Mental health needs are rising, but the shortage of mental health workers leaves many Nigerians without adequate support and care. Teletherapy offers a potential solution, yet access remains limited. Some African countries have about 1.4 mental health workers per 100,000 people, compared to the global ratio of 9:100,000. The situation in Nigeria is particularly sobering: approximately 200 psychiatrists serve a population of around 198 million individuals. About 26% of Nigerians experience a form of mental illness in their lifetime, yet only around 10% receive any care. Cultural stigmas, lack of awareness, and inadequate infrastructure contribute to this treatment gap.
With the expanding use of AI and technology to bridge healthcare gaps comes a promising development for mental health care. Teletherapy, powered by digital platforms, AI chatbots, and video consultation tools, is expanding the reach of mental health services, addressing gaps in traditional healthcare, and providing easier access, anonymity, and reduced stigma. In a context where visiting a psychiatric hospital can carry social and logistical burdens, digital care opens a new door. But the question remains: Can a digital therapy session truly be as effective as an in-person session?
How COVID-19 Accelerated Teletherapy Adoption in Nigeria
The rapid expansion of digital connectivity in Nigeria created fertile ground for the rise of telehealth. Before the COVID-19 pandemic, telemedicine and teletherapy were available in Nigeria on a small scale, primarily through pilot programs. About 90% of Nigerians with mental illness lacked access to treatment, and very few technologies were deployed. The pandemic marked a turning point, as lockdowns and the risk of infection forced healthcare providers to adopt digital consultations.
Teletherapy modalities, such as video calls, chat apps, and phone consultations, gained traction during this period. Platforms like Zoom, WhatsApp, and Google Meet were becoming widely accepted for telepsychiatry. To meet the needs of clinicians and patients across Africa, low-bandwidth technologies began to dominate. Phone consultations were the most common modality (80%), followed by chat or instant messaging, while email was the least used. This reflects how telehealth services adapted to the continent’s infrastructure and connectivity challenges. The combination of increased digital readiness, urgent healthcare needs, and adaptive technology accelerated the growth of telehealth services, offering a convenient alternative to in-person care and setting the stage for continued expansion.
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Digital Startups Driving Teletherapy Access in Nigeria
With the growing demand for mental health services and the increasing integration of AI and digital tools in healthcare, several Nigerian tech ventures have emerged to address the issues of affordability, accessibility, and inadequate insurance coverage. The National Health Insurance Scheme (NHIS) provides very limited mental health benefits, mostly inpatient psychiatric care, with exceptions for severe outpatient cases, and no coverage for routine therapy sessions. Some private insurance companies offer limited coverage for therapy.
Platforms such as MyTherapist and Nguvu Health have emerged to fill these gaps, forming partnerships with private insurance companies such as WellaHealth and Axa Mansard, respectively, to enable Nigerians access remote mental health care at subsidised rates. For instance, a therapy session on MyTherapist starts from ₦3,000, when compared with the average traditional therapy session in Nigeria, which costs between ₦15,000 and ₦57,000, the value add becomes apparent as it offers accessibility to mental healthcare to many who may have found it out of reach due to pricing.
Other companies take a different approach to addressing the gaps. Friendnpal uses an AI model to connect users with licensed human therapists. The model targets users who may not typically seek formal psychiatric care.
Teletherapy Effectiveness: What the Research Shows
A research study on Digital Psychiatry in Nigeria showed that teletherapy is effective in improving care and mental health outcomes. The scoping review reports that simple interventions, like automated SMS reminders and phone check-ins, can reduce missed appointments and depression.
Professionals in Southwest Nigeria report that telehealthcare improves access, reduces stigma associated with visiting psychiatric hospitals, and streamlines care delivery. Evidence from Across Africa highlights how telepsychiatry helps bridge the gap in severe workforce shortages by connecting underserved or rural communities to trained professionals through video calls, phone consultations, and mobile-based interventions.
Patients also report high satisfaction with these approaches due to their convenience, personalisation, and ease of use. However, while the overall evidence is positive, effectiveness varies by condition. According to an international survey, mental health professionals perceive telehealth as more effective for anxiety and mood disorders, but less effective for psychosis and substance use disorders.
This suggests that teletherapy effectively addresses common mental health conditions, but complex or high-risk cases still often require in-person care. Experts caution that even with growing success, telepsychiatry cannot fully replace in-person care for severe mental illnesses that require physical exams, risk evaluations, or intensive interventions. In practice, a hybrid model remains the most effective approach to ensure safe, comprehensive and holistic mental health care.
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Barriers to Teletherapy Adoption in Nigeria
Despite the promise of teletherapy, multiple structural and regulatory barriers limit its adoption and scalability in Nigeria. Beyond general concerns about weak governance, the absence of a clear telemedicine law has resulted in gaps and harms. Nigeria has recorded significant data handling failures in the healthcare sector, such as the PLASCHEMA data breach that occurred in 2022, where over 37k personal records were exposed online due to poor security practices. In teletherapy, gaps in data regulation, unclear licensing frameworks, and the absence of clinical governance standards increase the likelihood of misdiagnosis or inconsistent care, leakage of sensitive psychological notes, or a lack of accountability when remote consultations go wrong.
Access to the internet, unreliable electricity, and the lack of mobile phones or computers worsen these limitations. Teletherapy requires a smartphone, reliable internet, electricity, and basic digital literacy, resources that many rural and low-income Nigerians lack. Poverty and low digital literacy among clinicians and patients have been linked to the poor uptake of telehealth services.
In Nigeria, the movement toward digital health regulation remains slow and politically contested. Healthtech founders, investors, and groups, such as the Healthcare Federation of Nigeria (HFN), continue to advocate for national telemedicine standards and clearer licensing at sector gatherings, including the Nigerian Telehealth Conference. The government is also implementing regulations to guide the update and adoption of digital health, including the Digital Health Bill, the National Health Digital Strategy, and the Nigeria Digital Health Initiative (NDHI).
But parts of the healthcare system remain cautious, warning that poorly drafted rules could legitimise tele-quackery or erode professional oversight. National constraints reveal that many facilities lack the necessary infrastructure for safe digital care. Without addressing these challenges, teletherapy will continue to grow in tandem with the rise in digital uptake; however, the expansion will primarily concentrate among urban, digitally literate populations, leaving rural and low-income populations behind.
Recommendations for Scaling Teletherapy in Africa
To overcome these barriers and realise the potential of teletherapy in Nigeria and across Africa, policymakers, health regulators, and digital-health stakeholders must work together. Other African countries offer models that demonstrate how regulatory, infrastructural, and service constraints can be addressed when governance and standards evolve in tandem.
Rwanda’s Digital Health Governance Framework integrates approvals, interoperability standards, and data safeguards into a system that guides digital health deployments. Ghana’s implementation guide for telemedicine and Kenya’s Digital Health Act policy brief show how governments can phase in regulation, starting with pilot oversight, then building accountability rules, and adopting national standards. These frameworks offer practical tools Nigeria could adapt, including registration pathways for teletherapy providers, minimum cybersecurity thresholds for platforms, and enforceable remote clinical practice standards.
For teletherapy to reach its full potential, governments must develop clear and enforceable telemedicine frameworks that protect patient privacy, ensure professional accountability, and provide guidance for cross-border practice. Investment is needed in digital infrastructure, including reliable electricity, affordable broadband, and smartphone access for both rural and urban dwellers.
Public education campaigns should address cultural stigma around mental health and promote digital literacy for both clinicians and clients. Most importantly, stakeholder collaboration is essential to create trustworthy and scalable therapy systems that reach the populations who need them most, ensuring that digital mental health care becomes a complement to, rather than a replacement for, traditional in-person services.