A patient lies on a foam mattress at the Dawanau Psychiatric Hospital, one of the few state-run mental health facilities where admission is free. It is the only Psychiatric Hospital hospital in Kano State, which has a population of 20 million people. Its seven wards can hold 20 ΓΆ€" 25 patients each and it is regularly close to capacity. While staff claim not to use chains to restrain patients, chains can be seen attached to polls in wards and one patient was seen to be shackled. Doctors say they are understaffed. Five consultant psychiatrists visit the hospital to provide care and there is one psychiatrist in full time training at the facility.