 33 and 34 — right to life and dignity — are justiciable. In Odafe v. Attorney-General, the Federal High Court held that denying medical care to detainees violates Section 34. The June 2026 panel applied the same logic.
But litigation is slow and reactive. It can free one inmate. It cannot constitute the Assessment Committee, fund the Department, or train 250 psychiatrists.
Without the Act’s mandated institutions, there is nobody to sue, no records to subpoena, no standards to enforce. The Constitution protects dignity, but the statute meant to operationalise that protection has been left hollow.
Seven Steps Toward Therapeutic Law
First, constitute the Department of Mental Health Services now. Without a coordinating body, the Act is an orchestra without a conductor.
Second, establish the Mental Health Assessment Committee. Every month of delay is a month of unconstitutional detention for Nigerians who cannot speak for themselves.
Third, capitalise the Mental Health Fund. Make contributions obligatory, not discretionary. Ring-fence the allocation.
Fourth, mandate state adoption with federal incentives. Tie health grants to alignment with the Act. Lagos and Ekiti have shown it is possible.
Fifth, protect the mental health workforce. Competitive remuneration and safe conditions are prerequisites for a therapeutic system. You cannot restore patient dignity while degrading doctor dignity.
Sixth, enforce Section 34 against non-orthodox detention centres. The prohibition against chaining must be backed by prosecution. The first prosecution would signal that the law means what it says.
Seventh, extend the Act’s protections to correctional facilities. The June 2026 panel proves the Nigerian Correctional Service operates mental health units without mental health capacity. The Act applies to “all facilities.” The government must meet the standard it imposes on private hospitals.
The Bottom Line
The Lunacy Act of 1958 was a law of exclusion. The Mental Health Act of 2023 is a law of inclusion. It includes the mentally-ill in the community, in the Constitution, and in the human family.
However, a law of inclusion that is not enforced becomes cruelty by another name. It tells the vulnerable: we see your suffering, we wrote a statute, and we did nothing.
In my MSc dissertation, I examined the therapeutic jurisprudence elements of the Mental Health Act. I concluded it contains the architecture of healing. I did not predict how completely that architecture would be left unbuilt.
Three years after assent, the chains are still on. The psychiatrists are still leaving. The Assessment Committee still does not sit. The Department still has no office, no staff, no phone number.
Health law is not statutes on paper. It is whether a person in crisis walks into a facility and is met with care rather than chains. The Mental Health Act promised that transformation. Lawmakers, ministers, and citizens must now ensure that promise is kept.
Because dignity delayed is dignity denied.
And for the mentally-ill Nigerian in Aba, in Kano, or in any unregistered “prayer house” where the Lunacy Act still lives in practice, that denial is not abstract. It is a chain around the ankle, and a law that forgot to unlock it.
•Sanu is a Nigerian lawyer, researcher and health law scholar. His MSc dissertation examines therapeutic jurisprudence in the Mental Health Act 2023. This column appears weekly.
