Suicide never an option... Seek Help

When three officers in uniform ended their lives within 16 days in 2021, many people asked what had gone wrong.

The reality is that many things could have gone wrong.

Humans, in dealing with certain challenges, sometimes decide to face their demons by ending their lives, with the wrong assumption that suicide is the only way out. 

However, this should not be the case, a professor of psychology, Professor Charity Sylvia Akotia, said. 

“Suicide should never be an option. It is preventable and help is available, she asserted.

Additional measures must be enforced to give people the hope and assurances not to opt for suicide as the solution to their predicaments, Prof. Akotia, who is a former Dean of the School of Social Sciences of the University of Ghana, indicated.

Decriminalisation 

For many years, caregivers, psychiatrics, psychologists and many advocates have been clamouring for the decriminalisation of attempted suicide.

The argument has been that suicide is a mental health issue and, therefore, individuals who have suicidal tendencies need help and not jail terms or punishment.

It is, therefore, welcoming that Parliament on March 29, this year, passed the Criminal Offences (Amendment) Bill, 2021, which decriminalises an attempt to commit suicide. 

The President of the Psychiatric Association of Ghana (PAG), Dr Ruth Owusu-Antwi, in an article, said the decriminalisation of attempted suicide would prevent underreporting of suicide cases which would help in accurate estimation of suicide cases.

Again, she said, it would encourage the government to commit more resources and attention to suicide prevention.

For the President of the Ghana Psychological Association (GPA), Dr Collins Agyeman Badu, the decriminalisation of suicide would encourage more people to seek help and have access to the right professionals.

That, he explained, was to enable the increasing number of people who had been invited to seek help for mental health challenges following the amendment of the act criminalising suicide to have access to the right professionals to take care of them.

“So now, there must be mental health professionals at all hospitals manned by government health workers. Psychologists are the primary gatekeepers to handle acute distress and challenges people are going through,” Dr Badu explained.

He said if the government did not promote well-being and prevent the onset of mental health challenges by engaging psychologists at the workplaces, schools and within the communities, the country might not be able to prevent people from getting into the pathways of mental health, including suicide, and that might render the amendment ineffective.

Statistics 

A report by the World Health Organisation (WHO) in 2021 indicated that about 700,000 people commit suicide every year globally. 

Although suicide is a global phenomenon that affects all countries, WHO estimates that 77 per cent of all suicide cases occurred in low and middle-income countries.

In Ghana, a report by the WHO in 2020 showed that there were 1,993 suicide cases annually on the average.

Apart from actual suicide, attempted suicide is also a canker, with the Ghana Health Service (GHS) estimating that 2,781 people attempted to commit suicide between 2018 and 2021.

According to the statistics by Ghana’s Mental Health Authority (MHA), in 2018 the number of people who attempted suicide was 797. This rose to 880 in 2019 and to 902 in 2021, while those who died by suicide went up from 69 in 2020 to 86 in 2021.

Risk factors 

In a lecture she delivered recently as part of the 75th anniversary of the University of Ghana (UG), Prof. Akotia said research indicated that the risk factors underpinning suicide could be classified into three parts — the individual, community and societal.

She explained that whereas mental disorders (depression and alcohol use disorders) were the main causes of suicide in developed and high-income countries, socio-cultural issues and the inability to deal with life stressors were the factors giving rise to suicide in low-income and developing countries.

“These include financial problems, cultural expectations of men and women, relationship break-up, chronic pain and illness, loss of a loved one, unemployment and dissociation from one’s community or social group,” she said.

The lecture, which was on a series of research conducted by Prof. Akotia and her team over the years, was on the topic: “When Life Becomes Unbearable: Dynamics and Complexities of Suicidal Behaviour and Prevention in a Cultural Context”.

It focused on what constituted suicide (cultural and legal), attitudes towards suicide, motivations for suicidal behaviour, suicide and the law, experiences of survivors and their families, and media perspective on suicide.

Lack of support for young people 

Prof. Akotia pointed out that although suicide cut across all age groups, it was prevalent among youngsters, with adolescents and young adults likely to end their lives that way.

Her findings sit well within estimates by WHO that suicide is the fourth leading cause of death among 15 to 29-year-olds, while research has also shown that one in every 10 adolescents in second cycle schools in Ghana has engaged in some form of self-harm.

The former Dean of the School of Social Sciences said a research conducted by her team showed young people who carried out suicide engaged in it due to a lack of support and what they perceived as personal shortcomings.

“The causes are mainly due to intra-personal factors such as personal shortcomings and perceived obstacles, followed by interpersonal causes such as lack of social support and broken heartedness and lastly, extra-personal causes such as economic stress and spiritual forces,” she indicated.

In 2016, the Mental Health Authority (MHA) said suicide among young people was of great concern and required a concerted effort by all stakeholders to prevent the future leaders of the country from taking such a route.

The MHA attributed the trend to the failure of society to support the youth “by ensuring that efficient and accessible support systems are in place to help build the mental fortitude of the youth and students in particular in their times of weakness and susceptibility.”

It said young people normally required help and support and would ordinarily not turn to suicide if such help and support were available.

“For most students and young people who attempt suicide, they are actually crying for help to end some unbearable feelings or a situation that seems intolerable”. 

“Young people easily develop suicidal thoughts when they feel trapped, confused, hopeless, helpless and distressed, and are desperate to escape from their suffering rather than actually wanting to die,” the authority said.

Media and suicide

In the lecture, Prof. Akotia pointed out that the media as a mass means of communication played a crucial role in suicide.

She said the media had a penchant for reporting on suicide, especially involving celebrities, in a manner that could trigger suicide tendencies in vulnerable groups such as young people.

“Clinical and research experiences on working on suicidality in Ghana for close to a decade have shown that most media reports on suicide in Ghana are not guided by any specific guidelines, and if they are, it is possible they are not compliant,” Prof. Akotia said.

The psychologist professor, therefore, advised the media to be circumspect in their reportage on suicide and ensure that such reports were in line with the WHO guidelines on responsible reporting on suicide.

Per WHO’s responsible reporting guidelines on suicide, a media reportage on suicide should include accurate information on where to seek help for someone contemplating suicide and educate the public on the facts of suicide and suicide prevention without spreading myths.

The guidelines also encourage the media to report on how to cope with life stressors or suicidal thoughts and how to get help.

Again, the WHO encourages the media not to give prominence to suicide stories, not to repeat such stories, not to provide details about the location of the incident and not to use sensational headlines or photographs or video footage.

Suicide not an option

The establishment of the MHA is good news, as it will help to provide direction on mental health and the institutional framework to confront issues such as suicide.

As part of measures to combat suicide, the MHA has established a toll free line – 0800678678 to provide psycho-socio support to people.

People who call the line will be given access to mental health experts, psychologists and other specialists who will help them seek redress to their psychological challenges.

Members of the Psychiatric Association of Ghana, who are also spread across the country and ready to render help, can be reached on national helplines, 020-000-9997, 020-681-4666 and 050-344-4793, Dr Owusu-Antwi pointed out.

Prof. Akotia insisted that suicide should never be an option and, therefore, there was the need for people to talk to others and seek help.

“Whatever situation you find yourself in, whatever challenges you are going through, remember that suicide is not an option and should never be an option. 

Suicide is preventable! Talk to someone, seek help early and know that there is hope. Indeed, hope is right here,” she said.

Preventive measures 

Dr Owusu-Antwi said decriminalising attempted suicide did not mean legalising suicide attempt, it was rather a freedom to choose to live.

She said the government had done its part by decriminalising attempted suicide and that took a huge burden off patients (the survivors) and their families, as well as the service providers. 

“But as a society, we still have an ongoing part to play in eradicating suicide from our country,” she said, and gave out some suicide warning signs for which the sufferers must seek immediate help.

Dr Owusu-Antwi provided 12 common warning signs of suicide, including active suicidal thinking and verbalising; expressions of hopelessness and depression; sudden recklessness, impulsivity and dramatic mood changes and persistent anxiety and agitation.

On ways to combat suicide, Prof. Akotia said it was imperative for people not to be judgmental about suicidal persons as that could lead to more suffering for such persons.

“Suicidal persons suffer in secret without being offered any help. Attitudes towards suicidal persons are largely negative, judgmental and condemnatory,” she said.

“Specific attitudes include silencing (where no one talks about it because it is perceived as a taboo) and trivialisation (where people cannot accept any reason for engaging in suicidal behaviour). Generally, such attitudes show a lack of understanding and knowledge of suicidal behaviour,” she added.

Again, Prof. Akotia said there was the need for the establishment of a National Suicide Prevention Centre to help with the collation of statistics on suicide and suicidal behaviours.

Such a move, she said, would help in the implementation of suicide preventable programmes, especially for vulnerable groups.

“Importantly, suicide prevention efforts require much coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, the media and many more. 

These efforts must be comprehensive and integrated as no single approach alone can make a significant impact on an issue as complex as suicide,” she added.

Another measure, she noted, was awareness creation, adding that the myth and taboo surrounding suicide must be shattered.

“We must talk about suicide in a very preventative manner so as to help persons who are going through suicidal crisis. 

Awareness creation will also help others understand that suicide is preventable and that we all can contribute in one way or the other to prevent this behaviour from escalating,” Prof. Akotia stated.