THE surge in
suicide cases in Nigeria is worrisome. Two specialists in suicide treatment and
prevention spoke to Good Health Weekly about the development and what steps
Nigeria should take to stem the tide.
WHY THE UPSURGE IN SUICIDE CASES
There has been an increase in awareness and increase in reporting but
there is an increase in suicide going by the number of cases we have seen in a
space of fives. We now see at least one related case of suicide every
month. There are several factors. The single largest factor is medical
depression and unfortunately, it is often misunderstood and undertreated in
this part of the world. When clinical depression is not treated it can progress
from mild to moderate and severe depression and then lead to suicide.
Why people are
not treating depression One is ignorance, lack of awareness, not knowing where
to go and other treatment parts. Before they present in the hospital they would
have tried other alternative treatment like churches, mosques and healing
centres. They explore other alternative care but by the time they know the case
will have been bad. Then the cost of treatment. Unfortunately, mental health is
not covered under the National Health Insurance Scheme. So a lot of people have to pay out of pocket
and where you cannot treat depression very well you will have increased suicide
cases.
We do know that
when you people think of factors of people becoming depressed the first thing
that comes to their mind is financial. Yes, we do know that it is an important
risk factor or contributor but from the cases, we have analysed we found out that
the commonest causes are illness and mental disorders.
HOW COMMON IS SUICIDE?
Eighty-five percent of suicide
occur in low and middle-income countries where Nigeria belongs, unfortunately,
data is not available for 70 percent of these countries and that is one of the
reasons why we personally decided to set up Suicide Research and Preventive
Initiative SURPIN. It is not about taking up the preventive perspective it but
we need data and research to know how to plan an intervention strategy.
What we
rely on largely is World Health Organisation, WHO, statistics but we do know
that suicide is underreported globally not only in Nigeria because a lot of
them will never get to a health establishment. There is still a lot of stigma
associated with it. Even when we have
clear cases after a post mortern that a person died of suicide the family tell
the mortician not to state that even in death.
We must also not
forget that it is not only the person that dies who is affected. It also
affects the bereaved. Even the figures we have are underestimated. We have far
more cases that we have estimated. Even with the fact that we were seeing an
average of one case monthly in LUTH alone, that will tell you that it is far
more than we have reported.
Even with
the WHO statistics that we are using which is about 800 to 1 million that means
every 40 seconds somebody is dying of suicide globally and it is estimated to
increase by 2020 to 1.53 million and that is why the WHO is asking countries
who don’t have National suicide prevention plan to get on board so that we
could even reduce it by 10 percent by 2020.
That is why we established SURPIN.
WHAT NIGERIA SHOULD BE DOING.
We need to recognise that suicide
is preventable and build outlets and resilience and this starts from the home.
We have seen an increasing number of young people who are breadwinners. We are
putting too much pressure on children. We have so many of them in the
universities; there are too many destructive families. We need to address the
issue of destructive families where mothers and fathers are not together
because it affects children. Early childhood experiences are the bedrock of
depression in future. Because of our culture, we used to have this communal
thing. When a husband and wife are longer together, an uncle or aunty will come
and take te child and that used to save the child from destructured family but
now it is no longer happening.
These children
train themselves. We have destructive families all over the world but there is
a system that protects the child but we don’t have it here. These are some of
the things we should do. Physical connection helps build resilience, there must
be deliberate effort. Since there is no structure if a child goes to school he
or she sees it as a second home. It is unfortunate that the school is taking
over roles of fathers and mothers.
This wasn’t happening in the ‘60s. There is
need to train religious leaders on how
to identify depression. We are doing that. There are no cardinal signs but you
will notice real change in behaviours.
In 2017 the theme for the World Health
Day was “Depression Ask. Nobody wants to
die. The fact is that all the people that die by suicide do not want to die.
But they simply do not want to continue living the way they were living.
If you give them
an option, they will take the option. This is where the idea of the hotlines
come in. If you catch them at the early stage before the period when they will
be having worthlessness or hopelessness, they will change their mind. Role of
drug abuse You could say that depression causes about 90 percent of suicide
cases but what happens to the remaining 10 percent?
Substance abuse, relationship problems and
financial issues and other human issues account for this 10 percent. In recent times the younger generation –
adolescents and youths are engaging more in drug and substance abuse,
particularly, prescription drugs. They want to withdraw but there are
withdrawal syndromes, all the side effects and problems of family members
getting to know. All these are causing issues that will make them want to die
by suicide.
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