Challenges of tackling suicide in a depressed and recessed economy

‘The Commonest Cause Of Suicide Is Depression’
Speaking with The Guardian on the increasing rate of suicide among Nigerians, a consultant psychiatrist, Dr Ambrose Lawani said there is need for a new legal framework for mental health that removes stigmatisation of the ailment and makes provision for the federal government’s universal health coverage that will ensure that every ward in the country has primary health centre.


Lawani, who is a former Vice Chairman, Edo branch of Nigerian Medical Association (NMA) said Nigeria still operates a colonial government mental health policy just as he called on religious leaders to also do their bit in stemming the tide.  


“The truth of the matter is that this (suicide) has been happening here and there, but because of the profile of the individual involved, that is why it is assuming this dimension. But the issue definitely is that like we have heard from the media, this same person has attempted suicide in the past by jumping from a high building about four years ago. When that happened, people need to focus attention on the person because the possibility of a repeat was very high.

“Once somebody has attempted suicide, relations should ensure that there is surveillance around such individuals. Most times, most of the people who have mental issue always think that life is no longer worth living. The commonest cause of suicide is depression and drug abuse. Remember there was also the case of a baker that shot himself after going to interact with his priest, so the role of religious bodies cannot also be over-emphasised in this matter. 


“That mental health has been incorporated as the ninth component of the primary healthcare should be seen to be a reality in practical terms and not just a policy statement.”
 
 
On the way forward, Lawani said:  “Now we know the Federal Ministry of Health is talking about universal health coverage, opening primary health centres in every ward and making it accessible to Nigerians, the government should make provision for mental healthcare centres in rural areas. Presently most of them are in urban areas. 
  

‘Suicide Is As Old As Man’
From Nnamdi Akpa, Abakaliki
THOUGH the rate of suicide is very low in Ebonyi State reports have shown some pockets of suicide committed mostly in the rural areas. Most of the people attributed it to the economic situation.

There was the case of a businessman (name withheld) who committed suicide because he could not pay his creditors. There was another case of a girl who drank poison, because her fiance married her best friend.

Speaking on the menace, Mrs Onwka Eze narrated how she met her son’s lifeless body hanging on the ceiling fan. She said she would have prevented him from committing the act had it been she was in the house.

She advised parents to always teach their children about life and society so that they will grow with it. A psychologists working at Ebonyi State University, who pleaded anonymity, said that man is a product of nature and that nature plays a significant role in the development of the mindset of any individual.

He noted that though suicide is as old as man, he quickly added that most of the suicide committed was done out of ignorance. He believed that proper and regular sensitisation can curb the menace.

‘People With Suicidal Thoughts Are Often Overwhelmed By Hopelessness’
By Shakirah Adunola
Speaking on the menace, a Lagos-based businessman, Adeniyi Akinola said: “People with suicidal thoughts are often overwhelmed by feelings of sadness and hopelessness and they think they have no option. There was a time I ran into huge debt and I didn’t know how to overcome it. Different thoughts were coming to me like committing suicide. I confided in my siblings and they stood by me until I finished paying off my debt. I managed to put myself together and get on with life because the world won’t stop a bit for anyone’s problems.”

Abiodun Shittu, a teacher, said depression is real and most times those who commit suicide usually give signs. “It is only that people around them don’t notice it. There are a lot of things that could lead to depression like debt, inferiority complex, child abuse, spouse abuse etc. Before you know it such person will start withdrawing from people, brooding for long, start giving away things they treasured and other unusual behaviours.

“Most time we ignore people behaving in such way and they end up committing suicide. Most time people neglect those that are depressed. If you come across such people give them help, ask them pointedly if they are planning to commit suicide, you will be surprised to learn how easy they will open up to you because they need help,” Shittu said.

To Bumi Olaniyan, a petty trader, severe depression is always accompanied by sense of suffering as well as hopelessness. She said: “The pain of existence often become too much for severely depressed people to bear. Thou I have never lost a friend or family member to suicide, but I have heard stories of people that commit suicide from their family members.’

‘With Economic Hardship, Most Nigerians Are Prone To Suicide’
By Chuks Nwanne
For Justin Akpovi-Esade, a Lagos-based journalist and Media Lobbyist, the recent spate of suicide and attempted suicides have sparked a debate in our society.“Not that suicide cases have not been reported in the past in Nigeria, but the death by suicide of that medical doctor who jumped into the lagoon was a sharp deviation from the usual pattern we are used to. I will not want to associate last Sunday’s incident with mental illness because for me, that was an isolated case. The young man could not handle a particular crisis in his life and he snapped. Suicide is a convenient way out for people, who allow their problems to overwhelm them,” he said.

Akpovi recalled that in the early 90s, a boy of about 12, who was scolded by his parents for a perceived wrong-doing in a village close to his, went into the nearby bush and committed suicide.“Would anyone then say he was a mental case? Doctors would no doubt have a medical explanation for irrational actions like that, but madness is far from it, for me,” he said.

In his reaction, Sam Anokam informed that, not too long ago, a top psychiatrist raised the alarm that most Nigerians are suffering from various degrees of mental illness.
“From what is happening vis-a-vis the economic hardship, most Nigerians are prone to suicide. The level of depression in the polity is alarming to say the least and that is why people are committing suicide. But the situation can be managed using information,” he said.

However, for Pastor Ike Ofoche, UK-based health informatician and deliverance minister, the difficulty in pinning down a definition for mental health arises from the fact of its size and complexity, adding that the assumption also in Nigeria that mental health connotes madness doesn’t help matters.

“Safe to say therefore that whatever affects our thought process, general feelings and mood, our conducts and behaviour negatively constitute a mental health illness or problem. Some of these can be as a result of depression, anxiety disorders, schizophrenia, eating disorders, addictive behaviours, bipolar, psychosis and other personality disorders,” he said.

On the spiritual angle, Ofoche explained: “Stages of mental health can either be mild (onset), medium and advanced or severe. The first two stages are hardly picked up in Nigeria; in Igbo land, they are referred to as Agwu. The last stage is more widely accepted and that’s when you see them taken to mental hospitals like Aro in Abeokuta or some end up in herbal homes and spiritual churches. In the course of treatment by these homes in Nigeria, some are paraded in chains for the sole purpose of begging for alms.”

Ofoche observed that the absence of credible database or clinical records make it difficult to ascertain the level of mental health illness in Nigeria, but noted that all the issues such as self denial, lack of concerted efforts by the authorities, low family support base, poverty and cultural dispositions all conspire to obfuscate the true picture. However, he is of the opinion that mental illness does not necessarily lead to suicide.

On the role of the religious institutions, Ofoche said: “Churches and Mosques must include mental health in their sermons to increase awareness. Support and help from churches, mosques, families and friends in this direction will help immensely. We need to avoid stigmatisation and render assurances and assistance where necessary,” he said.

He, however, urged families and friends to check on relatives regularly with a view to ensuring they are not being bugged down by issues they don’t want to discuss.“Remember a depressed economy can lead to more depression so the prevailing recession in Nigeria must not be allowed to slip into economic depression to avoid mass suicide,” he said.

While tracing the link between mental illness and suicide, Chiedu Uche Okoye observed that today in Nigeria, people doing hara-kiri have become a common occurrence and sight. “Otherwise respectable people, who looked imperturbable and sane, and who seemed to us to be well heeled, did commit suicide.”

‘A Lot Of People Are Depressed In Nigeria’
By Odita Sunday
FORMER director of Department of States Services (DSS) and private security expert, Mr. Dennis Amachree, has attributed the rising cases of suicide in the country to depression and hopeless situation many Nigerians find themselves.
 
Citing the case a Lagos-based medical practitioner who committed suicide last Sunday, Amachree noted that he might have decided to take his own life since he could no longer cope with his predicament.
 
According to him: “There is no increase in suicide cases, but it is a unique trend that is surfacing and we have to work on it and make sure it does not escalate.  “I view people who commit suicide as people who are depressed. You can notice the kind of media attention the doctor’s case drew, because right now in Nigeria, people can get worried up to the extent of killing themselves, which has now become a problem.
 
“You would notice that cases that were not reported in the past would surface, because people can no longer handle their depression again, which they have been handling in their own personal ways.
 
“Suicide is not a crime until you are caught trying to commit one. You can be arrested and sued to court because you are trying to take a life. “But when you have taken your life, there is no way anyone can arrest you.”