People who attempt suicide are sick but law sees them as criminals

EVEN THOUGH SUICIDE is one of the leading causes of death, little attention is paid to it.

Dr Catherine Syengo Mutisya, the head of substance abuse and management in the Ministry of Health, quotes the World Health Organisation (WHO) as saying 7,126 Kenyans commit suicide every year; the country is ranked 29th in the world with regard to its suicide rate

Attempted suicides are at least 20 times more common, bringing the figure to 142,520.

But Dr Mutisya says the number is higher: “Since suicide is a crime in Kenya and is often concealed, we do not have clear records.

“We rely mainly on reports from health facilities. Of course, not all such cases end up in a health facility.”

She says even doctors don’t report attempted suicide because they are aware that there is an underlying mental problem, “yet if we report it, the patient could end up in jail”.

She says in about 90 per cent of the suicide and attempted suicides cases, there is an underlying diagnosable mental health condition.

DEPRESSION

While depression is the leading cause of suicide worldwide, other mental disorders also lead to suicidal tendencies, as do drug abuse and eating disorders.

The remaining 10 per cent are due to other factors like frustration, a loss or a break-up, job-related issues, bad relationships, being a victim of bullying or sexual abuse and other experiences that cause emotional turmoil, “although discussions are ongoing whether it is just that the mental disorders in this 10 per cent haven’t been picked up,” says Dr Mutisya.

She adds the only mental illnesses that are not associated with suicide are dementia and mental retardation because the patients are not capable of planning such a thing. All others are associated with high rates because in addition to the illness, the individuals are stigmatised.

Of all those who attempt suicide, one-third repeat the behaviour within a year and nearly 10 per cent eventually commit suicide.

SHORTAGE OF FUNDING

Yet tackling the issue is hard mainly due to a shortage of mental health programmes and funding.

Ms Peris Njeri, who attempted suicide twice, said at the inaugural Suicide Prevention Day celebrations at the Mathari Hospital on September 11 that many mental patients cannot afford treatment in private hospitals — where consultation fees range between Sh2,000 and Sh4,000, —yet there are very few mental health doctors in public hospitals.

The teacher and mother of three, who suffers from bipolar disorder I and II, appealed to the government to increase its budgetary allocation for mental health to enable the expansion of facilities and programmes in the area.

On the two occasions she attempted suicide (1990 and 1995), she did not get the expected support from her family, Ms Njeri says.

She was put on treatment in the 2000 after her problem was diagnosed.

This year’s suicide commemoration theme, 'Connect, communicate and care' aims at creating awareness in society.

New trends show that more people between adolescence and the age of 25 are committing suicide.

Dr Mutisya says here are two peak periods: from adolescence to age 30, and from the 60s onwards. She notes: “We are seeing a new trend among the youth, probably because they cannot adjust to everyday stress, especially among school children who commit suicide mostly because of failing exams, as well as young jobless adults and those in relational crises.”

“More needs to be done because we’re seeing higher numbers,” she adds.

HIDING CASES

Dr Mutisya says it is sad that so much effort is put into hiding cases of suicide and attempted suicide.

“When someone commits suicide, it is seen as a curse and people don’t want to talk about it,” she says.

“In some cultures the body is beaten while in others the family members have to be cleansed. That means many cases go unreported,” she adds.

That is why the Ministry of Health wants attempted suicide decriminalised, she says.

Legally, anyone who attempts suicide is guilty of a misdemeanour punishable by imprisonment for a term not exceeding two years or with a fine, or both.

Dr Mutisya argues that this law only serves to hide the problem and endanger more lives.

“We want attempted suicide to be recognised as a psychiatric illness, not a criminal offence,” she says. “Any person who attempts to kill himself is unwell.

“Sick people need treatment and care, not jail.”

She says talks are ongoing within the ministry, which has also initiated talks with the Kenya Human Rights Commission (KHRC), with the aim of getting the government to repeal the law.

She says decriminalising attempted suicide will reduce the stigma, save victims from punishment, and lead to a more accurate collection of suicide-related statistics, as well as accessibility to opportunities for prevention.

She says the ministry had proposed the development of a framework to deliver mental health services to all those who attempt suicide.