Public acceptance of coercive measures in Nigerian mental health care

Background: For the first time, Nigeria has enacted a new mental health law that regulates the use of coercive measures in mental health care. Aim: The study aimed to investigate the extent to which the Nigerian public accepts the use of coercive measures in the treatment of people with mental health conditions and to understand the impact of stigma and other sociodemographic characteristics. Methods: A cross-sectional survey was conducted among 615 adult respondents from Nigeria's six geopolitical zones. The study instrument included a case-specific vignette, a social distance scale, and a brief sociodemographic form. Descriptive and inferential statistics were conducted with SPSS v.25 software. Results: More than half of the study respondents agreed that the vignette character should be forced to go to the hospital if he refuses to go (65%, n = 400), and he should be forced to take medications at the psychiatric hospital (55.1%, n = 339). The least accepted coercive measure was Isolation (28.8%, n = 177). There were significant associations between social distance and the acceptance of involuntary admissions, forced medication, mechanical restraints, and isolation (p < .05). Social distance score was highest among respondents who agreed that the vignette character should be isolated (24.023 +/- 5.503; F = 24.672, p < .001). Conclusions: The study highlights variations in public attitudes toward coercive psychiatric measures, within the Nigerian context compared to other countries. The lower acceptance rates for isolation as a coercive measure underscore the cultural importance of social interaction in Nigeria. The relatively recent implementation of Nigeria's Mental Health Act also suggests a potential gap in public knowledge regarding the criteria for coercive measures. Future research should aim to include diverse populations and consider longitudinal approaches to assess changes in public attitudes as awareness of mental health legislation increases.