When a family member starts behaving in ways nobody understands, many Nigerians turn first to a herbalist, a pastor, an imam or a prayer house. Here’s what the research says about that path, where it can go wrong, and how to use it safely.
Many Nigerian families consult a traditional or faith healer before, or alongside, a hospital. Healers can offer comfort and meaning, but chaining, beating and forced fasting cause serious harm, and chaining is illegal. You can honour your beliefs and keep medical care going.
Why many families go to a healer first
When a mental health condition appears, families often look for a cause they recognise: a spiritual attack, a curse, a punishment. Healers speak that language. Relatives’ opinions, fear of stigma, doubts about hospital treatment, and the cost and distance of hospitals all push the same way. Nigeria also has very few psychiatrists for its population.
In studies at Nigerian psychiatric hospitals, between about three in ten and eight in ten people had seen a traditional or religious healer before they reached psychiatric care. Religious healers were the more common first stop. At the Federal Neuro-Psychiatric Hospital, Yaba, seven in ten people with schizophrenia had seen a spiritual or traditional healer first, and most of them said they believed the illness had a spiritual cause.
These beliefs aren’t about education. A large survey in the south-west found education made no difference to whether people believed in spiritual causes. Many families also use healers and hospitals at the same time.
The biggest gap, though, is no care at all. In a large household survey across 21 states, only about one in eleven people with a mental health condition had received any treatment in the past year.
What healers do
Practices vary. Traditional healers may use herbal preparations, divination and rituals. Faith healers in churches and Islamic centres may use prayer, fasting and deliverance. Many take people in to stay at their centre.
Research suggests healers can ease distress and support people with milder anxiety or low mood, and many families value the comfort and meaning they offer. There’s little evidence that healing changes the course of serious conditions such as psychosis or bipolar disorder.
Where it can go wrong
- Delay. People who start with a healer often pass through several carers before reaching effective treatment. In the Yaba study, people who went to a healer first saw almost six carers, on average, before a psychiatrist, and went longer with untreated psychosis.
- Chaining and abuse. In 2018 and 2019, Human Rights Watch visited 28 facilities in eight states and Abuja, including traditional healing centres, churches, Islamic centres and some government-run centres and hospitals. It found people chained in 27 of them, some for months or years. It also documented food withheld as “fasting”, herbs forced on people, and beatings. It noted that many of the healers it met seemed to genuinely care about the people in their centres.
- Stopping medicine. Some families stop prescribed medicine while a person is with a healer, or are told to. In a Maiduguri study, people who were also seeing traditional or spiritual healers were far more likely to be missing doses of their prescribed medicine.
- Unknown herbs. A mixture prepared by a healer has no ingredient list and no dose. Tests of herbal products sold in Nigeria have found heavy metals, bacteria and fungal toxins in some samples. Even a NAFDAC listing means a product passed safety tests, not that its claims were proven, and its label must say so.
What the law says
Nigeria’s Mental Health Act bans anyone, including faith-based institutions, from using chains, shackles, handcuffs or ropes on a person with a mental health condition, in any public or private place. Breaking that rule can bring a fine of at least ₦2 million, up to five years in prison, or both.
The Act counts traditional healing centres and faith-based establishments that provide mental health care as facilities, so its rules on consent and restraint reach them. Only an accredited facility may keep someone against their will, and only after two doctors have examined them. Anyone who witnesses abuse of a person with a mental health condition must report it to the police.
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Human Rights Watch says chaining continues despite the ban. Our explainer on Nigeria’s Mental Health Act covers the law in more detail.
Healers and doctors can work together
In a trial in Ibadan and in Kumasi, Ghana, primary health workers visited healers’ centres every week, gave medicine for psychosis, and worked alongside the healers’ own treatments. After six months, people in that group had fewer symptoms and less disability than people who got the healers’ usual care. All the healers were also trained to avoid harmful practices, and shackling, scarification and long fasts fell sharply in both groups.
The World Health Organization also calls for closer collaboration with traditional and faith healers, alongside safe, well-regulated practice.
Using a healer safely
If you or your family choose a healer, these steps lower the risks:
- Keep taking prescribed medicine and keep hospital appointments. Don’t stop without talking to the doctor.
- Tell the doctor about every herb or remedy, and tell the healer about every medicine.
- Agree in advance: no chains, no beating, no forced fasting, no forced herbs.
- Visit often, and make sure the person can leave and have visitors.
- If things get worse, go to a hospital. Our guides to psychiatric hospitals in Lagos and Abuja, and to Yaba Left, explain what to expect.
Warning signs at a healing or prayer centre
- Chains, ropes, shackles or handcuffs.
- People locked in or unable to leave, or a “two-week” stay that stretches into months.
- Food or water withheld as “fasting”.
- Beating, whipping, or cuts made in the skin.
- Herbs or medicine forced down someone’s throat.
- People sleeping, eating and using the toilet in the same spot.
- Family kept away.
- Being told to stop all hospital treatment.
- Children held with adults.
- Any sexual contact presented as “healing”.
If someone you know is chained
If they’re in immediate danger, call 112, or 767 in Lagos. Report the abuse to the police: the law requires it, and senior police officers or social welfare officers can move someone who’s being cruelly treated or neglected to a place of safety for a medical examination. You can also contact the National Human Rights Commission on 6472 or 0800 647 2428, Monday to Friday, 8am to 4pm.
Faith and therapy can go together
If faith matters to your family, you don’t have to choose between it and care. Many therapists respect faith, and some specialise in it: you can find therapists who offer faith-based counselling. Our guide to answering “just pray about it” may help with family conversations, and you can read more about psychosis and schizophrenia.
Frequently asked questions
Do traditional healers treat mental illness?
Many do, with herbs, rituals, prayer and fasting. They can offer comfort and support, but there’s little evidence that healing alone changes the course of serious conditions such as psychosis. Keeping medical care going alongside is safer.
Is it illegal to chain a person with a mental illness in Nigeria?
Yes. The Mental Health Act bans anyone, including faith-based institutions, from using chains, shackles, handcuffs or ropes on a person with a mental health condition. The penalty is a fine of at least ₦2 million, up to five years in prison, or both.
Can I use a traditional healer and a hospital at the same time?
Many families do. Keep taking prescribed medicine, tell the doctor about every herb or remedy, and tell the healer about every medicine.
Are herbal remedies safe with psychiatric medicine?
Not always. Herbs can interact with medicines, and a healer’s mixture has no ingredient list or dose. Tell your doctor about everything you take.
Suggested read: Islam and Therapy: Common Questions
What should I do if a relative is chained at a healing centre?
If they’re in immediate danger, call 112, or 767 in Lagos. Report it to the police, and you can also contact the National Human Rights Commission on 6472.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
