Suicide Prevention: Our collective responsibility

On all fronts, Nigerians and Nigeria needs to do better in handling mental health issues.

Promethazine till the morning, hope I don’t wake up tomorrow”, Roddy Ricch says oh so casually on the chorus of “War Baby”. At first, the morbid sentiments glaring out of the line will take you by surprise, but when you think about the fact that 40% of adults suffer from a mental illness and approximately one million people die of suicide each year, globally, Roddy Ricch’s casual ideation feels more like a vulnerable confession of the dark thoughts far too many of us are familiar with.

In 2016, using global data, the World Health Organisation estimated that suicide was the second leading cause of death in the youthful population. Here in Nigeria, last year, we saw a harrowing spike in the number of people taking their lives, and out of the 42 Nigerians who had been reported to have committed suicide in the first six months of 2019, 11 of them were students.

As well as pre-existing mental illness or temporary psychological fragility, other factors such as financial instability, chronic illness and/or pain, issues in relationships, substance abuse, insufficient support in dealing with these problems and life’s other stressors can cause one to make an attempt. When considering these things within the African context, most of these risk factors are magnified. Research has proven that low-income earners, individuals with poor physical health and drug users are more likely to make attempts on their life, so when considering that majority of the continent’s population are living below the poverty line, healthcare is notoriously inadequate, and there’s an opioid epidemic brewing, these statistics grow even more worrying. In Nigeria specifically, marital issues (within and without marriage) have been proven to be one of the leading triggers of suicidal thoughts, with research showing that unmarried women were more predisposed to suicidal ideation.

However, given the gravity of this particular cause of death, the existing research and anecdotal accounts that prove that suicides are being attempted at alarming rates, we Nigerians, and arguably Africans as a whole, have a generally apathetic approach to mental health issues. Though social media is increasing our awareness and sensitising more and more young Nigerians, the lingering stigma surrounding mental illnesses and the lack of data leaves many people with terrible misconceptions about matters of mental health.

For one, most people still only recognise specific mental illnesses, completely overlooking eating disorders, personality and mood disorders, anxiety disorders and even post-traumatic stress disorders. Clinical Psychologist, Samul Adekunle Junaidu, in explaining why mental healthcare is an important asset in suicide prevention, tells Daily Trust, “I think it goes down to the kind of awareness in our environment, where, you see somebody all dressed up very well but when the person tells you that he or she has mental illness you ignore thinking maybe he or she is not very serious.” What Junaidu refers to is our inability to conceive that somebody is genuinely unwell, unless they are exhibiting it clearly, especially when this has to do with mental health. Even then, when a person’s behaviour is erratic, unhealthy and clearly unstable, society tends to vilify that person, as opposed to compassionately consider the fact that they might be going through a bout of psychological instability, due to immediate triggers combined with (or sometimes not) a preexisting mental health disorder.

Junaidu went on to say, “mental illness plays a large role in people attempting and committing suicide. This could result from stress, overwhelming situation, it could be because of depression; there are several situations, where an individual could commit suicide.” We saw this play out live on national television in the Big Brother House last Saturday, as Erica’s inability to cope with the stress and overwhelming situation she had found herself, led her to a breakdown and suicidal thoughts, thinking and feeling that she is better off not being here.

Suicidal thoughts, or suicide ideation, refers to thoughts or even plans about dying or taking your own life. Suicidal ideation exists in two forms: the passive and the active, the latter of which we more readily recognise as suicidal thoughts because it includes intent and plans to kill oneself. “I’m going to kill myself” is what we expect a suicidal thought to be, however Roddy Ricch’s “hope I don’t wake up tomorrow” and Erica saying “I shouldn’t be here, I’m only here because my parents made a mistake” are both also suicidal ideations. These statements are what would constitute passive suicidal ideation (wishing you were dead or that you would just die without actual plans of suicide), and equally deserve our attention and medical care.

Our conditioning of what we consider to be suicidal thoughts and the reality of the harmful ideations that plague people’s minds are less than accurate. The thoughts can range from creating a detailed plan to having a fleeting consideration, and does not (always) include the final act of suicide. This, however, does not mean that we should disregard passive suicidal ideations though, because people who are suffering are not offered the right kind of attention, it could end in them committing the final act. Contemplating suicide is usually a symptom of an underlying issue and typically the final result of mental illness left untreated. Owing to the stigma that exists and our general lack of primary concern, most people who are thinking of taking their own lives do not seek help. As a society, we ought to create an environment which accommodates people who are candidates of feeling this way and nip it in the bud before it gets there. We’re all quick to attend to physical illness or harm, as the effects are immediate and visible, with a desperate need to prevent this harm deteriorating to death, however, we fail to understand that with a mental illness, it is quite the same.

As a country, one of the first steps we must take is to decriminalise attempted suicide. In Nigeria, according to our Criminal Code, attempting suicide is illegal and individuals found guilty of the ‘misdemeanour crime’ could face up to one year in prison. In the Gambia, Uganda, Malawi, Kenya, Tanzania and Ghana (where it’s also a misdemeanour) attempted suicide is illegal too. According to a criminal law paper written by Cheluchi Onyemelukwe, one of the justification for criminalising attempted suicide is for the law to act as a deterrent, so people won’t want to attempt for fear of going to jail. Onyemelukwe’s first rebuttal to that argument is that most Nigerians do not even know of the existence of such a law. In the event that they do, however, most people attempting suicide wish to be successful, therefore, by their estimations, no crime would have been committed as they wouldn’t have attempted suicide but succeeded at it. By the time someone’s mental wellbeing is being challenged and they are contemplating suicide, the added pressure of being considered a criminal in the eyes of the law and morally reprehensible in the eyes of our hyper-religious society, compounds onto their stress and doesn’t encourage the individual in need of help to seek it.

If the case escalates to incarceration, even more hopelessness and depression will set in, not to mention that putting someone in prison doesn’t alleviate their stress or worries, nor does it improve their finances, mental health, relationship issues, or whatever the trigger(s) toward their attempt were. We need to deal with all those things through public health laws, and not criminalisation. According to The Premium Time, “the federal government said it had expended N500 billion on its social investment. The irony of it all is that not even a dime in such momentous intervention was dedicated to any issue related to mental health.” There have been many criticisms of the national budget, and inadequate support of and investment in mental healthcare is yet another shortcoming of our federal government, that we need to demand they improve.

Onyemelukwe’s paper shares the detail of who a man attempted suicide after being arrested for killing himself. Whilst Lagos State has amended the Criminal Code Law (the only state to use that right in relation to this law), the state’s courts are tasked with making a hospitalisation order. Though this is a progressive step in recognising that people who attempt suicide are in need of medical care, by dragging them to court, we are only adding to the trauma with which they’re already burdened. Criminalisation must be stamped out in all forms for us to truly take a step in the right direction when it comes to looking after our people.

Next, we must take as a society is to reframe our perspectives. Nollywood movies, for example, have a history of portraying “madness” as a punishment for evildoing, which has trickled down into common thought, as the The Federal Neuro Psychiatric Hospital located in Yaba, popularly known as ‘Yaba Left’ is often used as a tactic to scare children into good behaviour, if it’s not serving as the punchline of a joke or particularly descriptive insult. Instead of praising the function and existence of such an institution, we have made it the butt of our derision, thereby isolating patients who need our support most of all, and discouraging people with mental illnesses from seeking help for fear that they too will become the rimshot.

Once our attitudes toward suicide and mental health issues as a whole becomes less mocking,  judgemental or even blissfully ignorant, then we can focus on properly educating the population on mental health. This isn’t something that Nigeria or Africa alone are struggling with, the world at large is guilty of neglecting mental health issues or treating them with little care. Kanye West, who most people are aware has been diagnosed with Bipolar Disorder, is very often derided when he is going through a public episode. Big Sean in his latest album ‘Detroit 2’ spoke about being taught science but not how to deal with his anxiety on the Nipsey Hussle-assisted “Deep Reverence”.

In our Issue 004 cover story, the girl on fire, Tems revealed that she had once hurt herself in school, seeking for a physical pain to numb the psychological pain she was feeling. Davolee, on ‘Festival Bar‘ tracks 3 and 4 talks about leaning on drugs and alcohol (even though he knows that’s who he truly is) to cope with the pressure of success, which drove him into depression. Both Tems and Davolee, when they were going through some of their harshest life trials looked to harmful means to subside their trauma. According to Dr Ani Kalayjin of Colombia University and president of the Association for Trauma Outreach and Prevention a lot of Nigerians experience trauma that causes depression, hopelessness and when this isn’t dealt with, the trauma culminates in PTSD, which is another risk factor for suicide. If in Nigeria, we paid closer attention to mental healthcare, both medically and supportively as a society, then Tems, Davolee and other Nigerians who face trauma on a daily basis – from loss of economic stability due to our ever devaluating currency, to being stopped by SARS and unsure of your fate – would have the right help to deal with their trauma, such as cognitive behavioural therapy, mindfulness therapy, and wouldn’t have to turn harmful solutions to temporarily drown their pain.

LVRN – the Atlanta label to which Cruel Santino is signed, as is Summer Walker, who has been very open about her anxiety disorder – have set up a mental health initiative for their artists, in order to ensure that their talent is given the care they need to manoeuvre fame and the mentally challenging stressors of the music industry. After contestants leave British summertime TV show, Love Island too, they are linked with a counsellor before the reenter the ‘real world’, their families also are offered counselling. This is an initiative Big Brother Naija too should adopt, and instead of the figurehead punishing her for spiralling out of control, Erica’s cry for help should have been taken more seriously and she should have been offered support and care. Simply being booted off and shoved back into a society that literally celebrated her loss could prove to be more harmful to her well being than not.

On all fronts, Nigerians and Nigeria needs to do better in handling mental health issues. We ought to make a conscious effort to cultivate a climate in which mental illnesses are not vilified, mocked or dismissed, an environment conducive to seeking help and receiving support, and a country in which attempting suicide is met with concern and not a criminal record.

We need change, so let’s forge it.

Written by Adewojumi Aderemi and Damilola Animashaun