Health Post

Dear All,

In our centre we welcome this editorial by The Guardian – it is good that such a powerful member of the media should devote an Editorial to the ‘cancer’ of suicide plaguing our country.

The editorial covered useful grounds of what may help stem the tide, from the personal to family and religious houses and civil society. But in our view it missed out quite a few major actions that Nigeria as a country needs to take right away: Pass the Mental Health Bill into law; establish a community focused mental health service anchored on the primary health care level which is nearer to the places where citizens live and work and play and socialize for the country like was started in Cross River state in 2004 (following in the footsteps of the Late doyen of Psychiatry in Nigeria Late Professor T A Lambo; establish a social safety net for Nigerians ( social security) that guarantees the few basic essentials for all citizens – shelter, food, health and pocket money. The news of suicide that we have heard recently gives the wrong impression that those affected come from the middle classes, because we really never hear of the very poor who take their lives in the villages, nooks and cranies of our country. Such a mental health service would need time to set up but as the Chinese say, the journey of a thousand miles start with the fiurst step- Nigeria can make a start now by the National Assembly (NASS) passing the Mental Health Bill and Mr President signing it into Law. That Bill has been in the NASS for almost 12 years, we are told.

WE agree with The Guardian that we should ‘be our brothers keeper’ but to think that we can recreate the old loved ‘African society’ is wishful thinking – the 21st century Africa is too different from that nostalgic society where up to five or more generations of a family lived together with the elders bringing up the children who grow up to take care of the elderly is far gone. Nigeria and indeed Africa must look to adjust to realities of today’s society of upwardly mobile and emigrating populations.

Getting the Mental Health Bill passed will be a very good start to establishing promotive, preventive, curative and rehabilitative mental health service for Nigeria that can help to curb the rate of suicides:

It is very unfortunate, even heart-breaking, that more Nigerians are taking the sad and tragic route of suicide or attempts at it out of their problems. The suicide case of Dr. Alwell Orji made headlines and the whole nation has been left heart-broken. In broad daylight, he alighted from a chauffeur-driven car on the Third Mainland Bridge in Lagos and took a deadly plunge into the lagoon. His body was retrieved from the depths of the lagoon days after. There were two other reported cases during the period. An undergraduate final-year student decided to end it all at Ladoke Akintola University Ogbomosho, Oyo State by hanging himself. A businesswoman in Lagos took a plunge into the same Lagos lagoon but was promptly rescued by men of the Nigeria Police. She complained that she was hugely in debts after being swindled by a bureau de change operator and wanted to end her life to avoid shame. The psychiatric hospitals across the country have also reported an upsurge in the number of persons presenting themselves for treatment .

Indeed, experts say that there are millions of people who have one form of mental disorder or another without knowing it. The figure given by World Health Organisation (WHO) is frightening. Over 350 million people worldwide suffer from depression. Some men who subject their spouses to routine physical or verbal abuse may be suffering from a form of mental disorder. Also, some persons who have a permanent gloomy outlook on life or who easily give in to violence may need psychiatric help. Persons who are unduly anxious may also be on the way to depression. Mental disorder can also manifest as anti-social behaviour like avoiding groups, friendly exchanges, family, friends and fellow employees.

A suicidal act is a cry for help on the part of the victim. For most, it comes too late. It is often the end-stage of depression. Some persons who have gone through tough challenges or crisis and who feel that there is no hope or no need to continue in life seek to terminate their lives abruptly. They succumb to months or years of feeling worthless or unwelcome. Often their loved ones miss all the signals of despondency. When some loved ones see the signals they are often helpless, so enmeshed in their own problems that they hardly have the time and resources to confront the problems of others. It is true that some mentally ill mask their pain and frustrations, appearing cheerful to people but dying gradually within.

One of the ways suicide cases can be minimised is through education and social security. Traditionally in African countries, depression which manifests in different forms is treated as a curse or the result of trafficking with spirits. The truth is that mental depression is not an attack from witches or ‘evil forces.’ Depression is like any other illness; its only difference is that it attacks the mind. Victims are hardly in control of their thoughts and actions. It is not a taboo. It is not the result of evil actions. It is a case of the mind weakening and getting distorted when assailed by severe or deadly incidents.

Families which have mentally-depressed patients or persons should show more love for their kin. It is stressful looking after a loved-one who suffers from mental disorder. Social support and expert advice as well as help are crucial in handling mental cases. Once a person shows such symptoms, he should be promptly taken to a psychiatric home for evaluation and treatment. While treatment is on in the hospital, the patient needs social and family support. After being discharged from hospital, that support is more crucial. Always, patients need to be urged or reminded and monitored to take their medication. Tying up such persons and giving them the harsh treatment does not help. It simply aggravates the problem.

The tradition of being our brothers’ keepers for which the typical African was known appears to have been whittled down by the pressures of modern life. In times of distress, whether in form of illness or loss of job or material things, each person needs to stand by his or her brothers and sisters. Such support provided by family and friends help distressed persons to overcome trauma. Anyone can suffer a breakdown. Thresholds may differ. But anybody can become a victim of mental ill-health.

Another problem which mental health victims suffer is stigmatisation. People tend to stigmatise persons who have suffered a mental breakdown or some peculiar ailment. Employers also do. Such persons also suffer discrimination sometimes within a family. It is worse in the social environment. The fact is that with proper medical attention, a mentally-ill person can function effectively and live a normal life. Marriage and the support of close persons help persons with mental health challenges to carry on in life.

In these hard times, there is need to stress hope as a reason to live. To have hope, all need to have faith, ‘the substance of things hoped for.’ With faith and hope, people are unlikely to degenerate into despondency. Hope should be reaffirmed and preached whenever the opportunity offers itself. Therefore, the churches and mosques have a role to play in this. Out of the ashes of defeat, so many people have emerged to clinch success and victory in life. A temporary loss does not translate into total failure in life. Parents are obliged to bring up their children stressing the positive always. They should, however, educate kids on how to cope with life’s challenges.

The Federal, state and local governments as well as non-governmental organisations have a role to play as well. Help lines should be established nationwide. Such bodies should educate the public in order to create awareness about this incipient condition. Post-treatment facilities should also be established so that institutions can provide a framework for recuperating persons who lack sufficient family support.

However, once a feeling of sadness or gloom continues, one must seek professional help immediately. Psychologists and psychiatrists trained to handle such disorders can help to control and lift the individual out of the condition. A man who had attempted suicide once is more likely to try it again except effective treatment takes place. The abhorrence of psychiatric help is the result of ignorance. If depression is left unchecked for a long time it could result in suicidal thoughts or suicide. People need to be educated that if they do not feel right either mentally or physically, they should seek professional help.’’

 Joseph Ana

Africa Center for Clin Gov Research & Patient Safety
@ HRI West Africa Group - HRI WA
Consultants in Clinical Governance Implementation
Publisher: Health and Medical Journals
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Cross River State, Nigeria
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