Experts call for National suicide prevention stategy, signing of Mental Health Bill into law , training of more psychiatrists
By Chioma Obinna & Gabriel Olawale
It is no longer news that Nigerians are facing tough times. The state of the nation in recent times could be much better if current indices are anything to go by.
Many local industries have shut down while several are on the verge of winding up due to dwindling fortunes of the economy.
The harsh economic challenges have resulted in massive loss of jobs and thrown millions into the over-bloated job market.
Year after year, educational institutions in the country turn out large numbers of graduates in different fields, sadly, these promising young Nigerians find themselves idle their parents have committed huge sums towards their educational pursuit.
Millions of Nigerians are hard pressed to make ends meet and are living from hand to mouth.
Just last week, the Governor of the Central Bank of Nigeria, CBN, Mr Godwin Emefiele, publicly admitted that Nigerians should brace up for tougher times. Unfortunately, the CBN Governor was only attesting to a fact that the whole world had known for some years now.
Stories abound of many Nigerians who have either ended their lives through suicide or attempted suicide as a result of the current economic hardship in the country.
Economic hardship aside, factors including terminal illnesses and depression are top risk factors for suicide. Medical and health experts in the country are worried about the current situation of things and have warned that Nigeria would likely witness increase in suicide rates because the country is breeding immature adults.
They say the traditional bonds and ties that once existed between families and friends have disappeared and the society is increasingly frivolous.
Once upon a time, suicide was taboo in Nigeria and Nigerians were not readily known for ending their lives by suicide.
But nowadays, however, hardly does a week pass without at least one reported case of a Nigerian dying by suicide.
According to the World Health Organisation, WHO, an estimated 800,000 people die by suicide annually and Nigeria now ranks among the top suicide prone countries. According to the World Population Review, Nigeria, with a crude suicide rate of 9.5 per 100, 000 population ranks 10th in Africa and 67th in the world.
The last one month has been rather traumatic. The insecurity challenges in most parts of the country aside, the media space has been awash with reports of cases of suicide.
On the morning of the 6th of April, 2019, the country was greeted with the suicide case of a lecturer at the Department of Mathematics, in the University of Ibadan.
It was reported that the deceased ended his life after unfulfilled dreams of completing his PhD programme.
The following week on 19th April 2019, a 100-level student of Kogi State University, Ayingba, also died by suicide after she was reportedly jilted by her boyfriend. She was said to have taken Sniper, a pesticide. Efforts to save her life were abortive.
Several days later on 29th April, news broke that another undergraduate, a 100-level student of Chemical Engineering at the University of Port Harcourt, Rivers State, ended his life after drinking two bottles of Sniper.
Shortly thereafter, an 18-year-old was found dead in her room in Aluu, one of the host communities of UNIPORT with bottles of insecticide and Snipper by her side.
On the 4th May 2019, a 26-year-old hairdresser in Lagos ended her life after her boyfriend of two years ditched her.
A week ago, (May 13th, 2019) another student of the University of Nigeria, Nsukka, also attempted suicide.
Another baffling case of suicide occurred on May 14th, 2019, involving one member of a Pentecostal Church in Lagos, who reportedly got depressed over his accommodation issues before taking his own life.
On the 15th May 2019, a 17-year-old in Jos, was reported to have drank Sniper to end his life when he learned that he had failed the 2019 JAMB exam.
A day after on May 16th, it was also reported that a third year Physics/Astronomy undergraduate of the University of Nigeria, Nsukka, was found dead in an uncompleted building in the educational institution. His lifeless body was found dangling on a rope suspended from a height.
Despite this long list of fatalities, experts fear that more Nigerians are likely to succumb to suicide if urgent attention is not taken to address underlying factors that are fuelling the upsurge.
They specifically warned that there will be increasing cases of suicide and mental illnesses.
The experts point to the extinction of the traditional family structure, the desperation to make it at all cost, lack of job security, shortage of psychiatrists and none passage of Mental Health Bill among others as factors that needed urgent attention to stem the rising tide of suicide.
Good Health Weekly findings reveal that people that experience setbacks are more likely be depressed and contemplate suicide than others.
According to the WHO says, globally, 300 million people – 4.4 percent of the world population – are affected by depression, a leading cause of suicide.
The WHO also notes that 5.4 percent of Africans have depression and contributes to 9 percent of global cases of depression.
In Nigeria, WHO statistics showed that depression affected about 7 million people in 2015 (3.9 percent), while in 2016, suicide was the second leading cause of death among people between the ages of 15 and 29.
To date, 60 countries have good quality vital registration data on suicide while only 38 countries have in place a national suicide prevention strategy. Nigeria is not listed among these countries.
WHO asserts that National suicide prevention strategies are essential for elevating suicide prevention on the political agenda. Such strategy and associated action plan are necessary to push forward the implementation of suicide prevention. Without these, efforts are likely to abate and suicide prevention will remain neglected.
We must train and retain more psychiatrists — Prof. Akin Oshibogun
In the views of a Professor of Community Health at the Lagos University Teaching Hospital, LUTH, Prof. Akin Osibogun , the breakdown in traditional family structure remains one of the major factors for the increase in suicide.
“We need to rebuild our social network. People are ending their lives by suicide because they don’t have a social mechanism to relate with. Traditionally we have family support, but as we get urbanised, people are now more on their own.
“What is done in other parts of the world is that they establish social services where people can make contact with those socio services. Currently, with traditional family structure breaking down because of urbanisation and yet we are not establishing a socio support system, there will be an increase in suicide cases.
“We have about 40 to 60 million Nigerians with one form of mental disorder and we have less than 200 psychiatrists in the country. The shortage is global, and we need to put in place structures that will encourage our psychiatrists to stay in the country while we train more,” Oshibogun stated.
It would be recalled that Nigeria has been struggling to formulate a modern mental health law since 2003 to replace the old Lunacy Act of 1958.
Unfortunately, the bill has only made little success. According to experts, if passed into law, it would fill the gaps in terms of treatment, patient protection, financing, human resources, and mental health services.
Signing of Mental Health Bill is crucial — Dr. Taiwo Sheikh
Corroborating his views, President, Association of Psychiatrists in Nigeria, Dr. Taiwo Sheikh everybody wants to be successful and that success sometimes comes with itsown price.
“Substance abuse which is also a topical issue in Nigeria today often comes to mind. Study shows that youth within the ages of 18 to 35 years are the most vulnerable to substance abuse in Nigeria, this is the core wall for nation- building and drug is consuming them. So it is a huge problem and we need to find a way to deal with it.
“Another thing is stress which pushes human being to the wall. When you are pushed further, you break and come down with different types of mental issue.
“Today, depression is high among mental health issue, many people are carrying the burden of depression without their neighbours being aware because the assumption is that for you to say you have mental illness you have to walk naked on the streets or tear off your clothes.”
Sheikh said the signing of Mental Health Bill into law will help to protect mentally ill persons, protect care givers, establish nature of care someone can render to mentally ill person and also define who is responsible for funding, treatment among others.
He added that the brain drain in psychiatry will expose the mentally ill to quacks which portends ill for the mental wellbeing of Nigeria.
“This means that problems such as drug abuse, depression and suicide will rise and those affected will not get the professional care they need which may itself take a greater toll on the economy of the individual or the family, as out of pocket pay remains the norm.
“Such untreated or poorly treated disorders may have an effect on the suicide rates in the country as well.”
Spiritual and religious activities help — Dr. Jibril Abdulmalik
Also, a Senior Lecturer and Consultant Psychiatrist with the University College Hospital, UCH, Ibadan, Dr. Jibril Abdulmalik, said stress has been implicated in mental health problem, adding that helpful strategies to overcoming stress include regular physical exercise (releases feel-good chemicals that promote relaxation); employing humour to diffuse tense situations and to keep the big picture in view; investing and nurturing relationships – with family, friends and colleagues; taking breaks – not necessarily expensive vacations but maybe a visit to the beach for a quiet stroll and meditation alone.
“Spirituality or religious activity may also provide solace and comfort for some people. Engaging in a charity cause for altruistic reasons is also helpful to provide balance and it evokes a deep sense of satisfaction and well-being when we do something for a good cause.”
There is need to decriminalise suicide — Dr. Raphael Ogbolu
The Coordinator, Suicide Research and Prevention Initiative (SURPIN)/ Certified Mediator, LUTH, Dr. Raphael E. Ogbolu, some cases of suicide were due to struggles with depression and drug abuse which had been linked to suicide.
Ogbolu confirmed that suicide accounts for 1.5 percent of global deaths and ranks among the top 20 leading causes of death. The Consultant Psychiatrist noted that 78 percent of suicides occur in low and middle-income countries like Nigeria.
He said according to the WHO rate, suicide prevalence in Nigeria was put at 9.9 per 100,000 people in 2015, up from 6.5 in 2012, also, higher than regional average of 8.8 percent.
Stating that suicide was commoner among women with 5.1 percent than men (3.6 percent globally), he regretted that suicide was under-reported and hidden as a result of the stigma associated with it.
“Many countries have no suicide prevention plan and no reliable statistics on causes of death, some countries criminalise suicide attempts.”
On warning signs of suicide, he listed changes in a person’s behaviour, social isolation, a person talking about death more about suicide and hurrying to settle quarrels, debts, etc, and exhibits behaviours with a high risk of death among others.
To prevent suicide, Ogbolu recommended the need to decriminalise suicide, provide prompt treatment to those with depression and substance abuse.
“There is a need to talk to someone about it, there i need to speak out if you see signs in anyone. Guide those you fear are at the risk to seek professional help; show more compassion and support for others, stop stigmatising others and be kind in your dealing with others.”
Giving hope to those with depression, Ogbolu said the condition is treatable with effective medication and psychotherapy.
“If depression is poorly treated it tends to linger for years. It has a tendency to recur if not well managed. Again, there is a need to manage stressors well. Be your brother’s keeper, speak out/talk to people, build bonds, encourage people to seek help, and seek professional help.
For more information and help on suicide issues, call SURPIN-LUTH helplines: 09080217555, 09034400009, 08111909909 and 07013811143.”