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.
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 didn't give an incline 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 who have taken the root 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 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 may 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 need to inform and educate people about suicide; we need to 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 try to do talks, visiting the churches, mosque, and school anywhere there is assembly we talk to them and educate them about mental. 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, 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 break down there are all kinds of reason 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 piloting such ignorance. We realised that one thing we need to do is to educate people that 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. For instance, partners you sell telephones, give us then we give to the trained personnel. You can also train helpers for us. 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 aspect of mental health. We want to design flyers, which we circulate. We need institutional support, for example for someone who's 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 also to subsidies the medication for mental health. To get somebody into admissions for two months you first deposit N120,000 and the drugs are not cheap. Psychiatries is not a popular branch of medicine. We want motivation for psychiatric medical students. Anyone that wants to study psychiatries should be given incentives. We do not too many private psychiatric homes in the country because some will tell you it doesn't pay. So, instead of bringing such person to psychiatric home they take them to prayer homes. Government has a role to play, providing incentives for health workers in that profession is very important. They should also reduce the cost of drug. 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.
I was kidnapped for 16 days held, tortured, beaten threatened by kidnappers. When I came out I had to go through counseling. I saw a psychologist, I saw a neurologist, I saw a psychiatrist, I just went to them and say 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 advance 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 of them go for treatment. Take for instance you have a very traumatic experience, armed robber came, violated your privacy and rape you. The experience is just 30 minutes but it lingers in the memory for almost three years. In the advance world, you go to counseling they begin to talk you out of it.
Our people say once a mad man enters market you cannot care the person again that is not true. It may be a metaphor for saying that for someone who is mentally challenged to walk the street and goes into the market place to scavenge, it may be a way to say that the thing has gone far but doesn't 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 traditionalist, some go to pastors and Imam 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 Nigeria.
Nigeria currently is going through serious economic meltdown and young people, the graduate, they can't get job. 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 enter 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 job 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 don't 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 things 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's not going to school again that she will end it all. They panicked she panicked but I told them how to handle her because both parents can't control her anymore.
People see it, they read about it the more, your report it, the more attractive it becomes to some people. At the same time, we will not ask the media not to report it. You can see it's more reported in social media.
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 does 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 counselled if you need to see a psychiatrist then we set up meeting. We begin to get funds from sources so that we support those going through this crisis because the anti depressants is 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 of among teenagers are 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 commits 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 they become mentally ill.
They suffer from delusions, paranoia fear and terrible dreams. Some when they age they begin to suffer from dementia. We are looking at suicide and depression and asking what the society can do to intervene and reduce the rate of suicide. Some people who are successful in life, some are wealthy they now begin to suffer from psychological imbalance; something begins to disturb their mind. It may not be something physical or real but the mind is diseased. Go to the specialist to treat the mind it is not only poverty that causes mental health.
It is something that affects the mind, sometimes it has to be body chemistry; sometimes it could be a fear of losing the wealth. Some people made so much money that they are now afraid of the door. They cannot open the door. Some have become so rich they can't step out of the house after 7:00pm. They cannot eat out. The relations cannot visit; if they visit they do not stay long. When you enter your office you see a sheet of paper somewhere and say who brought this.
There are different things that lead to depression and mental health issues. As human being many things can happen to you and make you sad or happy. Cause of depression is perpetual stage of sadness; it is 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.