By Doris Obinna
Describing suicidal behaviour as a mental health issue, consultant psychiatrist, former chief medical director at the Lagos State University Teaching Hospital (LASUTH), Dr. Femi Olugbile, has termed it deliberate self-harm, leading to death of the individual.
According to Olugbile, suicidal behaviour refers to behaviour such as deliberate self-injury or the taking of an ‘overdose’ (poison) that appears directed at causing death or severe injury to the individual.
He said: “Suicidal attempt description is frowned at by some authorities because it is perjorative and appears to carry an implication of criminal action. While deliberate self harm is used to describe self-injurious behaviour that has not resulted in the death of the individual, either because it was programmed that way or something else intervened. It is therefore, important to understand suicide as illness.”
The United State National Library of Medicine defined mental disorders (or mental illnesses) as conditions that affect thinking, feeling, mood, and behaviour. They may be occasional or long-lasting (chronic). They can affect your ability to relate to others and function each day.
“Mental health includes our emotional, psychological and social well-being. It affects how we think, feel and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.”
Olugbile, who spoke at a recent webinar with theme “Responsible Suicide Reporting: Role of Nigerian Journalists,” organised by The Nous Charity Incorporated Organisation and Mental Health First Aid Instructors, in collaboration with Health Writers Association of Nigeria (HEWAN), urged journalists to embrace the approach of reporting suicide as a disease.
“More than 90 per cent of people who commit suicide suffer from an associated physical or mental health condition. Chronic physical illnesses, especially those associated with pain, may be associated with suicidal thinking and incidents of ‘completed’ suicide.
“The overwhelmingly significant correlation is with mental illnesses. The commonest mental disorder associated with suicide is depression, anxiety, panic disorder, schizophrenia; substance abuse may also be associated,” he said.
Explaining further, Olugbile noted that: “While a few culturally determined incidents of suicide occur from time to time, for instance, the Japanese ritual of seppuku, and euthanasia-on-demand, which is legal in a few places, is not generally regarded with the stigma attached to suicide, there is stigma attached to suicide all over the world.
“This pertains not just to the individual but also to the family, and is especially severe on the nuclear family. Indigenous Nigerian culture frowns at suicide, irrespective of cause. It is ‘shame on the family.’ Some would not allow religious funeral service or burial in normal burial sites.”
Continuing, he said, the 2015 Lagos Mental Health Survey showed that about eight to out of every 1,000 adults (7.6 per cent of the adult population) had suicidal ideas in the previous two weeks.
“The rate of death by suicide for Nigeria is 6.9 per 100,000 population per year. That is, about seven out of 100,000 Nigerians die by suicide in a year with the most affected below the age of 30 years and are more common among females, while completed incidents are more in males.”
Need for national suicide prevention strategy
Also, founder of Nous Foundation Nigeria, Lade Olugbemi, who spoke on “Responsible Suicide Reporting (RSR): The Social and Legal Implications,” called for a national suicide prevention strategy in line with World Health Organisation’s directives to tackle the menace of suicide in Nigeria.
Olugbemi, a UK-based Nigerian lawyer, said the Coroner’s Act and the role of the coroner should be made more active in disclosing the source of death. He pointed out that, in Section 327 of the Criminal Code Act, suicide is a crime in Nigeria, punishable by one-year imprisonment for a failed suicide attempt.
He said Nigeria’s law on suicide “is a legacy of old laws from the era of British colonisation,” noting that similar provisions in other African countries de-criminalise, instead of criminalising, suicide attempts.
Olugbemi frowned at the manner of reporting suicide by the media, stating that the media is a risk factor in the way and the manner it reports on suicide. He tasked journalists to be cautious in the choice of language when reporting on the subject.
“Be more aware of critical risk factors like levels of sensationalism, stigmatisation, copycat effects, harmful speculation, etcetera.”
Suicide as mental illness
Explaining why it is important to understand suicide as illness, Olugbile said there was a need for paradigm shift.
“Existing Nigerian law treats suicide as a criminal act. The survivor in a suicide scenario is regarded as a culprit and not a victim or patient, as there is judgement and not compassion or empathy of which the family are often regarded as guilty by association.
“The press (the professional press and the citizen press of the social media) in their approach to the reporting of suicide, often reflect the suicide as sensational criminal incident rather than suicide as Illness approach, which is the evidence-based, humane and modern approach.”