Mental wellness can reduce suicide tendencies

From a statement such as, “I wish I go to sleep and never wake up or be knocked by a speeding car,” to taking an overdose, herbicides, pesticides, hanging and jumping off a building, suicidal thoughts and attempts are the second leading cause of death among the youth between 15 and 29 years and the fourth leading cause for those between 15 and 19 years of age, according to the World Health Organisation.

Globally, more than 800,000 people die as a result of suicide every year. Suicide is also the fourth leading cause of death among 15- and 19-year-olds, with about 77 percent of global suicides occuring in low-and middle-income countries. 

According to a report by the Transcultural Psychosocial Organisation (TPO), Uganda registered 368 suicidal cases in 2021. 128 of these were women while 240 were men. Franko Olong, a psychological therapist at Strides of Hope (SoHope), says women are more susceptible to suicide because they are greatly affected by depression, with many attempting suicide three times more than men.

However, since men have better access to suicidal tools and consider acknowledging a need for help as a weakness, they actually commit suicide more than women. 

“Women value interdependence, they consult friends and readily accept help whereas men think they are independent. Therefore, it may be hard for them to change their decisions, especially about suicide,” Olong says.

Why suicide?
Suicide can be triggered by a multitude of factors but most importantly, depression and a lack of understanding for self, says Evelyn Kharono Lufafa, a counselling psychologist at Makerere University in Kampala.

Mental health problems might be made worse by losing a job, property, business, a loved one and when one fails to cope with the change, it may lead to suicidal ideations and actual completion if one does not get help.

“Culture that sets certain responsibilities might also cause mental health issues. For example, a man is expected to provide for the family and in case they fail to fulfil this duty, they might get depressed, leading to suicidal thoughts, especially if the affected person interprets this as failure.”

Other causes include chronic illnesses, a history of substance abuse, a history of attempted suicide bullying at school, personality problems, domestic violence and physical abuse.

Who is at risk?
While there is a well-established link between suicide and mental disorders (such as depression and alcohol use disorders), many suicides happen impulsively in moments of a crisis. They are caused by the inability to deal with life problems such as financial constraints, domestic violence, relationship break-up or chronic pain and illness.

Conflict, disaster, violence, abuse or loss and a sense of isolation are strongly associated with suicidal behaviour. Vulnerable groups who experience discrimination such as refugees and migrants, indigenous peoples and prisoners may also be suicidal. However, Lufafa says, by far, the strongest risk factor for suicide is a previous suicide attempt.

Signs and symptoms
Suicide is a series of events and it may start with the victim having long sleepless nights, changes in eating habits, anger, aggression and getting easily agitated. Others include engaging in reckless behaviours, including excessive alcohol or drug consumption, avoiding social interactions with others, expressing rage or intentions to seek revenge.

One may also hear voices, feel empty and alone, misuse of money, everyone is against me attitude, easily offended, negative performance at work, in school or home, energy changes and so many other symptoms.

Once you or someone you know experiences the above symptoms, Olong advises seeking help as quickly as possible.

Seek medical help
Suicide is a psychiatric emergency and so, in case one has such thoughts, they need immediate attention from a medical person or psychiatric help. If the person has attempted to commit suicide, they must be put in a safe place under strict observation. Then, they should be taken for therapy for the cause to be addressed.

“If the cause of the suicidal thought is not addressed, the person is likely to attempt suicide again and could be successful. It is important that the caregiver or the family look out for signs of withdrawal, extreme wishes of death, attempts and involve a medical person or police if they lack support to take the patient to hospital or a rehabilitation centre,” Olong says.

Once at the rehabilitation centre, the therapist will do a comprehensive assessment of the person’s behaviour and initiate talk therapy once they are able to talk about the cause for their suicidal thoughts.
With the help of counselling and proper medication depending on the cause, the therapist must help the victim solve the problem in order to avoid repeat attempts.

“When speaking to them, stay calm and speak in a reassuring tone. Acknowledge that their feelings are legitimate, offer support and encouragement, tell them that help is available and that they can feel better with treatment,” says Lufafa.

If talk therapy is not enough to successfully lower the risk, medication may be prescribed to ease symptoms, such as depression and anxiety. Treating these symptoms can help reduce or eliminate suicidal thoughts. Antidepressants, antipsychotic medications, anti-anxiety medications may be prescribed.

In addition to talk therapy and medication, Lufafa says, suicide risk can sometimes be reduced by simply adopting certain healthy habits such as avoiding alcohol and drugs, exercising regularly, enough sleep and avoiding isolation.

Prevention
According to Gloria Aminat, the founder of Bora Minds Foundation, mental wellness is essential in preventing suicide. 

“There is no such a thing as generational suicide but when we fail to solve the problem that causes someone to commit suicide, then we are not helping at all,” she says.

Every parent, caregiver and entire community should foster socio-emotional life skills in adolescents and the general community. They should help vulnerable people avoid isolation since it is a major risk factor.

“We must be intentional about spreading love. One does not have to be professional. They just have to listen when one needs a listening ear,” Aminat says.