THE MANAGEMENT AND REHABILITATION OF

SCHIZOPHRENICPATIENTS IN FEDERAL MEDICAL CENTER (FMC),

WADATA

BY

AGUNDU VICTORIA NGUHER

BSU/BM/NUR/REM/19/1531

A PROJECT REPORT SUBMITTED TO THE DEPARTMENT OF NURSING

SCIENCES, COLLEGE OF HEALTH SCIENCES, REV FR MOSES ORSHIO
UNIVERSITY; IN PARTIAL FULFILMENT FOR THE AWARD OF THE
DEGREE OF BACHELOR OF NURSING SCIENCE (BNSC).

JUNE, 2025
 CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks,
feels, and behaves. It is characterized by symptoms such as delusions, hallucinations,
disorganized thinking, and impaired social functioning. Globally, schizophrenia is
recognized as a major contributor to disability, with approximately 24 million people
affected worldwide, or about 1 in every 300 individuals (WHO, 2022). The disorder
typically begins in late adolescence or early adulthood and often becomes a lifelong
condition requiring long-term management.

On a global scale, schizophrenia poses a significant challenge to health care systems due
to its chronicity, complexity, and social stigma. According to the WHO (2022),
individuals with schizophrenia are two to three times more likely to die early than the
general population, often due to preventable physical diseases such as cardiovascular
illnesses, diabetes, and infections. Mental health services globally have seen efforts to
integrate psychosocial rehabilitation with pharmacological treatment to improve patients'
quality of life and functionality (Rajan & Menon, 2020). Countries with developed health
systems have implemented community-based care, occupational rehabilitation, and peer
support programs to enhance recovery outcomes. However, even in these settings, gaps
still exist in achieving holistic care, particularly due to stigma, limited funding, and
workforce shortages.

In Africa, and particularly in Nigeria, the situation is more challenging. The continent
carries a disproportionate burden of mental health disorders due to poverty, conflict, poor
health infrastructure, and cultural misconceptions about mental illness (Gureje et al.,
2020). Nigeria, with a population exceeding 200 million, has a significant shortage of
mental health professionals, with less than 300 psychiatrists serving the entire country
(Ebigbo & Ike, 2021). Mental health services are heavily centralized, with few tertiary
hospitals providing specialized care, and most rural areas lacking any form of psychiatric
services. Cultural beliefs and stigma further complicate access to care, as many
individuals with schizophrenia are often misunderstood and subjected to traditional or
spiritual interventions rather than evidence-based treatment.

Rehabilitation, an essential aspect of schizophrenia management, remains grossly

underdeveloped in Nigeria. While medications such as antipsychotics help manage acute
symptoms, rehabilitation services such as skills training, social integration, and
psychological support are scarce (Onu et al., 2023). Families bear the brunt of care, often
without support, leading to caregiver burnout and poor outcomes for the patient. Efforts
by the Nigerian government to improve mental health care include the passing of the
Mental Health Act in 2021, which aims to protect the rights of individuals with mental
illness and improve access to care. However, the implementation remains slow, and
practical improvements on the ground are limited.

Federal Medical Centre (FMC), Wadata in Makurdi, Benue State, is one of the few
tertiary facilities offering psychiatric services in the North-Central region of Nigeria. It
provides care to a large population, including patients with schizophrenia. However, the
scope, effectiveness, and availability of rehabilitation services at FMC Wadata remain
under-researched. Most studies in Nigeria have focused on epidemiology and
pharmacological treatment of schizophrenia, with limited attention given to the
rehabilitation process and its impact on recovery outcomes.

Given the complexity of schizophrenia and the central role of rehabilitation in fostering
recovery, there is a need to evaluate how facilities like FMC Wadata manage and
rehabilitate schizophrenic patients. Understanding the strengths and limitations of current
practices will inform better resource allocation, staff training, and policy implementation
aimed at improving patient outcomes.

This study, therefore, seeks to examine the management and rehabilitation of

schizophrenic patients at FMC Wadata. It will explore the treatment modalities available,
assess the availability and utilization of rehabilitation services, and identify the
challenges encountered in delivering effective care. By doing so, it aims to contribute to
the improvement of mental health services and patient outcomes in Nigeria.

1.2 Statement of the Problem.

Schizophrenia remains a significant mental health challenge globally, but its impact is
especially severe in developing countries like Nigeria, where healthcare systems are often
under-resourced and overwhelmed. Despite decades of global advocacy for improved
mental health care and the availability of evidence-based treatment protocols, the actual
quality of care and rehabilitation services for people living with schizophrenia in Nigeria
remains inadequate.

In Nigeria, patients with schizophrenia face a complex array of challenges ranging from
limited access to quality healthcare, stigmatization, and a gross shortage of trained mental
health professionals. Most mental health services are concentrated in urban areas, leaving
rural communities underserved. Even in urban centers, the quality and scope of care vary
significantly. The National Mental Health Policy, although progressive in content, suffers
from poor implementation and funding. These systemic issues mean that many patients
do not receive the comprehensive care they need to achieve functional recovery and
reintegrate into society (Ogunlesi et al., 2020).

At the institutional level, facilities such as FMC Wadata offer psychiatric services, but
there is limited information on how well these services address the holistic needs of
schizophrenic patients. The focus of care is often limited to medication management,
with minimal emphasis on psychosocial rehabilitation. Patients are frequently discharged
with little or no follow-up or community support, leading to high relapse rates and
readmissions. Rehabilitation services like vocational training, psychotherapy, and family
education, which are crucial for long-term recovery, are either underdeveloped or
completely absent (Rajan & Menon, 2020).

Furthermore, the social stigma surrounding mental illness remains a formidable barrier.
Families are often reluctant to seek care for affected members, and those who do are
frequently discouraged by the inadequate services available. Schizophrenic patients often
become isolated, unemployed, and dependent on caregivers, thereby increasing the
socioeconomic burden on families and the community at large (Gureje et al., 2020).

Despite the existence of various treatment guidelines and frameworks, the actual practice
at healthcare facilities often deviates due to resource limitations, lack of trained
personnel, and poor monitoring mechanisms. There is also a paucity of local research
data to guide policy and practice, especially concerning rehabilitation. Without a clear
understanding of existing challenges and success stories, efforts to reform and strengthen
mental health services will remain ineffective.

Therefore, this study seeks to investigate the current management and rehabilitation
practices for schizophrenic patients at FMC Wadata, with the aim of identifying gaps and
proposing evidence-based recommendations for improvement. The findings are expected
to enhance patient outcomes, inform policymakers, and contribute to the growing body of
mental health research in Nigeria.

1.3 Objectives of the Study

The main objective of this study is to evaluate the management and rehabilitation of
schizophrenic patients in FMC, Wadata.

I. Assess the current treatment modalities used in managing schizophrenia at

FMC, Wadata.
II. Determine the availability and use of rehabilitation services for schizophrenic
patients.
III. Identify challenges faced in the management and rehabilitation of
schizophrenic patients.

1.4 Research Questions

This research seeks to answer the following questions:

I. What treatment modalities are currently used in managing schizophrenia at FMC,

Wadata?
II. What rehabilitation services are available and utilized by patients at FMC,
Wadata?
 III. What are the challenges associated with managing and rehabilitating
schizophrenic patients?

1.5 Significance of the Study

This study will contribute to improving mental health care practices at FMC, Wadata, by
highlighting the strengths and weaknesses of current management and rehabilitation
practices. Findings will help health care providers, policymakers, and stakeholders
identify effective strategies and implement evidence-based interventions.

Furthermore, the study will provide valuable insights for academic and clinical training
institutions in refining mental health curricula to incorporate more practical and holistic
approaches to psychiatric care.

Non-governmental organizations (NGOs) and international partners may also benefit

from this research in understanding local realities, thereby aiding in the design of more
targeted interventions and support systems.

The study will also empower patients and caregivers by providing a voice to their lived
experiences and challenges, thereby promoting patient-centered care and advocacy for
better mental health policies in Nigeria.

1.6 Scope of the Study

This study is limited to the management and rehabilitation of schizophrenic patients at
the Federal Medical Centre (FMC), Wadata, in Makurdi, Benue State. It involves 50
patients diagnosed with schizophrenia and receiving care at the facility. The study
focuses on available treatment modalities, rehabilitation programs, and challenges
associated with the process.

Although the study is confined to one facility, its findings may be reflective of similar
mental health care environments across Nigeria, particularly those facing similar
constraints in resources, staffing, and infrastructure. The study will not cover other
mental disorders or patients outside FMC Wadata. It will also exclude long-term outcome
assessments due to time constraints, focusing instead on current practices and challenges.
This study will contribute to improving mental health care practices at FMC, Wadata, by
highlighting the strengths and weaknesses of current management and rehabilitation
practices. Findings will help health care providers, policymakers, and stakeholders
identify effective strategies and implement evidence-based interventions. It will also
serve as a reference for future research in mental health nursing and psychiatric
rehabilitation.

1.7 Operational Definition of Terms

• Schizophrenia: A chronic mental disorder characterized by delusions, hallucinations,
disorganized thinking, and social withdrawal.
• Management: Clinical interventions used in the care of schizophrenic patients including
medication, psychotherapy, and nursing care.
• Rehabilitation: The process of restoring schizophrenic patients to optimal social
functioning through therapy, skills training, and support.
• FMC Wadata: Federal Medical Centre located in Wadata, Makurdi, providing tertiary
mental health services.

*
References

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Gureje, O., Oladeji, B. D., Montgomery, A. A., Araya, R., & Bello, T. (2020). Integrating
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Onu, V. C., Chukwu, C. O., & Mbamara, S. U. (2023). Community mental health in
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