Young people in Nigeria and suicide

It was nice seeing you during the recently concluded National Health Dialogue in Abuja. Kudos to your efforts in being a champion of health for over two decades now. Please as someone mentioned during the conference ‘mental health’ is neglected in Nigeria and also we are recording increased rate of suicide among young people. I will be happy if you can shed more light on it.

Fatima X.

Thanks for your question Fatima, and good to know that you found our humble contributions to the health sector useful. The World Health Organization (WHO) defines suicide as “the act of deliberately killing oneself. Risk factors for suicide include mental disorder (such as depression, personality disorder, alcohol dependence, or schizophrenia), and some physical illnesses, such as neurological disorders, cancer, and HIV infection.”

By way of introduction it has being documented that every year more than 800,000 people take their own lives 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. Suicide occurs throughout the lifespan and was the second leading cause of death among 15–29-year-olds globally in 2012.

Suicide does not just occur in highincome countries, but is a global phenomenon in all regions of the world. In fact, 75% 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.

Who is at risk?

1. There is a link between suicide and mental disorders (in particular, depression and alcohol use disorders).

2. 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.

3. In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behaviour.

4. 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. 5. By far the strongest risk factor for suicide is a previous suicide attempt.

Methods of committing suicide

1. “It is estimated that around 30% of global suicides are due to pesticide selfpoisoning, most of which occur in rural agricultural areas in low- and middleincome countries.

2. Other common methods of suicide are hanging and firearms.

3. Knowledge of the most commonly used suicide methods is important to devise prevention strategies which have shown to be effective, such as restriction of access to means of suicide.”

How to prevent and control suicide

1. Reducing access to the means of suicide (e.g. pesticides, firearms, certain medications).

2. Reporting by media in a responsible way.

3. Introducing alcohol policies reduce the harmful use of alcohol.

4. Early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress.

5. Training of non-specialized health workers in the assessment and management of suicidal behavior.

6. Follow-up care for people who attempted suicide and provision of community support.

Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labour, agriculture, business, justice, law, defense, politics, and the media. These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide.

Some challenges

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1. 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.

2. 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.

3. Resources and time in raising community awareness, training of social workers with skills to identify risk factors of suicide and provide support to those at risks is very key and still a challenge.