Of Suicide and Health Workers’ Call for Mental Health Bill

With the recent call by psychiatrists in the country for the setting up of Mental Health Bill into law, Odimegwu Onwumere writes that there is need to pay heed to the call given the concerted and coordinated concern that a sound mental health requires to help curtail suicide

The suicide buzz has left healthcare workers in Nigeria in a helter-skelter mood and they are looking for solution to curb the operation in the country.
On March 19 2017, one Dr. Allwell Oji, a 35-year-old medical doctor said to be working with Papa Ajao branch of Mount Sinai Hospital in Lagos, took his life.

Dr. Oji threw himself into the lagoon at the Third Mainland Bridge, Lagos. Nigeria has been awash with all manner of stories surrounding his death ranging from a diabolical call he got to other sinister stories. But, it is suicide!
The health sector feels devastated if it cannot arrest further situation given that after the incident, some Nigerians apparently have attempted suicide and reports say that many are still promulgating the idea.

Opinion leaders say that the suicide attempters might not know that suicide is restricted in the Nigerian law and this is contained in Section 327 of the Nigerian Criminal Code. And the law states, “Any person who attempts to kill himself is guilty of a misdemeanour and liable to imprisonment for one year.”
According to them, “If the attempters knew that suicide was illegal, one Taiwo Titilayo Momoh, a textile dealer at Balogun Market, and Mrs. Abigail Ogunyinka that wanted to take their lives by jumping into a river, just six days after Dr. Oji took his life, would not have attempted that.”

However, a consultant psychiatrist at Lagos University Teaching Hospital, LUTH, Dr. Yewande Oshodi is among the persons that raise awareness on the issue. Dr. Oshodi who was among the professionals that gathered at LUTH to campaign against suicide on March 25 2017, made this known:

“Suicide is most unwanted incident anyone could like to experience either by losing a loved one and it is preventable to some degree. The stigma of psychotics and mental health makes it difficult for people to come out when they are going through issues.”
Specialists in the health sector are gearing to map out measures to save Nigerians from depression given an account by the World Health Organisation (WHO) which predicts that sicknesses like cancer, stroke, HIV/AIDS will be a tap at the back to the pending disaster people will suffer from depression by the year 2020.

This being heralded, health experts say that Nigeria has been showing untoward attitude to mental health. For instance, the Association of Psychiatrist in Nigeria (APN) says that the authorities have shown deaf ears in its harangue that the mental health bill should be passed into law as the number of victims is increasing.
The healthcare workers have however called on the senate to pass the Mental Health Bill into law in order to arrest the psychological problems that might be besetting some citizens. Investigations therefore reveal that since 2003 a new Mental Health Bill was introduced and Nigerians were in high hope that succour had come their way.

But this patronising idea of a Bill ended on the floor of the Senate, without a passage of it into law. In 2008, it was yet expected that the Mental Health Bill had been passed into law. Those who know better say that when the Bill was raised in 2003, “The Bill lacks certain provisions that are now considered de rigeur in mental health law internationally.”

Fourteen years after, opinion leaders in the health industry frown at this, saying that the country is still operating legislation on mental health which is the Lunacy Act, 1958, following the Lunacy Ordinance, passed in 1916.
From Lagos to Lokoja and sundry, medical professionals like Dr. Moruf Mustapha and Dr. Oluwadamilola Ajayi raise their voice in requesting for a mental health law with the belief that it is not a bad idea to have the law.

Their fear is heightened on a confirmation showing that Nigeria is not working with more than 500 psychiatrists who are practicing in Nigeria: A country with an estimated population of 180 million people.
Worried by this, statisticians crux that what this means is that 360,000 citizens are cared for by just one psychiatrist and this is a far too burden of load. Professionals’ anguish, as they bare their minds on the subject, is that mental disorders are rarely diagnosed in the country and treated.

Consequently, it becomes stealthy that one in half a dozen persons have trait of this disorder in their life time with depression being a major perpetrator. They narrate their tribulation that depression is an ailment that must be cramped before sufferers pull the line of suicide. In their words, “Depression is not profound sadness; it is not just an inability to cope with life experiences; it is not caused by a character or personality flaw; it is not a moral failing, neither is it a spiritual affliction.”

This is even as the WHO states, “Every year more than 800, 000 people take their own life and there are many more people who attempt suicide. Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind.”

At a public lecture recently, Consultant Psychiatrist, Irrua Specialist Teaching Hospital, Edo State, Dr. Obagaye Olukunle said that “80 per cent of people who commit suicide have psychiatric diagnosis.”
Olukunle’s voice suggests that where there is a decline in psychiatric handling in the country, tendencies of psychiatric disorders skyrocketing is not farfetched and this might as well lead to suicide.

Dr Oshodi adds, “Over a five-year study period, 7.2 per cent of cases referred to psychiatry consultation – liaison services in LUTH – were cases related to suicide. Reports had shown that during lifetime, about 3.0 per cent of Nigerians have had thoughts about ending their lives, 1.0 per cent will plan on how to kill themselves, while just under 1.0 per cent will carry out an attempt to kill themselves.”
Against this setting, the WHO has made it a necessity in its Mental Health Gap Action Programme (mhGAP) launched in 2008. This initiative harnesses “evidence-based technical guidance to scale up service provision and care in countries for mental, neurological and substance use disorders.”

As if not done with that, in 2014, the international body launched the first WHO World Suicide Report tagged ‘Preventing suicide: a global imperative’. Those who know better say that the publication was aimed at raising awareness beyond bars in the areas of the importance of public health, and make suicide prevention a topmost issue on the universal health agenda. Developing countries like Nigeria are being supported by the body and given foster mapped out for formidable suicide prevention methodologies.
The WHO is of the view, suggesting that, “Stigma, particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and are therefore not getting the help they need.

“The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health problem and the taboo in many societies to openly discuss it. To date, only a few countries have included suicide prevention among their health priorities and only 28 countries report having a national suicide prevention strategy.”
The United Nations body adds, “Suicide does not just occur in high-income countries, but is a global phenomenon in all regions of the world. In fact, 75 per cent of global suicides occurred in low- and middle-income countries in 2012.

“Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions. For national responses to be effective, a comprehensive multi-sectoral suicide prevention strategy is needed.”
It is hoped that Nigeria, as among the WHO Member States, will work in line with the WHO Mental Health Action Plan 2013-2020, dedicated towards reducing the suicide rate globally to 10 per cent by 2020.