Mental Health Chatroom by Professor Taiwo Sheikh

Welcome to this week’s “Mental Health Chat Room”, this is a chat room where we discuss the basics of our mental health in order to understand and have a full grasp of the rudiments of mental health and mental well-being. This is an essential component of our mental health advocacy activities aimed at promoting our wholesome wellness, prevent mental illness, improve our awareness of mental illness, understand that effective, qualitative and modern (technology based) mental health care services are available in Nigeria and globally to enhance quality living, harmonious interpersonal relationships and peaceful coexistence within our communities.

A recap of our last conversation where we discussed the increasing spate of attempted and complete suicide in our communities; it was clear that every suicide is a preventable tragedy! Depression is known to be the most common cause of suicide worldwide and this is the reason we chose to discuss depression and suicide.

Today we are discussing the need to decriminalize attempted suicide and “tame suicide tragedy” as a continuation of our chat on attempted suicide and suicide.

“Life, as they say, is a gift from God and can be given only by him. Hence, taking away life and even one’s own life has always been forbidden. Religion, culture, and colonialism all condemned and prohibited suicide. The people who committed or attempted suicide have always been the subjects of wrath of the religion bound societies and some cultural sanctions in Nigeria.

Internationally, Germany, in 1751, was the first country to decriminalise attempted suicide. After the French Revolution, all countries of Europe and North America subsequently decriminalised suicide. In 1983, the Roman Catholic Church reversed the canon law that prohibited proper funeral rites and burial in church cemeteries for those who had committed suicide. All of these developments have been instrumental in shifting global attitudes about suicide in modern society.

But this may yet to be the story of suicide in Nigeria and many underdeveloped countries in the world, who still toil under very primitive, restrictive and inhuman colonial laws that certainly lack compassion for human suffering! For instance, Nigeria is still toiling under the burden of the 1916 “lunacy law” which the country inherited from her colonial masters and became regional laws in 1959.

A very cruel law that doesn’t understand the modern concept of mental health and psycho-social disorders. Attempting suicide is a criminal offence under Nigeria’s criminal laws. This law is currently enforced in several states in Nigeria. A legacy of old law from the era of British colonisation, several other African countries have provisions in their criminal legislation criminalising suicide attempts; this provision is quite retrogressive, restrictive and stigmatising.

The Criminal Code Act, Chapter 77 of the laws of the Federation of Nigeria 1990, Chapter 27; number 326 criminalises aiding suicide, while number 327 criminalises attempting to commit suicide! The law does not only prevent persons with suicidal behaviour to seek help but it also assign punishment to anyone who tries to help and fail to report to the law enforcement agencies!

Thus, most times even the surviving family members and health care workers were “punished” for the act of the “sick”.

Suicide is a major cause of mortality worldwide. It is a human tragedy that accounts for an estimated one million deaths annually, this translates to at least one death resulting from suicide every forty seconds!

The magnitude of the problem is further compounded by the fact that the incidence of attempted suicide is about 25 times more than that of completed suicide. It is important to know that every act of suicide impacts on at least six other individuals, especially for the purpose of health planning intervention design. Suicide rates have increased by 60 per cent worldwide, in the last 45 years, with an estimated global incidence rate of 16 per 100,000, thus constituting a major public health burden. These rates are grossly underreported globally and especially many developing countries, including Nigeria; as we do not have meaningful records of deaths and their causes, this has further lead to paucity of information as regards the incidence of suicide and suicidal behaviours in Nigeria

Suicide accounted for 1.8 per cent of the total disease burden as at 1998, but is projected to rise above 2.4 per cent within the first quarter of 21st century. Presently, suicide is the third leading cause of death among young people, aged 15 to 44 years, and ranks second for adolescents between ages 15 and 19 years old. These reports have prompted health workers, activists and global community to become vigorously involved in campaigning to bring the public health burden and impact of suicide to the attention of governments, policymakers and the public through the collation and dissemination of statistics (figures don’t lie as we are about to see!), and the development of preventive programmes.

It is estimated that globally, about one million deaths occur from suicide every year; which roughly translates to one suicide death every forty seconds. The incidence of attempted suicide is 25 times more common than completed suicide and it is accounting for 49 per cent of all cases of violent deaths globally.

Other major contributors to violent deaths worldwide include homicide (32 per cent); with conflicts and wars making up the remaining 19 per cent. Considering notable drivers of attempted suicide and suicide in Nigeria and the world, mental health disorders are most frequently rank on the top, especially depression. Among such drivers include restrictive laws, such as the criminal laws of Nigeria which will not permit individuals to seek proper care and even be assisted because of the fear of the law; trivialising attempted suicide and negative cultural and religious values, and the resulting stigma are some other drivers. 

Some cultural considerations have been well documented in the story of Okonkwo in Chinua Achebe’s “Things fall apart”. Almost all the religions condemn and prohibit suicide with each having an elaborate description of the punishments incurred by the offenders in their respective hells.

Cases of suicide and attempted suicide are frequently accompanied by psychological burden from feelings of guilt, sorrow and anguish, which is often experienced by the family members and close associates of individuals (who commit suicide). Every act of suicide, affects averagely six other people, at the very minimum. This impact becomes amplified, when a suicide occurs in a public situation, such as in a school, work environment or open spaces (major bridges, stadium etc).

There is paucity of information about the epidemiology of suicide in Nigeria, just as we find in many other developing countries, suicides are generally under reported. This is partly attributable to the routinely poor records of death and its causes, and more so due to culture driven stigma towards family members of victims of suicide or attempted suicide!

In conclusion, it is quite obvious that suicide has become more prevalent in recent years, and is now reported regularly in the news. There is increasing awareness of the challenge of suicide and attempted suicide partly as a result of increase in social media use. Today suicide and suicidal behaviour have become public health issue in Nigeria and the rest of the world. The provisions criminalising attempted suicide in Nigeria should, as a matter of urgency be repealed, this move might go a long way in reducing the stigma attached with suicides. People will not any longer feel the need to hide their suicidal thoughts and would be encouraged to talk about it with others and subsequently to seek professional help. Cultural and religious factors preventing people from reporting and stigmatizing suicide should also be addressed through public enlightenment campaigns. The time is ripe for Nigeria to repeal the obnoxious, archaic and inhuman 1916 “lunacy act” which does not speak nor understand modern mental health language, it places emphasis on only custodial care and does not have mental health promotion, mental illness prevention, treatment and rehabilitation in its entire content.

I hope today’s conversation will further stimulate discussions on the need to decriminalise attempted suicide in other to save our youths who constitute a very large proportion of those at risk of this preventable tragedy. I await your comments, please.

Note:  If you have comments, questions and  contributions, please reach out to us on: +2348037004611 or email us at latshe1@gmail.com.

Readers comments

I’m seeking help for depression

Dear Prof,

I have  challenges.  For some time now, I have been depressed.

I want to know what are the common causes of  depression?  How can it be diagnosed and treated?

Where can I find self-help materials for depression?

George, Lagos

Prof says,

Self-help resources are not a substitute for diagnosis or treatment. If you have concerns about low mood, it’s best to talk to your doctor first and rule out physical causes for your symptoms.

However, once you’ve checked in with your doctor, self-help materials can be a great way to learn more about depression and practice different skills at your own pace or in between treatment sessions.

Addicted to substance abuse for 10 years

Dear Prof,

I have been using addictive  drugs for close to 10 years now.

I want to know when substance abuse becomes problem? Where can I get effective  help?

Janet Egwu, PH

Prof says.

Every person has a different relationship with substances like alcohol and other drugs, and people use substances for different reasons.

What’s beneficial for some may cause problems for others, or for the same person in different situation.

Disclaimer

Comments expressed here do not reflect the opinions of vanguard newspapers or any employee thereof.