DR PIWUNA CHRISTOPHER is a Consultant Psychologist. He is also the Chairman, Committee on Mental Health of the Nigeria Medical Association (NMA). In this interview with our Correspondent, HASSAN ZAGGI, he enumerated some reasons that could lead one to committing suicide. He also blamed the government for not giving mental health and in fact, the health sector in general the needed attention. Excerpts:
Why will someone want to commit suicide?
Well, naturally, there are different reasons why people commit suicide. People could commit suicide because they want to fix a system. When they think that something is wrong and that by taking their lives the system can get better, for altruistic reason they will want to commit suicide. For example, the chap in Tunisia who, through taking his life led to the Arab Spring to what we have today.
People could commit suicide because of some risks that their lives take. For instance, use of psycho active substances could also be a risk of committing suicide. People could also commit suicide because of the disorderliness in the society. You have a mindset of what you expect from the society, but suddenly, the society is not what you are thinking of. That could lead someone to taking his life.
Having said that, there are health conditions that tend to make someone more vulnerable to taking his life. Depression is one such conditions. The typical symptoms of depression including feeling of sadness, lack of energy, not enjoying life generally could push someone to a state of hopelessness and despair. At that time, people who commit suicide have no place to turn to rather than just to take their lives. To them, only one door is open and that one door away from all the challenges they are facing is just to take their lives.
In Nigeria’s context, where can we point our hands to?
In Nigeria’s context, you could not put your hand in one thing but at multiple things. For instance, Nigeria is a disorganized country now. Let’s face it. Take the politics out. Are our people happy with what is going on in this country? There are people who are hopeless and feel a sense of despair and these people may have an underlying mental illness (a psychiatric disorder). So, these things just come together and the way out for them is to take their lives.
The way out as I see it is to increase awareness about those things that can lead to suicide. For instance, mental illnesses- depression in this case. Depression is not the only mental illness that can cause you to take your life, but it is a leading cause among some of them.
That is why the NMA has taken it upon itself to talk about it so that when one has depression, he will be able to see that it is something that is treatable and that taking his or her life is not one way of coming out of depression.
We need to also ensure that most, if not all people in this country have access to health care and mental health in particular is very important.
We have people who are taking their lives in the villages and have similar conditions with people who take their lives in the cities, what are we doing about them? It is just lack of access to health care and the gap between those who are ready to provide the mental health services and the services that they need to provide is very wide.
There is a dearth of mental health personnel in the country. The ratio of psychiatrists doctors and other mental health professionals is about 180 to 5,000 to every person. Therefore, we need to improve manpower of mental health professions. Because we cannot provide specialise manpower at every place that is needed, what we can do is to build low to middle level manpower. People who even though they cannot treat depression, they can be able to identify depression and point at the direction to go.
We need to ensure that mental health is accessible to all people. That is why the NMA is advocating that we should accelerate work towards Universal Health Coverage (UHC).
Talking about awareness, is it not an indictment on the health experts that you waited until the situation has grown to this high proportion that you are rising your voices?
Well, I am not very quick at rejecting faults if somebody says I have one. However, this thing is everybody’s job. It is not the job of only the doctors. You must not know how to treat depression before you talk about it. If we have faults as doctors in raising these issues, journalists perhaps have 10 times that fault because they are the major source of reaching to the people.
Journalists also need to raise awareness and be advocates for mental health anywhere they find themselves.
Some people blame those who commit suicide for not going to the church or the mosque to get words of hope and comfort. Do you buy the idea?
In fact, I don’t buy the idea. If you ask me, I will tell you that the churches and mosques have also contributed to the suicide. This is because most of the churches and mosques that we have today will give you the impression that things are going to work in a day or two, at worst by the end of the year. We have stickers boldly written- ‘This is my year of success,’ ‘This is my year of advancement,’ ‘This is my year of favour.’ Churches create all these things and at the end of the year the person looks at his life and sees that there hasn’t been any favour, no advancement and in fact, he is even deeper into the problems that he started with at the beginning of the year. I think churches should also take responsibility.
The religious groups have a role to play, but my thinking is that they do not help people out. They must come clean and tell people that, look, we are not magicians.
If you are opportune to be face to face with the President and his ministers, what advice will you give them concerning the current high level of depression in the country?
In fact, I will ask them to accelerate UHC to ensure that everybody have access to affordable health care.
Our health system now appears more to be reactionary, solving problems that arise every day. A minister can be in office two or three years and all is doing is to solve problems as they come. We are not strategically achieving our goals.
If you go to the Federal Ministry of Health, I believe that they will have piles of national health strategies, national programmes on health and many things. We are very reactive to the situation that we find ourselves.
We need to have a strategic plan and to follow it through. Like a national rolling plan for 4 years, 10 years and ensure that it is followed to the later. I will also tell them. to plan.
As it is now, today you will hear that this CMD has been sacked, another has been reappointed. For years now, we don’t have boards in the sector and the ministry is just watching.
I can categorically say that the health sector is not getting the attention it deserves and we do not need the President to do this for us. People are simply not doing their jobs. We are not planning anything. Even the plans that are in place, we are not following through with them.
Speaking on health insurance, how come it is only covering people who are working for the federal government?