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ON THE VEXED ISSUE OF SUICIDE

TALKING SUICIDE By Femi Olugbile The title of the event was ‘The First National Conference On Suicide Prevention’. The crowd gathered at the Ade Ajayi Auditorium of the University of Lagos on Saturday, the 26th of October was a potpourri of mental health professionals, politicians, government officials, civil society organisations, students in school uniform and members of the public. It might have struck an observer as curious that such a crowd could be assembled in Lagos for discussion of such a morbid subject on a Saturday, a day normally dedicated to weddings and other jolly events. Suicide is a taboo topic in Nigerian culture. Traditionally, in some parts of the country, if a person takes his own life, he is deemed to have brought shame on himself and his family, and to have forfeited even the right to be buried where other family members are buried. Nowadays, every so often, people read sensational stories in the newspapers and on social media about the Third Mainland Bridge and how it is beginning to acquire notoriety as a favourite launchpad for ‘suicide divers’. Only recently NAFDAC – the food and drug regulatory agency, came up with a regulation banning the sale of the small bottle of ‘Sniper’, the weed killer that has become a quick and convenient- if extremely painful- tool for people wanting to die by poison. The posture of local officialdom to citizens who are desperate enough to want to take their lives ranges from the unsympathetic to the frankly bizarre. It is a criminal offence, in Nigeria, to attempt suicide. If a person attempts suicide and does not die, he is liable to be hauled off to jail and not to hospital. Every year, one million people all over the world ‘successfully’ kill themselves. Many more than that number ‘attempt’ suicide and do not ‘succeed’, either because some other event supervenes, or the attempt was really a ‘cry for help’. A survey carried out in Lagos in 2015 showed that 7.3% of adult Lagosians had thought, at least fleetingly, about death in the one-month prior to the survey. Most – but not all, people who commit suicide have a diagnosable mental health condition, usually Depression. The Nous Foundation, you would learn as you arrived at the venue, was an organisation founded by some Nigerians, some of whom were based in the diaspora. They were keen to raise public awareness on Mental Health issues in the country. They organised the Saturday event, in collaboration with SURPIN (a Suicide Research and Prevention Initiative based in Lagos) and Sparkle Foundation. Their plan was to have an audience of all arms of government and all stakeholders in Mental Health, including young people, sit to dialogue. They wanted to provoke a national debate, push for the decriminalisation of suicide, emphasize the importance of early recognition and intervention in emotional problems, reduce stigma towards mental illness, and demand a national Suicide Prevention Strategy. Mental Health is in a parlous state in Nigeria. An extreme paucity in the numbers of Specialists at the top is complemented with a crass failure to implement a common-sense reengineering of the grassroots primary healthcare system to enable it to serve as the first line of entry for provision of basic mental health care to the people. As a result, at least 70% of Nigerians with any mental illness get no treatment at all. The overwhelming majority of the untreated mentally ill Nigerians are people with Depression and Anxiety in offices, factories, schools and board rooms all over the country, living unsatisfactory and unproductive lives as the ‘walking wounded’ victims of treatable illness. On top of this, the Mental Health Law of the country is an antiquated colonial inheritance designed for the last century when there was limited knowledge and little by way of effective treatment for the different varieties of illness. The brightly coloured hair of Lade, CEO of Nous Foundation, bobbed up and down as she moved around to keep the proceedings flowing. A representative of the Chairman of NAFDAC, the Mental Health Desk officer of Lagos State Ministry of Health, the Medical Director of the Federal Neuro-Psychiatric Hospital, Yaba and various other persons got up to address the eager audience. They plugged for suicide prevention services and a change in the approach to mental illness in the country. The Chairman of the Senate Committee on Health, Senator Oloriegbe, promised not only to champion a quick passage of a new Mental Health Law but also a general revamp of mental health services. A psychiatrist from SURPIN reeled out 24- hour Suicide telephone helplines, run by the organisation, that could be reached from all across the country, and from which help could be immediately deployed. You were called to spend a few minutes on the podium too. You focussed on the need for government to be an enabler and facilitator, and for all activists and stakeholders working in the field to break down their siloes and integrate their efforts and resources to maximise the benefit to Nigerians. You gave specific recognition to ‘Joy Incorporated’, a body of young Nigerians who not only ran a suicide telephone hotline, but also a manned walk-in hub for emotionally distressed citizens in Lagos. Shade, a UK based Forensic Psychiatrist, talked about the necessity for positive change. The President of the Association of Psychiatrists in Nigeria made an impassioned plea for a quick passage of a fit-for-purpose law. Someone in the audience wanted Mental Health service, which was conspicuously missing from the Basic Health Insurance schemes that had been rolled out, to be mandatorily included in all Health Insurance coverage in the country. A representative of the students admitted they had gained immensely from what they had heard so far. Sunmi Smart-Cole, veteran journalist and photographer, presented copies of his prized new photo- book, to some of the participants. Very useful, as Saturdays went, you remarked to yourself as you made for the exit, at the end.