Feyikemi Akinyelure has spent the last several years listening to the conversations that Nigeria’s mental health policy has been built without. A Lagos-based behavioural health researcher and founder of the Dora-Care Behavioral Foundation, she has watched a generation of interventions arrive in underserved communities with the authority of data and the weakness of distance.
Her argument, now set out in a recent peer-reviewed paper, is that the country’s response to a crisis of scale has been designed from the wrong end of the data pipeline, and that the cost of that inversion is measured in the people who never walk into the clinics built for them.
The numbers that frame the crisis are familiar. One in four Nigerians lives with a mental health condition, according to estimates cited by the Federal Ministry of Health, yet fewer than ten per cent ever receive formal care. The country has roughly 250 practising psychiatrists for a population of more than 220 million, one of the lowest ratios in the world, according to the World Health Organization. These are the figures most often quoted in the policy conversation.
In Akinyelure’s perspective, they are also the reason the conversation keeps producing the wrong answers. In her words, “Policy is being built from the top of the data pipeline down,” she says. “The numbers tell you how many people are unwell. They do not tell you why the woman in Ajegunle will not walk into a clinic, or why the young man in Kano describes his depression as a spiritual problem, or why the mother in Enugu trusts her church elder more than a state-funded counsellor. Until policy learns to hear those answers, it will keep funding services the people it is built for will not use.”
Her paper, Leveraging Behavioural Health Data for Policy Innovation: Closing the Loop Between Community Insights and Public Health Decision-Making, published in July 2025, makes a case most behavioural health research has avoided. Epidemiological data, for all its sophistication, captures incidence without context. It tells policymakers the scale of the problem and almost nothing about the texture of it. The result is a generation of interventions that look rigorous on paper and fail quietly in the neighbourhoods they were designed for.
Her framework proposes a deliberate architecture for closing that gap. It sequences four elements most health systems treat as separate: participatory data collection through focus groups, community dialogues and citizen-generated platforms; advanced analytics that combine that qualitative material with clinical and administrative records; ethical data governance to protect communities whose disclosures carry real social risk; and the institutional capacity to translate what is heard into what is funded. The architecture is not theoretical. It draws on work she has done at Dora-Care building community-led mental health programmes in underserved Nigerian communities, where the distance between a clinical database and a lived experience of stigma is the distance between a policy that works and one that does not.
Her argument arrives at a moment of unusual policy urgency. The Mental Health Act 2023, signed into law to replace the 1958 Lunacy Act, committed Nigeria for the first time to a rights-based framework for mental healthcare. Implementation remains uneven, and the funding mechanisms that would give the Act operational force are still being designed. State-level planners are, at this moment, drafting the frameworks that will determine whether the law becomes delivered or remains declared.
“An Act is a promise. A budget is a decision. A community-informed programme is the difference between the two,” Akinyelure observes. “Every state government now writing its implementation plan is making a choice about whether to build that plan from a spreadsheet or from a conversation. The spreadsheet is easier. The conversation is what will actually reach people.”
What distinguishes her work in a field crowded with advocacy and thin research is the bridge she occupies between clinical public health, community development, and data governance. Few behavioural health researchers in West Africa have combined those disciplines into a single operational framework, and fewer still have done so while running an active community foundation whose programmes provide the ground truth against which her research is tested. Her contribution is to insist, with methodological rigour, that community insight is not a supplement to behavioural health data. It is behavioural health data.
The methodological move at the centre of her paper is one most behavioural health research has been reluctant to commit to. Community insight, in her design, does not sit at the intake stage of a dataset. It sits inside its analytical core. That relocation changes what a behavioural health dataset is understood to contain, and changes in turn what a policy built on it is understood to be accountable for.
The accountability she has in mind is harder than a dashboard and slower than a survey. It is the work of remaining in a community after the questionnaire has been filed, and of letting what is said next revise what was concluded before. It is the part of behavioural health policy most frameworks have never been built to hold, and in her reading, the part that decides whether any of the rest of it reaches the people it was written for.
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