Suicide is second leading cause of death in people from age 10 to 34
As LUTH opens research and prevention centre
By Azoma Chikwe
The recent unfortunate deaths by suicide have raised genuine concern among health practitioners as well as the general public. The sad stories are a great shock to the state and nation. As a health institution, the Lagos University Teaching Hospital (LUTH) has commiserated with the families and the general public on the tragic losses and opened a Suicide Research and Prevention Centre to deal with the rising incidence of suicide.
Suicide is a global event which occurs all over the world with the World Health Organisation (WHO) reporting that up to 1 million people die by suicide every year, despite most cases not being reported. Eighty-five percent of suicides occur in Low and Middle Income Countries (LMIC), of which Nigeria is one.
“Financial status is one of the things that can make a person want to commit suicide. During the global economic recession, there were a lot of suicide worldwide,” says Dr. Raphael Emeka Ogbolu , Consultant Psychiatrist and Coordinator, Suicide Research and Prevention Initiative (SURPIN) and Staff Emotional Care Services (SECS). SURPIN/SECS, LUTH.
A recession is a significant decline in activity across the economy, lasting longer than a few months. It is visible in industrial production, employment, real income and wholesale-retail trade. The technical indicator of a recession is two consecutive quarters of negative economic growth as measured by a country’s gross domestic product (GDP), although the National Bureau of Statistics does not necessarily need to see this occur to call a recession.
Suicide is preventable, but there is a lack of prevention strategies in most countries including Nigeria. Experts say one way to prevent suicide is to take care of our mental health, especially because depression is a very significant cause of suicide.
Apart from depression, suicide risk is also associated with substance abuse especially alcohol, chronic painful medical conditions, terminal medical illnesses, social isolation and lack of support and other major mental health problems.
It is important to note that suicide idea and risk affect not only adults but can also affect adolescents. Stakeholders and the general public can effectively work together to help reduce the rate of suicide in line with WHO’s goals of reducing it by 10 per cent by 2020.
Recently, LUTH initiated a Suicide Prevention Service called the Suicide Research and Prevention Initiative (SURPIN) and Staff Emotional Care Services (SECS). “Events of the past few days have further underscored the need to commence these services immediately,” says Dr. Raphael Emeka Ogbolu , Consultant Psychiatrist and Coordinator, SURPIN/SECS
“It is hoped that the programmes will help save lives and prevent death by suicide both locally and nationally. we shall be collaborating with all relevant agencies. In that moment of desperation and utter hopelessness, what people need is a listening ear and support to help them choose to live on. Many of those who are so saved have come to thank God they did not take their lives. This is why we must keep trying to reach them, especially at that moment, by encouraging them to speak up and not feel ashamed.
Chief Medical Director(CMD), LUTH, Prof. Chris Bode said, “When people feel they are helpless, when they feel there is nothing else to do , they start considering taking their lives.I have two close people who took their lives and till today I feel guilty because I felt I should have done more to stop them. There is nothing in life I couldn’t have done for these people, but I thought everything was alright.
“So, there are people suffering around us, we must be each other’s keeper . One of the suicide cases was somebody I spoke with in the afternoon of that fateful day, a few hours later, I heard she was dead. I still feel guilty. I thought everything was alright. Everybody is special.
“A doctor lost a patient in the theatre, the doctor started crying, he was so emotional . He was asked to treat somebody else next day, he said no and asked, “Do you want the patient to die too?” He was depressed . Doctors are bad losers, we have to encourage them. Same goes for health workers.
“People should shun the stigma that seeing a psychiatrists means that someone is mad. You are not mad, you are doing the right thing. Psychiatrists are our friends. Again,movie scripts should be written to elevate ideals in the society and not to give people bad signals,” he said.
According to Ogbolu, “Every month, we see about four cases of attempted suicide in our hospital. The stigma of psychiatric health makes people not to come out when they have suicide intentions. Last week, a child took an overdose tramadol right under the mother’s nose, and she did not know. Let us look out for suicidal signs in people around us, ask after their welfare, their mental health, we could prevent suicide.
“LUTH has a Suicide Research and Prevention centre, anybody can call for counselling. One man in Maryland, Lagos, wanted to jump from a three storey building, he was nude. People gathered around and watched, nobody tried to stop him. I went to him, spoke to him and he changed his mind. He was taken to Yaba Psychiatric Hospital for care, today he is doing fine. So, suicide is preventable. In 2009, when we had a radio programme, a lady called and said she wanted to take a pesticide, we counselled her and she dropped the idea.
“WHO said that about one million commit suicide every year. Suicide is a criminal act. WHO is trying to decriminalise suicide, maybe, that may reduce suicide.
“It is not only depression that leads to suicide. Suicide is more associated with substance abuse disorders, especially alcohol. Most times, most people with suicide intentions have mental problems. So, it is not only depression that lead to suicide.
“ Suicide is not alien to our culture. In the novel, Things Fall Apart, Okonkwo committed suicide. So, suicide is not alien to us. The goal of WHO is to reduce suicide by ten per cent by 2020, and Nigeria should not be left out.
“Signs to show that a person may have suicide intentions include change in behaviour, increased alcoholism, changes in facial expression, loss of a loved one particularly if the loss was tragic, loss of sleep. When these signs manifest, ask questions.
“One of the protective factors against committing suicide is the available social support. If the individual’s social support lies heavily on his pastor, there is nothing wrong in going to see the pastor when the person is emotionally down. The single most important factor that will make somebody take his life is hopelessness,” he said.
Contributing, Consultant Psychiatrist, LUTH, Dr (Mrs) Yewande Oshodi, said, “Chronic illnesseses can make people want to take their own lives. So, suicide does not mean somebody is mad, it could be the person has emotional problem. If there was a family history, if there was a history of previous suicide attempts, there is a likelihood that the person can attempt again. Dissemination of information should be done carefully, don’t give information in a hurry that could cause emotional stress that could lead to suicide. When you see knives around the house, firearms, sharp objects, gather them and keep to prevent suicide,” she said.
Recognise warning signs
Depression carries a high risk of suicide. Anybody who expresses suicidal thoughts or intentions should be taken very seriously. Do not hesitate to call the local suicide hotline immediately.The best way to minimise the risk of suicide is to know the risk factors and to recognise the warning signs.Take these signs seriously. Know how to respond to them. It could save someone’s life.
Suicide is a potentially preventable public health problem. In 2014, the last year for which statistics are available, suicide was the tenth leading cause of death in the United States.. That year, there were nearly 43,000 suicides, and 1.3 million adults attempted suicide, according to the Centre Disease Control(CDC). Suicide is the second leading cause of death in people from age ten to 34.
Men take their lives nearly four times the rate of women, accounting for 78 per cent of suicides..
Risk factors for suicide vary by age, gender, and ethnic group. And risk factors often occur in combinations.Over 90 per cent of people who die by suicide have clinical depression or another diagnosable mental disorder. Many times, people who die by suicide have an alcohol or substance abuse problem. Often they have that problem in combination with other mental disorders.
Adverse or traumatic life events in combination with other risk factors, such as clinical depression, may lead to suicide. But suicide and suicidal behaviour are never normal responses to stress.
Other risk factors for suicide include: One or more prior suicide attempts, family history of mental disorder or substance abuse, family history of suicide, family violence, physical or sexual abuse, keeping firearms in the home, chronic physical illness, including chronic pain, incarceration, exposure to the suicidal behavior of others.
Warning signs that someone may be thinking about or planning to commit suicide include: Always talking or thinking about death, clinical depression – deep sadness, loss of interest, trouble sleeping and eating – that gets worse . Having a “death wish,” tempting fate by taking risks that could lead to death, such as driving fast or running red lights,losing interest in things one used to care about, making comments about being hopeless, helpless, or worthless, putting affairs in order, tying up loose ends, changing a will, saying things like “it would be better if I wasn’t here” or “I want out”, sudden, unexpected switch from being very sad to being very calm or appearing to be happy, talking about suicide or killing one’s self, visiting or calling people to say goodbye.
People should be especially concerned if a person is exhibiting any of these warning signs and has attempted suicide in the past. According to the American Foundation for Suicide Prevention, between 20 per cent and 50 per cent of people who commit suicide have had a previous attempt.
What to do to help
First, if someone you know appears to be depressed and is contemplating suicide, take that person seriously. Listen to what he or she is saying. Take the initiative to ask that person what he or she is planning. But don’t attempt to argue him or her out of committing suicide. Rather, let the person know that you care and understand and are listening. Avoid statements like: “You have so much to live for.” And ask if the person has sought help from a medical or mental professional, or if he is currently being treated by a mental health professional.
If someone you know appears to be depressed and talks about suicide, makes a suicidal gesture, or attempts suicide, take it as a serious emergency. Listen to the person, but don’t try to argue with him or her. Seek immediate help from a health care professional.
People who experience a major depressive episode are often suicidal. It is a key symptom of the disease. Some studies show that the neurotransmitter serotonin plays a central role in the neurobiology of suicide. Researchers have found lower levels of serotonin in the brainstem and cerebrospinal fluid of suicidal individuals.
In addition, suicidal behavior sometimes runs in families. Remember, any talk of suicide is always an emergency. Have the person talk with a health care professional immediately.
Where to get help
Encourage a suicidal or depressed person to seek the help of a mental health professional. Because the person may feel so hopeless that he or she may not think it’s possible to be helped, you’ll probably have to be persistent and go with that person.
If your loved one appears to be in imminent danger of committing suicide, do not leave him or her alone. Remove any weapons or drugs he or she could use. Accompany him or her to the nearest emergency room or call help lines.
TIPS ON HEALTHY LIVING : Take your holiday as a heart-warming time
The holidays can be a heart-warming time, filled with moments spent with family and other loved ones. While the season can tend to bring on a little stress to go with the festivities, don’t let it interfere with the magical spirit that only the holidays can usher in.
Following old traditions that have been in your family for decades can be fun, like placing a special ornament on top of the tree or pitching in for a special family dinner. But starting new traditions can be just as exciting. Let’s take a look at a few festive ideas to make the season memorable and a little bit healthy, too!
Decorate the house
Decorating can quickly become a favorite holiday tradition, especially when it involves warm cocoa and your favorite holiday playlist set on repeat.
Whether it be loading up the family to go search for the perfect Christmas tree or dragging your great-grandmother’s tree down from the attic, there’s just something about climbing a ladder and stringing it with lights and sparkling ornaments. Plus, it’s good exercise, especially when the mirth spreads to the outside of the house and the front yard!
Get outside and play sports
Many families love to watch the big game on TV around the holidays, but
it’s even better to be a part of it! Get your crew together for a friendly game of touch football, or find an ice skating rink. There are plenty of sporting ideas
that get you and your loved ones up and moving about after that giant dinner. Even a walk around the block could become a fun, healthy tradition!
Give to others
The holidays can be a great time to reach out to your community and help those in need. You can find a soup kitchen that could use extra volunteers to help with some of the meals around the holidays, or you can do something as simple as dropping a few dollars into a collection plate at work. Better yet, get rid of some of the clutter around your house and put together a box of donations.
Experience the arts
The holidays is a wonderful time to take in a thought-provoking play at the local theater or attend the symphony. Check the events section in your local newspaper, and you will be sure to find a myriad of fun activities that quickly become annual traditions, whether it be going Christmas caroling or taking in the seasonal display at the city art museum.
Spruce up healthy treats
While you might be tempted to overindulge in the Egg Nog and eat your fill of your aunt’s famous peanut butter fudge, remember that there are fun, healthier treats that can be quick and simple to make. Try some gluten-free gingerbread with a low-fat icing in holiday colors or dark chocolate squares topped off with confetti sprinkles.