When the communities battle an epidemic or natural disaster, the first response is always physical hospitals, tents, vaccines, and food supplies. In Nigeria, we have seen it time and again, from the Ebola outbreak to the floods in Bayelsa and Lagos, from the COVID-19 pandemic to recurring cholera and Lassa fever epidemics. Government mobilizes emergency teams, health workers step forward, and humanitarian groups rush to meet basic needs as it should be. But when the immediate crisis subsides, the emotional toll which is often far less visible becomes evident. People affected directly and indirectly are left grieving, anxious, and often traumatized.

For too long, mental healthcare has been treated as a luxury in crisis response. One can dare say a “soft” issue to be addressed after physical needs are met. While the prioritisation and triaging protocol often detects that care should be provided in this order. More often than not, care stops at this level. For instance,  a meta-analysis on the impact of disasters conducted using 22 different studies, posited that most disaster responses were built primarily on physical interventions. As such the prevalence of mental health issues like anxiety was recorded to be up to 84% in some cases, while Post Traumatic Stress disorder was as high as 52%

Examining this statistic, every emergency reveals the same truth, the trauma left behind after each disaster can cripple communities as deeply as the disaster itself. As World Mental Health Day 2025 draws close, this year’s focus on “Access to Services: Mental Health in Catastrophes and Emergencies,” urges us to recognize mental health as essential infrastructure as vital as electricity, water, and healthcare in every disaster plan.

The Overlooked Casualty of Crisis

In the aftermath of any catastrophe, people do not just lose homes or loved ones. They lose their sense of safety, control, and normalcy. The psychological toll is immense. After the 2010 Haiti earthquake, studies found that nearly 70% of survivors experienced symptoms of post-traumatic stress disorder (PTSD). During the Ebola outbreak in West Africa, fear and stigma compounded grief, leaving thousands traumatized. Even years later, many survivors reported persistent anxiety and depression, with one study revealing that 22% of the population had high levels of anxiety and depression based on an analysis conducted using the GAD-7 and PHQ-9.

Despite these figures, in most emergency responses, mental health is treated as an optional add-on. While, budgets are allocated to rebuilding roads, hospitals, and schools, and other infrastructure, rebuilding the mind is often left. With psychosocial support often arriving late if it arrives at all. Emergency teams are rarely trained in trauma-informed care, and local communities are left to navigate emotional devastation alone.

Ignoring mental health in crisis situations does not just harm individuals, it weakens overall recovery. People struggling with untreated trauma are less able to return to work, rebuild homes, or participate in community life. In essence, without mental resilience, physical reconstruction might not last.

Mental Health as Critical Infrastructure

When we speak of infrastructure, we tend to imagine steel, concrete, and power lines. But what sustains societies through crises is not just physical infrastructure it is psychological and social infrastructure. Essentially, the capacity of people and institutions to absorb shock and recover.

If water systems and hospitals are essential to survival, so too are the human systems that maintain hope, empathy, and stability. According to treating mental health as essential infrastructure means embedding it into every stage of disaster management from preparedness and response to recovery and resilience-building.

Looking through the stages, the shift has to begin with policy recognition. Governments and humanitarian agencies must formally integrate mental health services into both state and national emergency frameworks. Mental health professionals should be part of emergency operations centers alongside logistics and medical teams. Funding mechanisms should ensure that psychosocial support is not an afterthought but a core line item in disaster budgets.

With policy integration, comes Capacity Building which is equally important. Every emergency response team from paramedics to community volunteers should be equipped with basic psychological first aid skills. Just as responders learn to stop bleeding or perform CPR, they should know how to calm panic, listen empathically, and connect survivors to care. We tend to think of “infrastructure” as things we can see, but really treating mental health as infrastructure means,

• Including psychosocial support in emergency budgets and preparedness plans.

• Training responders from NEMA officials to Red Cross volunteers in basic psychological first aid.

• Setting up rapid-response mental health teams during disasters.

• Ensuring frontline workers, doctors, nurses, journalists, and security agents have access to counseling and debriefing.

Finally, in this age and era, technology can be a lifeline. Digital mental health platforms and crisis helplines are now infrastructures that can extend access where professionals are scarce. During COVID-19, several African countries launched free tele-counseling services that reached thousands proving that scalable mental health support in emergencies is possible, even in low-resource settings. In Lagos state, the COVID-19 emergency response line became a point through which psychological support was provided. This successfully piloting of the approach, revealed that telebehavioural mental health support can operate efficiently in our Nigerian setting.

Lessons from Around the World on Scale and Efficiency

We already have evidence of what works. After the Ebola outbreak across West Africa, the World Health Organization and local NGOs realized that the mental health of survivors and responders was a crucial part of recovery. In place within Liberia and Sierra Leone, post-Ebola programs integrated counseling into community health systems leading to reduction in stigma and helping families heal.

After Japan’s 2011 earthquake and tsunami, the government established Kokoro no Care centers community hubs that provided psychological support, group therapy, and outreach programs. These services became a cornerstone of long-term recovery, reducing suicide rates and fostering social cohesion.

In Sierra Leone and Liberia, the Ebola response revealed the consequences of neglecting mental health. When the outbreak subsided, WHO and local partners set up dedicated psychosocial support programs for survivors and health workers. That experience reshaped how West Africa approached later crises, embedding mental health into health security plans.

Here in Nigeria, a few initiatives have shown what’s possible. During COVID-19, organizations like Mentally Aware Nigeria Initiative (MANI) and as well as the Lagos State Government launched digital helplines and online counseling platforms that successfully reached thousands.  For a second, imagine if, during the next flood or epidemic, the federal and state emergency management agencies automatically deployed trauma counsellors alongside medical aid. Imagine if every primary health centre had a trained staff who could offer psychological first aid. That is what it means to treat mental health as a infrastructure that can lead to better health outcomes.

The Way Forward

The world is entering an age of compounded emergencies: climate change, pandemics, economic shocks, and displacement crises collide more frequently than ever before. As these catastrophes multiply, the mental health needs of affected populations will only grow. Failing to act now will deepen social fractures and slow recovery for decades. According to WHO, Nigeria has fewer than 300 psychiatrists for a population of over 220 million. The gap is not just in service delivery but in mindset. Sadly, but truthfully, we tend to address mental health reactively after suicide cases rise, after a pandemic, or after a natural disaster. But we are now at a critical juncture where we need a proactive mental health system, one that is embedded in education, disaster planning, and healthcare financing.

In my perspective, here are four steps policymakers and all service provision actors need to take,

1. Embed mental health into national emergency preparedness plans. Every disaster response blueprint should include psychosocial response protocols and clear referral systems.
2. Invest in community-based mental health systems. The goal is to train local volunteers, teachers, and health workers to provide first-line psychological support.
3. Protect the protectors. Emergency and healthcare workers face immense mental strain, especially in light of their scarcity. As such their well-being must be safeguarded through supervision, counselling, and adequate rest periods.
4. Leverage digital tools. Expand crisis helplines, mobile counselling platforms, and virtual peer support groups to reach displaced and remote populations quickly. We know they work efficiently hence, right now, the goal should be expansion and better service delivery.

Rebuilding Healthy Minds, Not Just Walls

If the past decades have taught us anything, it is that resilience is not measured by how fast we rebuild infrastructure but by how deeply we heal as communities. A country can replace bridges and clinics, but if its people remain traumatized, recovery remains fragile.

Mental health is not a luxury of peace, it is a necessity in chaos. It is high time our policymakers, donors, and humanitarian leaders fund and treat it as such. Because every time a disaster strikes, the question should not only be how quickly we can restore power or deliver food. It should include how soon we can help people find the strength to hope again.