Author name: Noetic Minders Health Services

Advocacy

“Suicide” As Newspaper Headline: To What End? By Margaret Uddin-Ojeahere.

Avoid the gory details of the act, methods and locations; avoid repeated use of images which display the means or faces of the affected individual. Preferably report the consequent trauma and emotional devastation felt by their survivors, the vacuum left behind and probably the attendant hardship that ensues in some instances. The reportage of suicide should underscore the fact that suicide can be prevented… The World Mental Health Day is marked every 10th of October. This year’s theme revolves around suicide ― the taking of one’s life, with this fatal outcome being a deliberate intention. Unsurprisingly, domestic media reports of each incident of suicide border on the sensational. Different reasons account for this. From pure naivete and the shock of learning of an event perceived to be alien to our culture, it may seem appropriate to report such a seemingly interesting event. Against the widely reported “fact” that Nigerians are regarded as some of the happiest and resilient people on earth, these reports raise questions about how much is myth, misconception or the consequence of changing dynamics. For others, it is an opportunity to draw attention on a social media platform. Usually just a click on the ‘send’ button is all that is needed to disseminate information. There is also the possibility of a trained professional eager to carve a niche for herself in the field of journalism, regardless of the consequences. So, why should the consequences of suicide coverage be an issue of concern, when all the disseminator wants to do is to inform? What readily comes to mind is the “Werther effect”. A phenomenon where there occurs an increase in the imitation of a widely publicised suicide. This concept was coined from the novel The Sorrows of Young Werther by the German writer Johann Wolfgang von Goethe, where the leading character dies by suicide in the name of love. Sequel to the book’s publication in 1774, over three dozen young men took their own lives in circumstances similar to that of the protagonist. This phenomenon is synonymous to suicide contagion or copycat suicide. It has been established over the years that the more sensational the portrayal of a suicidal act, wherein the details such as the method, the location and the events that surrounded the act are well elaborated, especially when a renowned individual is involved, a spike in occurrence is observed. This imitative behaviour has been observed to spread quickly and spontaneously, among young adults usually. It has also been suggested that the glamorisation of suicide by the media may influence and motivate similar actions in susceptible individuals to contemplate or outrightly complete it. There is the question of why so much hullabaloo over reportage of suicide plagues the mind. After all people die daily and it is not reported with so much fuss. What then makes the topic of discuss spectacular, such that each one discovered results in people going through pain to ensure it gets some degree of review? Could it be its intentional nature that makes it uncanny and sensational? Howbeit, a life is lost and people are bereaved, and just as we are sensitive to the demise of others, which occurred from a gamut of causes, we should also consider the families and loved ones of individuals who died from suicide when reporting the event. It is bad enough that they have lost someone. To be constantly reminded and stigmatised consequent upon the demise of their loved one might just be a pain too much. If we intend to curb this growing menace, then it is high time responsible portrayal of suicide is ensured by regulatory bodies for traditional media organisations and the encouragement of sensitive reportage by self-made journalists who are oblivious to the adverse impact on family and loved ones. Some might say this suicide thing is starting to sound like a cliché, however for a doctor or a mental health practitioner, suicide or attempt at the act is an emergency that results in the mobilisation of resources to ensure that the individual gets appropriate care, and this involves the collaborative effort of both professionals and non-professionals. It is therefore not surprising that the World Suicide Prevention Day on September 10 and The World Mental Health Day chose the same theme this year, of “Working Together to Prevent Suicide”. It is no longer news that suicide is among the top-20 leading causes of death globally across all ages and the second leading cause of death among youth aged 15-29 years, or that over 800,000 people worldwide die by suicide annually. Every 40 seconds, one person will die by suicide and for every suicide, an estimated 20-25 people would have attempted it. One wonders how many more people have entertained suicidal ideas or thoughts. Mental illness is one of the most important causes of suicide, and depression, a major contributor to these. Perhaps what may be news to some is that for every act of suicide, about 135 people are affected by their death, which makes an estimated 108 million people who have lost someone to suicide worldwide. It is important to note that people bereaved by suicide are referred to as suicide survivors. These data, in my opinion, are conservative, considering the fact that suicide is under-reported in countries like Nigeria, where stigma greatly affects survivors’ willingness to admit to death by suicide in the family. Thus, this phenomenon is mostly concealed, but for the advent of social media. In recent times, the print and electronic media have ensured that incidences of suicide are reported at such rapid speed, with the gory details splashed all over on an almost daily basis, making it difficult to ignore. Pictures are splattered over social media as statistics for suicide jingles or seminars. Mouths wag and judgmental statements are made in loud whispers. Beyond the increased number of cases consequent upon the sensational reportage, empathy and the feelings of the survivors should be taken into cognisance. We need to remind ourselves that a tragedy

Mental Health

Who Needs A Psychiatrist? By Margaret Uddin-Ojeahere

It is important to emphasise that seeing a psychiatrist does not necessarily mean that one is “mad”. At times people need help to cope with the challenges they face, whether at work, in their academic pursuits or otherwise, which may threaten their mental health. The question, “Who needs a psychiatrist?”, is becoming more pertinent than ever before in the history of man. Not only because the different turmoil across diverse parts of the world have led to an increasing number of individuals with one form of mental illness or the other. But, also, because of the misconception by a considerable number of people that “psychiatrists” attend to only “mad” people. The erroneous impression most people have of mental illness is that of a disheveled, matted-haired, tattered-clothed individual who goes around hoarding rubbish and talking to invisible beings. This is as far from the truth as it can be. Truth is, mental illness bears the face of your neighbour, a colleague at work or a member of your church or mosque. However, a lot of people find this simple fact hard to process. While I cannot fault them for this, considering the longstanding stigma and its attendant psychosocial consequences that have been associated with mental illness, I am also mindful that people give their own explanations to what confounds them. Unfortunately, in Nigeria, dare I say worldwide, mental illness has continued to be shrouded in a great deal of mystery, leading to different reactions in which general perception has oscillated between the extremes of fear, ridicule, revulsion and ignorance, on one hand, and fascination, voyeuristic curiosity and normalisation on the other hand. It is therefore not surprising that several misconceptions surround mental illness and the role of the “psychiatrist.” The mere mention of a “psychiatrist” sends cold shivers down the spine of most people. “Why a psychiatrist?” “Isn’t that a doctor who treats ‘mad’ or ‘insane’ people?” “Is my case that bad?” “After all, I am educated. I have a good job. I don’t need to hear about a psychiatrist”. And the list of excuses goes on and on. …there exists a huge burden of mental illness, and a dire need for psychiatrists around the world. Yet, Nigeria has about 250 qualified psychiatrists to a population of 40-60 million people with mental illness. Even more bothersome, of late, has been the massive exodus from the country of doctors in different areas of specialisation. Health, if the World Health Organisation (WHO) is to be believed, is a “state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity”. Is there “health” without “mental health”? Not if “mental health” is understood as a “state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make contribution to her or his community”. WHO, the author of that last quote, also estimates that more than 450 million people worldwide suffer a form of mental illness. In the U.S., the National Alliance on Mental Illness reports that one in five people will experience a form of mental illness every year and for one in 25 persons, it will be severe and persistent. Our Federal Ministry of Health recently put the number of Nigerians suffering from one form of mental illness or the other at about 20 per cent to 30 per cent of the population. What this therefore means is that there exists a huge burden of mental illness, and a dire need for psychiatrists around the world. Yet, Nigeria has about 250 qualified psychiatrists to a population of 40-60 million people with mental illness. Even more bothersome, of late, has been the massive exodus from the country of doctors in different areas of specialisation. Needless to say that a number of these psychiatrists are leaving the country for perceived greener pastures. Can we blame them for not being patriotic or for wanting to “check out”? No! In a country with little or no job prospects for newly qualified specialists in various medical fields, little wonder this exodus continues. Evidently, not every doctor desires farming nor tailoring, as suggested by the Minister of Health in one of his interviews. Beyond her other hobbies, though, a psychiatrist is a qualified medical doctor specialising in the study, prevention, diagnosis and treatment of mental disorders. The psychiatrist is trained to evaluate patients, determine whether a person’s symptoms are the result of an underlying medical condition, which may result in the manifestation of a psychiatric disorder from a solely psychiatric condition, as seen in some cases of schizophrenia or the combination of a medical and a mental disorder. The sense, therefore, that psychiatrists treat only ‘mad’ or ‘insane’ people is a distortion of the fact that the public perception of mental illness revolves around psychotic behaviours. Yet, a significant number of people worldwide (Nigerians inclusive) experience less profound forms of psychiatric illnesses such as anger problems, sleep disorders… Psychiatrists are licensed to prescribe appropriate medications, as well as to engage in psychotherapy to alleviate these mental disorders. They usually work with other mental health workers, including psychologists, nurses, social workers, vocational therapists, speech therapists etc., and in liaison with other non-psychiatric physicians. Psychiatrist also engage in intersectoral collaboration with the public, private sectors and civil societies to ensure the best care possible for people with mental illness. The sense, therefore, that psychiatrists treat only ‘mad’ or ‘insane’ people is a distortion of the fact that the public perception of mental illness revolves around psychotic behaviours. Yet, a significant number of people worldwide (Nigerians inclusive) experience less profound forms of psychiatric illnesses such as anger problems, sleep disorders, anxiety and trauma-related disorders. The reality, then, is that not all people seen by a psychiatrist have obvious forms of mental illness. Part of our uniqueness as human beings are our idiosyncrasies and foibles. Most people will have a mental health challenge from time to time, usually

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