It would be imperative to begin this piece with the definition of health. World Health Organisation (WHO) succinctly defined it as: “A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” Unfortunately, in today’s increasingly demanding and competitive world, mental and social well-being aspects of health have been neglected to the peril of the individual and society. British criminal psychologist, David Farrington, captured this insidious neglect as thus: “Problem children tend to grow up into problem adults and problem adults tend to produce more problem children.”
Suicide, a global health challenge, is one of the major devastating and re-occurring manifestations of Nigeria’s deteriorating public mental health. It is the act of killing oneself. It is most often as a result of mental illness, with depression being one of such illnesses. Other mental illnesses that are strongly associated with suicide include substance use disorder and psychotic illnesses. Eating, personality, trauma-related and anxiety disorders are mental illnesses that could also lead to suicide.
However, suicide is not always due to mental illness. Sometimes, it happens impulsively in moments of crisis. Such crisis include the inability to deal with life stresses, such as financial problems, broken relationships, chronic pains or illness, among others. Suicide may also be a means of ‘crying for help’. In some cases, persons who died through suicide did not know the act would kill them. They made wrong judgements in an attempt to cry for help and that eventually took their life. In short, suicide could be regarded as a failed coping mechanism.
Globally, close to 800,000 people die every year due to suicide. Yet, there are many more people who attempt it on a daily basis. In 2016, according to WHO, it was the second leading cause of death among 15 to 29-year-olds in the world.Every suicide is a tragedy that affects families and societies, and it has long-lasting effects on a people.
These nuggets would help us understand that many people commit suicide not because they are weak, but because they are sick. They are in a disturbed state of mind and their minds keep telling them it is the right thing to do. Many who commit suicide struggle a lot to silence this internal voice that keeps telling them the only option is to take their own life. They are not cowards. They people struggling, in silence, with mental illness for a long time without help.
Suicide has become rampant in the country that it makes headlines in print and virtual media. This led Ester Onyegbula, in her recent Vanguard article titled ‘Revealing Notes of Suicide Victims’, to write, “Some years back, Nigerians were referred to as the happiest people on earth. Unfortunately today, that has become history as a lot of people slide into depression and become suicidal.” In 2018, Spectator Index published a WHO report that stated that Nigeria has 15 per cent suicide rate per 100,000 people, making it the 5th highest suicide rate in the world after South Korea (24 per cent), Russia (18 per cent), India (16 per cent) and Japan (15.4 per cent).
At this juncture, a few of the recent Nigerian suicide news would suffice in this rendition. Segun, in Ogun, killed himself because he scored low JAMB; Aisha Omolola, a 300-level student of Ahmadu Bello University, drank Sniper and died; JesutosinAdeniyi lifeless body was found dangling from a tree in Lagos; Allwell Orji, a medical doctor, jumped into Lagos lagoon; ChukwuemekaAkachi, a first-class, final-year English student of the University of Nigeria, drink Sniper and died… and the morbid list continues. In these cases, hanging, drinking of insecticide (example, Sniper) and drowning are the commonest ways of taking one’s own life. Other methods include firearms or medication overdose.
These saddening suicide stories and increasing mental illnesses in Nigeria, begs a pressing national question: Which way out? The need to curtail this wildfire called suicide cannot be overemphasised. First of all, the individual and the society should acknowledge that mental health is an integral part of their lives. It is unfortunate that people concentrate more on their physical health, while their mental health dilapidates.
Many Nigerians do not know what mental health is all about or do not take it seriously. How could people access treatment for mental illness when they are not aware of what it is? There are people who are suffering in silence, or who link their mental-illness symptoms to spiritual attacks or who assume their loved ones do not care about them. German-born United States physician and author, Martin H. Fischer, encapsulated this when he said, “If you are physically sick, you can elicit the interest of a battery of physicians; but if you are mentally sick, you are lucky if the janitor comes around.” Nigerian hospitals, prisons and government are not helping matter as well. This is reflected in a recent Punch front-page headline titled ‘Rising Suicide Crisis How 250 Psychiatrists Battle Nigeria’s 60 Million Mental Cases.’
Mental-health awareness is not dependent on whether one is educated or not. There are incidents of unawareness among well-educated people. A prior suicide attempt is a very important risk factor. There should also be government and organisational policies to reduce the use or abuse of psychoactive drugs. Follow-up care for people who have attempted suicide and provision of community support is very important. To reduce incidents of suicide, the government should employ enough psychiatrists and clinical psychologists in hospitals, prisons and school clinics. People should be mentally aware of their health and avoid the stigmatisation of people with mental illness. People should know that depression is not a sign of weakness. Rather, it is a sickness, which is manageable and treatable with professional help. People should understand that anyone, at any time, could develop mental illness like someone could develop physical illness. Furthermore, a review Nigerian education system is crucial. Students study in unhealthy and stressful conditions. High expectations and impossible workload—imagine a junior secondary school student taking 17 subjects in a term or a university student offering compulsory courses that are not related to his/her discipline—are doing more harm than good.
Hormonal changes, poor educational environment, poverty, inadequate social support, marital instability, violence, abuse, loss or sense of isolation could trigger mental illnesses, which could lead to suicide.
Olowa is a clinical psychologist with University College Hospital, Ibadan