Dr. Babatunde Suleiman is a Consultant Psychiatrist and Researcher at the Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso in Oyo State. In this interview with APPOLONIA ADEYEMI, he discusses role of families and communities in reducing suicides in communities, strategies to reduce stigma in mental illness, among others.
What are the risk factors for suicide?
Everywhere now in the world there is an increasing trend of suicide among young people between age 15 to 24 years. However, some of the risk factors of suicide are old age, mostly people who are above 45 years, people who are divorced, separated and those that are widows/widowers.
Others are people who have psychiatric conditions and are likely to have suffered depression. Alcohol consumption and other substance abuse are other risk factors.
In addition people who have terminal illness, or who have been suffering from chronic medical conditions such as cancers, HIV, among others are also likely to commit suicide. Furthermore, some people who experience breakup in relationships are likely to take their lives.
We lost a patient in the previous year because the relationship she was involved in for seven years broke up. The person in that union with her suddenly said he could no longer continue in the relationship. She was 36 years old; she had been dating the man for seven years.
The lady consumed insecticide and it killed herself. We were unable to revive her. Sometimes when society itself breaks down such that it cannot control social norms including the culture, just like we experience now in many upheavals and many uncertainties, it tends to cause more suicides.
Also, sometimes when some people feel too attached to a group such as the Boko Haram, or society, they are ready to lay down their lives for that group.
What can we do to reduce suicide?
There should be different levels of prevention. Anybody who is suspected of having a psychiatric condition including depression or abusing substance should be brought in for psychiatric assessment and management and the family of affected persons should be educated to support them.
For instance, three weeks before the lady whose case was mentioned earlier in this interview committed suicide, she was not eating; she cried throughout, telling people around that she was fed up with life.If she had been brought in for medical assessment, she may have been saved.
What are those signs that people should watch out for in those intending to commit suicide?
Anybody who is depressed and is above 45 years could be at risk of suicide, so are people that are socially isolated.
There should be special programmes in churches and mosques for the widows/widowers, elderly people that are lonely, to engage them. There should also be medical treatment for people who abuse substances.
What role should families play to reduce or discourage suicide?
There are some individuals who have increased risk.If family members are aware of anybody who has mental condition or somebody who has been diagnosed with medical illness, cancer, HIV and other ailments, they need to support them and make sure these persons are not lonely all the time.They should ensure that the persons should come around for medical attention; they should not be isolated.
How do we address stigma especially people with mental illness refusing to take treatment from psychiatric health facilities?
It’s a big challenge. Its not only psychiatric hospitals that are stigmatised.
Even psychiatric patients, too suffer stigma also. We have to combat the stigma. There are different types of stigma really – the one the society imposes and the one the fellow suffering mental illness imposes on himself – self-stigma. Even we psychiatrists are also stigmatised among doctors.
The first thing is to help reduce the stigma on mental illness.
Psychiatric illness is not different from malaria; we now have evidence to some extent to show that there is something going wrong with the brain, causing the mental challenge.
It’s not the fault of psychiatric patients but they can be rehabilitated and integrated into the society. There is some form of treatment that will do well on them.
That is education. We have to educate the people about programmes on the mental illness. People suffering mental illness are no longer dangerous than the ordinary people.
For instance, the average armed robber is a normal person. There was a robbery in Oshogbo not too long ago in which one pregnant woman was beaten up and matcheted in the leg.
The armed robbers never knew she was pregnant but when they realized she was pregnant they apologised to her, saying:
“please forgive us; we did not know you are pregnant. We wouldn’t have roughhandled you”, showing they were not crazy. So, the mentally ill person is not more dangerous than an average person. In fact, the average person is more dangerous because he is the one that is likely to cause you problem.
We have to de-mystify mental illness. Psychiatric patients are not dangerous. They can do well. If prominent people, who had suffered mental illness before and bounced back after receiving treatment, could demonstrate that prominent people in the society do break down from time to time, it could send the message that mental illness is like any other illness.
Another thing is proximity. Psychiatric health facilities like the Federal Neuro-Psychiatric Hospitals in Yaba, Lagos and Aro, in Abeokuta and others should be integrated into normal primary health care, PHC, centre.