Resolved to stem the increasing rate at which Nigerians, particularly the youths, are sending themselves to their untimely graves through suicide, psychiatrists, policy makers and other stakeholders recently converged on Lagos to discuss the causes and the way out.
Experts in psychiatry and general mental health management, drawn from across the country, took time to look at what they described as “archaic guidelines” in handling mental health patients, as well as stigmatisation and other factors that hinder the prevention of suicide. They unanimously condemned the law that criminalises anyone that attempts suicide.
The World Health Organisation (WHO) has said that suicide accounts for about one million deaths annually across the globe, which equates to one person taking his or her life every 40 seconds. It further revealed that at every successful suicide, there had been thirty suicide attempts.
At the conference that was organised by NOUS Foundation in partnership with Sparkle Foundation and Suicide Research and Prevention Initiative (SURPIN), the President of Association of Psychiatrists in Nigeria (APN), Taiwo Sheikh, defined suicide as a deliberate end to challenges that one might have struggled with over a period of time. He said that suicide has become a topical issue in Nigeria because conditions that are determinant of suicide are increasing every day.
He stated that it was difficult to separate suicide from mental health, pointing out that the thought to take one’s own life is usually as a result of a state of hopelessness that people find themselves in. He explained that people who commit suicide don’t want to die but they feel overwhelmed by some ugly circumstances and are desperate to end the pains.
“They believe that ending their lives would solve their problem. If the society has a way or ways of solving the problem for them, they will not commit suicide. Suicide is not demonic as some people might tag it; it is a mental health illness with psycho-social issues. If we recognise it that way, we will be able to help in preventing suicide. At the point when the person decides to take his or her life, it means the person has developed a condition that has changed the person’s sense of judgment. He or she no longer sees the situation the way other people see it, which brings about worthlessness,” he said.
On the role of poverty in pushing people to take their own lives, Sheikh explained that nobody was immune to suicide. Speaking from his many years of experience on the field, he said suicide happens among the poor, rich, young and old people.
The expert said that it was laughable that Nigeria was still using the Regional Act that was passed in 1916 to manage mental health patients. He said that its mere name – Lunatic Act, was an affront from those who formulated it. He said the present law on mental health doesn’t defend human rights.
His words: “Though some regions have reviewed the law, it is very archaic especially when you see some degrading terms used such as calling patients “idiots” as found in the Act. Remember that in 1916 there was no effective treatment for mental disorder as we now have today. What that means is that we are using a law that still sees mental health the way it was in 1916 when there was no treatment. We don’t want people to be in shackles while receiving treatment.
“In those days, if one had mental illness, one is condemned to asylum for life. But today, it is treatable and the patient can attain any level in life. The kind of bill we are demanding from the National Assembly now is to make mental health care service delivery universally accessible and affordable to Nigerians. What we have now is that the moment you are discovered to have mental health issue, your property can be sold by your family for your treatment. We want agencies that will implement national policies on mental health.”
He listed some factors that lead to suicide as untreated mental disorder, depression, psychotic disorder, socio-economic challenges and substance abuse.
The Medical Director of Federal Psychiatric Hospital, Yaba, Dr. Oluwayemi Ogun, advised the students who were present at the event and other Nigerian youths not to attempt suicide for any reason. She said that three adolescents were in the last two weeks admitted into her hospital.
She said that many people would love to dissociate themselves from mental health, which she faulted. She said that the theme of the conference – ‘Suicide Prevention’ – was a cause that everybody should be a part of. She recalled that there had been an increase in attempted suicide cases in recent times.
“If you are not good at your academics as a student, you can become successful in something else. We say that suicide is deliberately taking one’s life, but there are also other areas that we call suicide equivalent that is not much talked about. Our youths are crossing the Mediterranean Sea in search of greener pastures. We should look at what we are not doing well as a nation so that we will not continue to push out our productive youths to die in the desert,” she said.
Ogun said that when anyone is noticed to suddenly start withdrawing from engaging in normal activities consistently for some weeks, then the person should be evaluated for mental illness.
“The policy makers need to look at the law that says anyone who attempted suicide should be jailed for one year. We are indirectly telling the person to go ahead and commit the act or face a jail term if he or she fails. There was a person who wanted to commit suicide but was rescued by the police and taken to the station. But when they saw how he was behaving, they quickly took him to the hospital. Ideally, it is the psychiatric hospital they were supposed to have first taken him to,” the MD said.
The Chairman, Senate Committee on Health, Ibrahim Oloriegbe, described suicide as a public health concern and the second leading cause of death among youths. He, therefore, promised to ensure a speedy consideration to the Mental Health Bill and facilitate its passage which has been with the National Assembly for years.
He acknowledged that there was lack of national preventive strategy and inadequate mental health facilities. He also identified dysfunctional homes as causes of depression that could lead to suicide.
While calling for a strong social support system, he urged stakeholders to continue to collaborate with one another and to speak in one voice so that the plight of mental health patients would be ameliorated.
“If you have mental illness, it is not because that you have offended God in any way. It is just like somebody suffering malaria. The media need to help us to get a proper understanding of the issue,” the senator said.
Speaking on the uniqueness of the gathering, the Chief Executive Officer of NOUS, Ms Lade Olugbemi said though there were pockets of conversations on mental health issues in the past, the event was the first national conference that brought together experts and policy makers to address the menace.
Secondary school students from both government and privately-owned schools constituted more than 80 per cent of the audience at the event that took place at the University of Lagos (UNILAG) Main Auditorium. Olugbemi said that the conference couldn’t have been successful without the presence of the students. She expressed worry over the rate at which students in secondary and tertiary institutions were ending their own lives.
“There is a need for a lot of things to be changed. Strong support services need to be put in place. Teachers, parents, community and religious leaders need to know how to intervene. We are making the young ones to understand that life comes with ups and downs. They need to be taught how to respond to ugly situations at certain points in life. Unfortunately, we usually wait until it is too late to prevent the act.
“We are doing this with other bodies because we strongly believe that collaboration will have more impact on the society.
Olugbemi, who is a mental first aide instructor, decried the brain drain syndrome that has adversely affected the treatment of mental health cases in Nigeria. She said that it was unacceptable for about 200 psychiatrists to be attending to over 200 million Nigerians. She, therefore, urged the governments to make Nigeria conducive to health workers and other professionals in order to halt the mass exodus of health professionals to developed countries.
Recognising that the medical workforce was already overstretched, she demanded the special training of people at various levels to handle mental health cases. She explained that these sets of people would function as mental health first aiders who would in turn train more people that could intervene early when there is any suspected case.
In her contribution, a consultant psychiatrist, Kafayah Ogunsola, who represented SURPIN, said that after different researches, it was discovered that the major people that are committing or attempting to commit suicide are between 13 and 49 years. She said more males have committed suicide than females. She said that the males hardly share their problems with others or seek medical care.
“Challenges facing suicide prevention are strong discrimination against mental health; over- spiritualisation; criminalisation of suicide attempt by; shortage of mental health personnel and patient paying bills out of their pockets,” she said.
The President of Nigeria Medical Association (NMA), Dr. Francis Duyile, who was represented by Dr. Olusola, said a viable and a medically stable youthful population hold the key to a prosperous nation. He agreed with other speakers that prevention was the best way to tackle the situation.
THIS DAY
