How to reduce rising cases of suicide among teenagers in Nigeria, by MASHI

Recent studies have alerted to rising cases of suicide among teenagers and provided more reasons why Nigerians should visit psychiatrists and psychologists more often. Indeed, several researches have identified poor mental health care especially treatment of depression and post traumatic stress disorder as leading causes of suicide among the young population. To reverse this menace, a Non Governmental Organisation (NGO), the Mind And Soul Helpers Initiative (MASHI), has called for collaborative efforts among stakeholders, dedicated awareness programmes and government intervention. Founder, MASHI, and Head, Department of English, University of Lagos, Akoka, Prof. Hope Eghagha, in an exclusive interview with The Guardian proffers solution to reducing rising cases of suicide among teenagers in Nigeria. STANLEY AKPUNONU writes. Excerpts:

What inspired the establishment of MASHI?
We started off as a Facebook group with the name Help a Soul Alliance. We have about 10,000 members from all over Nigeria and different countries.

Recently we transformed to a mental health NGO now registered as MASHI. We have been concerned about the rate of suicide in Nigeria. It became something of public attention when young men and women started taking a plunge from the Third Mainland Bridge into the lagoon. We also held that young people are taking their lives, in the University of Lagos and Federal University in Abeokuta just to mention two. We have students took their lives with now notorious sniper.

I read about a young lady who took her life after a Facebook post. Looking at her she looks happy and smiling and she did not give an inkling to anybody in the environment that she is going to commit suicide, but by the next day she is gone and I started wondering what is going on. Why is it that young people have taken the route of taking their lives?

Worried by the trend, I started a discussion group, worked with a lot of professionals, counselors, psychiatrists, psychologists, nurses and enthusiasts, people who are also concerned.

What are the roles of the initiative to reduce the trend?
We report suicide cases; we take calls from persons who are depressed. We post things like, if you have suicide tendency let us know and the outcome has been amazing and overwhelming. We use the telephone to counsel people and when the need arises for referral we refer to hospitals and the individual talks to a psychiatrist. We have also found out there is a lot of ignorance about mental health and services of a psychiatrist.

Usually once you tell someone to go and see a psychiatric he will say, “I dey mad… why you go say make I go see psychiatrist, you dey craze, I no dey craze oh…”

One of the things to do is to create awareness among young people. We have started a series of lectures among young people in secondary schools. We take a professional who talks to them about suicide. We inform and educate people about suicide; we counsel and clear minds of people against the stigmatisation that comes with seeking help.

We need to do a documentary, in English and translate it to different languages and our partners across the country will play this in radio stations in the languages educating people. We also do talks, visit churches, mosques, and schools; anywhere there is assembly we talk to them and educate them about mental health.

Our plan is ultimately there should not be mad person in the streets of Nigeria because they do not have to be there.

What we have tried to do is to recruit people who are helpers; we have to create help lines for them across the country so that when you are going through that kind of distress you call and they talk to you. We are trying to establish a network with all the psychiatric homes in Nigeria.

What about the issue of stigmatization of persons with mental health issues?
Once you let it known that you visited a psychiatrist for help people will think you are mad. If it is in the office they look at you in a strange way.

When people have a psychological breakdown there are all kinds of reasons attributed to it. The most popular one in our country is the spiritual attack.

Sometimes, they say you have offended the ancestors or the village people, that you have committed an act of taboo. You find some highly placed educated people still parroting such ignorance.

Mental health is very important and mental health crisis can affect anybody without committing any offence and it does not need to be a spiritual attack. We come from a very superstitious society. We are looking at it from the scientific point of view that somebody who contemplates suicide; somebody with suicidal thoughts can be helped.

What have been the challenges towards meeting your vision?
We need funding, we need partners, and we do not say bring money but if you bring it is okay. Where a case is serious and the person needs a doctor, we need to subsidise the treatment. We need funds to do the documentary we talked about. We also need to go into movies using Nollywood series of 26 episodes focusing on different aspects of mental health. We want to design flyers, which we circulate.

We need institutional support, for example for someone who is in Calabar or Benin we do not have the resources to send somebody to travel all the way or send the person to hospital. We need the intervention of well meaning organizations. We have sent letters to MTN, Glo and 9mobile. We need help lines that would be toll-free lines.

Have you received any support from the government?
We want government to subsidies the medication for mental health. To get somebody into admission for two months you first deposit N120, 000 and the drugs are not cheap. Psychiatrics is not a popular branch of medicine. We want motivation for psychiatric medical students.

Anyone that wants to study psychiatrics should be given incentives. We do not have too many private psychiatric homes in the country because some will tell you it does not pay.

Government has a role to play, providing incentives for health workers in that profession is very important. They should also reduce the cost of drugs.

Most of the federal agencies, we need to double check things, attention is not really keen to mental health, it is unfortunate there are so many people who do not function well in different offices because they have mental disorder.

Do you have a personal experience?
I was kidnapped for 16 days held, tortured, beaten threatened by kidnappers. When I came out I had to go through counselling. I saw a psychologist, I saw a neurologist, I saw a psychiatrist, I just went to them and said look at my experience, and I went through this traumatic experience for 16 days. I was threatened with death.

The psychiatrist is not the enemy; soldiers who go to war and return usually suffer from Post Trauma Stress Disorder (PTSD). In the advanced world, when you fight and return you go through counseling because some do breakdown.

PTSD in Nigeria, we have 1.5 million cases each year but how many of them go for treatment? Take for instance, you have a very traumatic experience, armed robbers came, violated your privacy and raped you. The experience is just 30 minutes but it lingers in the memory for almost three years. In the advanced world, you go for counselling and they talk you out of it.

Our people say once a mad man enters the market you cannot cure the person again; that is not true. It may be a way to say that the thing has gone far but does not mean the person cannot be helped. Anybody with mental health challenge can be helped.

Some go throughout the entire life and people never knew. Some manage it, some seek help, some go to traditionalists, some go to pastors and Imams and a few go to see a psychologist or psychiatric; but there are some on the border line.

So you are recommending that Nigerians should start visiting psychiatrists and psychologists regularly?
Yes! The psychiatric cannot come to the public place and say come and patronise me, it is against the ethics of the profession but we who are enthusiasts that run the NGO have the obligation to educate Nigerians

Nigeria currently is going through serious economic meltdown and young people, the graduates, they cannot get jobs. We are not even talking about those who struggle for three to four years before gaining admission. It affects their self-confidence, they are not happy.

Some parents, I have been talking to them on how to handle these things. Then they entre the university and go through it for four or five years, some go through some stress within the university system. You finally graduate then wait for one year to go on national service, when they get to the service, they spend one year, that one year before national service is wasted they cannot work because they do not have a discharge certificate. They then manage to go, they are sent to place they do not like. They come home after the service no jobs some want to further; the funds are not there.

How can suicidal tendency be identified?
For some people depression starts slowly. They begin to question themselves, and their identity. Who am I? What am I doing in this world? Why is it that I have been forsaken? Why has the Nigerian state treated me like this? They ask these questions with no answers.

Gradually it leads to depression. They do not reason properly anymore. For some, they attempt to commit suicide. It affects young people but as we know age, status, wealth is no barrier or protection to mental health. It can happen to anybody.

At 58 a former adviser to President Obama, this year, committed suicide, had a wife and two kids Anthony Bourdain of Cable News Network (CNN) took his own life in France. Some parents drive their children to suicide, with talks like look at your mates, look at that person. You are just in this house eating and getting fat. Some kids will just get angry.

A mother talked to me that she was shocked when her ten years old daughter started saying she will end it all because she is fat, she is bullied at home and school, made jest of because she is fat. She said she is not going to school again, that she will end it all. They panicked, but I told them how to handle her because both parents cannot control her anymore.

What could be the causes of depression and suicide?
Sometimes, economic hardship can lead to suicide; shame, ignominy and disgrace can be spontaneous. For some, it is immediate reaction not as a result of depression.

For others, it is depression after a long time of experiencing hardship, they lose focus, and some hang themselves, some take over dosage of drugs, plunged into lagoon.

Whatever it is, termination of one’s life is not good. It is not something that should be encouraged. So, we want to provide hope and tell people a sad, traumatic experience is not necessarily the end of life.

Ultimately, we want to create a point, a facility, where those who are going through mental health will come for a chat. It is strictly a place you come and exchange views and you will be advised and by the time you are sufficiently advised and counseled if you need to see a psychiatrist then we set up a meeting.

We begin to get funds from sources so that we support those going through this crisis because the anti depressants are not cheap, people do not have the money, so family will lock up the person and chain the person in the house, some are boxed back to the village.

These situations do not need to arise, the one among teenagers is terrible, and it is a traumatic experience for the parents. Those who commit suicide have ended the problem for themselves but created problems for others.

Often some people who have terminal diseases tend to take their life because they cannot go through the trauma and when they do this it can never be announced because suicide is not an honorable thing in the society.

In Africa it’s an abomination, in Nigeria it is a legal offence, anybody who attempts suicide and is caught is prosecuted, that is one thing we want to do. We want to ask for that aspect of the law to be expunged.

The man who attempts suicide is not a happy person, he needs help, why punish the person by sending him to jail? That is double jeopardy, and these are some of the issues we are dealing with.

Part of our advocacy is that these homes will not be called psychiatric homes anymore. There are some mild names for it like Social Intervention Facility so that you can go there and get help.

Stigmatization of mental illness is all over the world but higher in Africa. Some who are going through illness along the line become mentally ill.

There are different things that lead to depression and mental health issues. As a human being many things can happen to you and make you sad or happy. Cause of depression is perpetual stage of sadness; if it continues, you no longer feel happy, you are not excited about anything. It lingers, so there are other symptoms, lack of interest, you avoid people, sleep disturbance, no self-confidence; lose interest in things they used to do.

Sometimes they become paranoid, they are controlled by fear. Nigeria’s mental health challenge should be treated as normal health issues and family support is also imperative in managing the scourge.