NGOs reach out to vulnerable people across the country where stigma attached to depression and suicide stops families from seeking help.
Towards the end of 2018, Abiola*, a social entrepreneur who manages projects for NGOs, noticed she was withdrawing from people and activities. Apart from being struck in a terrible relationship, she also lost her job.
“I became idle for the first time ever,” she tells TRT World. “I started to drown in depressive thoughts.”
The
death of her mom in 2015, which she hadn’t properly processed, made the
job loss and loneliness more difficult to bear. “I think I was in
denial for a long time,” she says. “It was as if everything was coming
back. I was hearing her voice.”
Although she knew the signs of depression and bipolar disorder—which manifested in her through reckless spending, extreme mood swings, isolation, and hyper-sexuality—she just couldn’t break out.
She stopped going to church, stopped hanging out with friends, and pushed everyone away. Finally, upon a close friend’s probing, she admitted that she needed help.
On Abiola’s behalf, the friend contacted Mentally Aware Nigeria Initiative (MANI), an NGO that focuses on mental health. They responded earnestly and connected her with a therapist.
According to research, one in every four Nigerians has a mental illness. The Nigerian government perpetuates this issue with archaic laws. Under Section 327 of the Criminal Code Act, “any person who attempts to kill himself is guilty of a misdemeanour and is liable to imprisonment for one year.” In 2017, a man was arrested and locked up for weeks for trying to take his own life.
But every now and then, there’s news of a young person taking his or her own life. The WHO states that “77 percent of global suicides occur in low-and middle-income countries.”
Stigma is high
Last October, a final year student of Lagos State University was reported to have killed herself because she was unable to pay her school fees and couldn’t write her final exams.
“We don’t have data pertaining to suicide,” says Titi Tade, Training Coordinator at Suicide Research and Prevention Initiative (SURPIN)). “The [suicide] rate we have are the ones we know about. People don’t report it.”
The Mental Health Act, a framework for policy formulation and management for mental illnesses, was presented to the National Assembly in 2003 but withdrawn a few years later. The bill was reintroduced in 2013 and later abandoned. A new bill was introduced in 2019 and has passed the second reading, but it hasn’t been enacted.
Factors such as ignorance about mental illness, poverty, and stigma often prevent people from getting professional help. “Stigma of suicide is quite high in Nigeria” says Tade. “There’s cultural stigma, there’s religious stigma.”
She shares stories about how people are discouraged from marrying into a family if a member has died from suicide. “The government has no suicide reduction plans,” she adds. “We [SURPIN] are a drop in the ocean. But we are trying to do something.
NGOs such as MANI and
SURPIN have been instrumental in bridging the gap left by the
government in mental health vigilance. They create awareness and provide
immediate help.
MANI has built a community on the internet for people to share their mental health journeys. There have been several instances where a Twitter user showed signs of suicide ideation and strangers rallied online, mentioning anyone who could help, including @MentallyAwareNG, who often found a way to get in touch with the individual.
Likewise, with volunteers across 34
states in Nigeria, SURPIN provides free consultation for people on their
first visit, and then refers them to a facility that can provide the
range of care and specialists the person needs. Most SURPIN members are
mental health advocates working in government establishments. They also
visit secondary schools and universities to get people educated on
mental health.
In 2020, according to Tade, SURPIN recorded the
highest number of calls on their hotline since the initiative was
launched in 2017. Due to the Covid-19 pandemic and its impact on work
and economy, financial challenges topped the list of the reasons people
called. This was followed by issues with relationships (particularly
romantic) and health (chronic illnesses). “Over 60 percent of the calls
are from [the] youth bracket,” she says. The youngest caller was 12
while the oldest was 71.
One of the principles of rehabilitation
is that healing is not linear. In 2021, Abiola lost her cousin and her
mental health deteriorated. She started self-harming. “Cutting myself
was an outlet.”
One day she swallowed a bunch of pills with no expectation of waking up, but she did, and was admitted to the psychiatric ward at the University College Hospital, Ibadan, where she was diagnosed with depression and bipolar disorder.
With medication, psychotherapy and occupational therapy, she was able to process the death of her mother and cousin. Her health improved and she started adopting healthy habits. Although she admits that she’s currently out of a job and trying not to stay idle, considering what that triggered the last time.
According to the WHO, “a prior suicide attempt is the single most important risk factor for suicide in the general population.”
Tade, who also works as a medical social worker at the Lagos University Teaching Hospital (LUTH), highlights the need for structures by government to reduce suicide and accompanying stigma. There are only eight neuro-psychiatric hospitals in Nigeria.
The Nigerian government can be more involved by formulating policies, building more facilities, raising the standard of care in hospitals, facilitating outreach programs, partnering with education and social welfare sectors, and providing funding for mental health initiatives to expand their impact, experts say.
Abiola received financial support from friends and family, but not everyone is as lucky. The cost of therapy is another issue that prevents people from getting help.
Rising poverty rate in the country makes it more difficult to pay attention to or access mental health care. During her stay at the hospital, Abiola noticed that very few therapists were present and they were always tired—a reminder of the long-lasting impact of brain drain on medical professionals.
Mental illnesses are on the rise globally and suicide is the fourth leading cause of death among teenagers. Tackling suicide is a collective effort. However, there’s only so much individuals and NGOs can do without well-equipped facilities and policy implementation by the government.
(NOTE: *Name changed to protect identity)
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