We must act now to reduce suicides in the country

This past week we marked the World Suicide Prevention Day, under the theme “Connect, Communicate, Care”. It is entirely understandable that most people think that suicide is a problem that only affects other people.

Many even think that it is not a common problem and we can afford to ignore it. When someone says something suggesting suicidal thoughts or ideas we are often quick to dismiss them with statements such as “Get over yourself already! Why would anyone want to kill themselves?” We are quick to tell them to “snap out of it” and be strong, and other similarly dismissive statements.

The fact of the matter is that suicide is extremely common and, according to the International Association for Suicide Prevention, over a million people worldwide die every year from suicide.

Up to 20 million people attempt suicide annually, meaning that every 10 seconds someone somewhere is attempting suicide.

There are Kenyans who would dismiss these statistics and say that suicide, as well as many mental disorders that increase the risk of suicide, is a “foreign” concept that probably afflicts only people in the West.

To use a popular epithet beloved of people around these parts, these concepts are “unAfrican”. Working with this hypothesis in mind, we have recently concluded a study in a community in western Kenya to determine the community prevalence of a number of mental disorders. Our findings confirm what others have suggested in the past.

Almost half of those we interviewed had at least one mental disorder at some point in their life, and only about two per cent of these had ever been diagnosed to have a mental illness.

Over 98 pc of the respondents with a lifetime history of mental illness had never been diagnosed or put on treatment, highlighting the massive diagnostic and treatment gap for these disorders. Over an eighth of the population had suffered from depression in their lifetime, but other mental disorders were very common as well.

ATTEMPTED SUICIDE

Finally, a whopping 16 pc of the population had ever attempted suicide in their lifetime.

We need to take a moment to think about these statistics for a moment. One out of every six people in this rural community had attempted to kill themselves at some point in their life.

The community we are talking about is a typical rural community in Kenya, where most of the people are Christians engaged in subsistence farming or are self-employed. More than half of the adults are married, and have a secondary or post-secondary school education. In other words, it is a “normal” Kenyan rural community.

It is reasonable to expect that with the stresses of modern living and the heightened sense of inequity present in our urban areas, the risk of mental illness and suicidality would be higher in urban areas compared to rural areas. One can therefore conclude that the estimates found in our study are conservative, and the problem of mental illness and suicidal behaviour is greater than these findings suggest.

Globally, depression, one of the most important risk factors for suicide, is the second leading cause of the burden of disease, and many countries are waking up to the reality that they must plan and deal with these conditions if they are to be assured of continued prosperity.

In Kenya, we are still in denial about the importance of our healthcare delivery system, experimenting with the lives of our people.

We apparently do not have the time or inclination to address the problem of mental ill health and suicide. We think, as we are wont to say, “We are doing just fine”. The many suicides that are reported in the press, the bizarre acts of violence, road traffic crashes, all point to the deteriorating state of mental health in this country.

The time to act is now. We must begin putting resources into mental health aimed at guaranteeing a better life for this and future generations.

Atwoli is associate professor of psychiatry and dean, School of Medicine, Moi University; [email protected]