The suicide epidemic - What is the problem?
The sudden suicidal episodes in Ghana have become a major public concern and it is my hope that this concern will continue to be discussed until we all, as Ghanaians, begin to understand that suicide, much as it is a public health hazard, lies on the compound of Mental Health Authority.
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For somebody to decide to take away his own life means that he has got to a point that he has decided to leave the world to those who own it and can live in it to continue without him or her. Before such persons reach such a conclusion, they might have exhibited some signals either through pronouncements such as “life is not worth living. I am fed up. I wish I were dead.
What is this life all about,” etc. Some will go to the extent of writing notes, but these are not taken seriously or no help is arranged for them out of lack of concern, stigma or simple ignorance.
The problem of suicide and its attempt have for a long time been debated among various religions and legally to a point that had led to entrenched positions for centuries. From a religious point of view, it is believed our bodies are just clay, but the life breath in us is from our creator God and, therefore, we have no right to take our own lives, to the extent that the bodies of those who commit suicide are treated differently by some churches. It was not until 1983 that The Roman Catholic church reversed the Canon Law that prohibited proper funeral rites and burial in church cemeteries for those who committed suicide.
Laws prohibiting suicide
Criminalisation of suicide had been the order of the day for a long time. Germany was the first country in 1751 to decriminalise suicide and after the French revolution, all countries in Europe and North Americas followed. Research done in most of these countries have not proven an increase in the suicidal rate because of the liberalisation of the law. In 2014, after a long battle, India succeeded in amending their law to decriminalise suicide. Decriminalisation of suicide will facilitate bringing the act into the open and allowing the right professionals to help.
What is the position of Ghana on decriminalisation of suicide?
In Ghana, the Criminal Code (Act 29, 1960) stipulates that non-fatal suicidal behaviour is considered a crime. In 1984, a memo was sent by me to His Lordship Justice Archer Chairman of the Law Reform commission which was captured to consider repealing this act. Unfortunately, I might not have convinced them enough. Another opportunity availed itself in 2012 when Dr Akwasi Osei and myself met the Parliamentary Select Committee on health at Koforidua when the draft mental health law was being prepared. The arguments levelled by us that suicide is a mental health issue and that Ghanaians will need education on the subject and people will be trained to work in the community to prevent it occurrence were not convincing enough. They said it would be free for all to commit the act. The argument for criminalisation is the belief that the law could act as a deterrent against other such attempts in the society. However, it is still not clear whether having a law to prosecute suicide attempters indeed act as a deterrent or not. In fact, those of us who have had the opportunity of examining people who have attempted suicide have noted with concern the gross mental health instability in them requiring urgent psychiatric attention than punishment. What some countries have done is to make it mandatory for people who attempt suicide to be seen by psychiatrists, clinical psychologists and Social workers.
What is the problem concerning our youth of today?
The quick technological advancement of the millennium has not matched the opportunities available for the youth of today. Our youth are very much in a rush to get to the highest affluence without much sweat. The “Sakawa” cult that enables young people to get rich very quickly is a societal problem that calls for our sociologists to unravel just as the current increase in road traffic accidents. Although parents sponsor their children to attain the highest level of education, some of our children are unable to cope with the competitive world and have not acquired confidants to turn to. It becomes problematic to them to inform parents about their difficulties for fear of disappointing them. Who are there apart from pastors, counsellors and the like and how many are they?
There are counselling and guidance units in all our universities and even in the lower educational facilities. It is not clear whether the students are aware and they know who they should see and their functions. The parents of our children, teachers, friends and indeed all of us have a duty to help people whose behaviour, appearance and the way they do things have changed.
Why will somebody want to kill himself?
The reasons are many and varied. Some of the reasons for suicide are beyond the control of the sufferer. Some can be biological, as part of the person's makeup, which may run in families. Examples are depressive illness, socio-economic factors such as poverty, disappointments in relationship, losses, family problems and stresses of all kinds can be implicated. In some cases, some may be hearing voices ordering them to commit suicide. If we critically assess these factors, what can emerge is that they cannot be considered as offence against the state; rather the state can be indicted for not providing preventive measures such as resourcing those entrusted to do the work.
What is being done and what are the problems?
The implementation of the Mental Health Act requires that emphasis is shifted to community care. In this regard, more mental health and allied workers have been trained.
The Kintampo project which has set out to train Community Mental Health Workers (CMHOs) and Clinical Psychiatric Officers (CPOs) has done a good job to train a lot of these workers to support the implementation of the Act but, unfortunately, most of them have not been posted (just as the many psychiatric nurses) into the health system to perform their duties.
Until more serious attention is given to mental health to continue with the implementation of the Act to improve on mental health services, more precious lives will, unfortunately, be needlessly lost.
The writer is with the University for Development Studies (UDS), School of Medicine and Health Science (SMHS) Tamale and is a Retired Chief Psychiatrist, MOH.