World Health Day: Can we Talk About Suicide?

One can indeed admit that attention to issues around mental health has never been so discussed as we now have perhaps as a result of the increase in reported cases of suicide esecially among Professionals.

There is no dubt that many people cannot really understand  why anyone would want to comit suicide? What it is to be depressed to the extent of nursing the thought of taking one’s life and so it may be difficult to identify the symptoms of depression until it is perhaps too late.

As attention is again focussed on this aspect of mental health, the World Health Organisation has identified the need for everyone regardless of who we are to begin to talk about this important aspect of health..mental health and depression.

In a recent presentation at the anual symposium of Health Writers Association of Nigeria (HEWAN) Week, Consultant Psychiatrist, Federal Neuro-Psychiatrist Hospital, Yaba, Lagos, Dr Stephen Olamide Oluwaniyi in a paper titled: ‘Mental Health in a Recessed Economy’, identified some dimensions to mental health of every individual.

According to him, “Mental Health and Wellbeing is linked to Emotional resources e.g. mood, coping styles and so on; It is also linked to Cognitive  resources  e.g. learning styles, flexibility and creativity; it has link with Social skills e.g..Listening, relating, communicating, co-operating and finally, it is linked with Meaning and purpose e.g. vision, goals, values and connectedness”.

Oluwaniyi submitted, “Optimal functioning in these various aspects constitutes positive mental health. This is what is required for a meaningful and productive life”.

Noting, “We all have mental health, just as we all have physical health and people living with a mental disorder can experience positive mental health, and an individual may experience poor mental health without a mental disorder.

“And of course, there are a range of personal, social, economic, and environmental factors that influence health status at individual and community levels. Such as personal or individual determinant, social factors, physical environment,government policy (Health policy, educational policy, economic policy, control of psychoactive substance use and  road safety) said Oluwaniyi.

Marking the pre-recession profile of the country, Oluwaniyi noted, “Even before the onset of recession Nigeria has been classified by the World Bank as a Low Income Country. She has: The prevalence of mental illness was reported at 20%, The ratio of psychiatrists to population was 1:1,400,000, An out-dated Mental health policy

Continuing he said, “Prior recession, The proportion of health budget to GDP is 3.4%. In per capita terms, public spending on health stood at less than $5, far short of the $34 recommended by WHO for low income countries within the Macroeconomics Commission Report.; About 3.3% of the health budget of the Federal government goes to mental health, with over 90% of this going to mental hospitals and The cost of antipsychotic medication for a day was N42 (7% of the minimum wage of N18,000) and majority still paid out of pocket”.

He lamented further, “Majority of mental health services are provided by the regional stand alone mental hospital contrary to the WHO recommendation for integrating of services into primary care at the community level. This often resulted in negative effect on continuity of service. There are no social programmes specifically targeting the needs of people with mental illness, and a large number are left to their fate” said Oluwaniyi.

With recession which he describes as “A business cycle contraction which results in a general slowdown in economic activity, there was results in decreased GDP, investment spending, household income, business profits, Unemployment and bankruptcies rates increase and in our own context, prices of various commodities including medicaments have risen considerably”.

The effects of recession in absolute terms therefore means, “it is now more difficult for people to access health care since a significant proportion of the population still depends on direct out-of-pocket payment.

“As a result of dwindling revenue, government may reduce total health spending. If this happens, accessing health care will be more difficult for the masses. Therefore, in recession the protective factors diminish while the risky factors prevail”, Oluwaniyi warned

Consequetly, the Consultant Psychiatrist pointed out, “.Poor mental health may manifest as feeling of distress, dissatisfaction , persistent irritability, aggression, and reduced productivity without specific mental disorders.

“On the other hand, it may manifest as diagnosable mental disorders such as anxiety disorders, mood disorders or psychoses, and substance related disorders and If mental disorders are not promptly and adequately treated they may lead to poor productivity, disability and mortality-suicides”.

He thus alerted, “There are indications that the current recession is already having negative effects on mental health of Nigerians and since positive mental health is fundamental to well-being, productivity and effective functioning, appropriate interventions at individuals and community levels are required to mitigate the negative effects”..

Key facts on Suicides:

  • Close to 800 000 people die due to suicide every year.
  • For every suicide there are many more people who attempt suicide every year. A prior suicide attempt is the single most important risk factor for suicide in the general population.
  • Suicide is the second leading cause of death among 15–29-year-olds.
  • 78% of global suicides occur in low- and middle-income countries.
  • Ingestion of pesticide, hanging and firearms are among the most common methods of suicide globally.

Who is at risk?

According to the World Health Organisation (WHO), while the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established in high-income countries, many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness.

In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behaviour. Suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, intersex (LGBTI) persons; and prisoners. By far the strongest risk factor for suicide is a previous suicide attempt.

 

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