Guest Lecture Series of the College of Medicine, University of Benin, Nigeria
Veering into the topic of “Suicide” means steering into a wide expanse of void space with much questions left to answer. Suicide remains one of the leading causes of death amongst young people and some elderly people all over the world.
I was at the lecture series organized by the College of Medicine, University of Benin, Edo State Nigeria that held on the 28th of January, 2020. In this event, the guest lecturer, Prof. Sunday O. Olotu, the Medical Director of the Federal Neuropsychiatric Hospital, Benin City, expansively discussed suicide, its prevention and promotion of mental health, with the aim of educating the general public on the ways through which suicide and suicide attempts can be greatly reduced in the local university community.
He noted that suicide is almost always preceded by suicidal behaviours, ideations and pre-occupations which may give way to planning, and an actual suicidal attempt. Suicidal behaviours often manifest as abnormal mental behaviours, emotional, psychological and cognitive behaviours, where the individual alters words or pre-occupies himself on thoughts that centres on the need to end their lives. With high rates in low and middle-income countries, suicides, however, cut across all socio-economic strata. High rates indicate values greater than 25 deaths per 100,000, and less than 25 deaths for low rates. The speaker also noted that bullying is associated with the incidence of suicides amongst young people between ages 15 and 29 years.
Epidemiologically, suicide is the 10th leading cause of death in America, the 5th leading cause of death of China, 2nd leading cause of death amongst young people, only second to violence-related causes. 75% of deaths are due to suicides in low and middle-income countries.
Theories Of Suicide
The keynote speaker also talked about the theories of suicides, including the Biological theory, Social theory, Freud’s theory, Menninger’s theory, and the Joiner’s theories of suicide. The theories that struck my attention were Social theory and Joiner’s theory. The social theory, according to the speaker, centred around love objects(objects to which the person is emotionally attached to). The individual then creates a subconscious image of the love object in his/her mind. Such that when there is a strong reason to develops hate for the external love object, he/she tries to eliminate the love object replica within their mind. However, that internal love object is really not physically present. Therefore, in trying to eliminate it, the individual believes it has to be by terminating their own life. Joiner’s theory borders on the feeling that the individual is a burden to his/her family or loved ones. They then seek to end their lives to relieve the perceived burden. It may also be due to the sense of thwarted belongingness, perception of disconnectedness from people and acquired chronic illnesses.
The speaker also pointed out some risk factors, including the following:
Poor Sleep Agitation
Dislocation and/or relocation from home
Bereavement and results of bereavement
Sexual assault, and
Depression is top of the list of the causes and risk factors for suicides. However, there are some factors that he described as protective factors and these include the list below. Recognising the risk factors and protective factors will help the individual and the community to prevent the incidence and prevalence of suicides in the community.
High social status
Engagement in rewarding activities
Good sexual life
In many parts of the world like Nigeria, suicide is considered a taboo and anyone suicide victim will not receive proper burial rites like is practised in other parts of the world. In Nigeria, a suicide attempt is a criminal offence and is punishable by the law for attempting to take one’s own life. In view of these, the speaker expressed that the laws do not see the victim as needing some form of help but rather, incriminating them.
Understanding the triggers of suicidal ideation, that is the premunition or thoughts of suicide, will help to profer preventive measures. At the tenets of suicide prevention revolves around identifying risk factors and mitigating them, and protective factors to promote them. The following list can be obtained:
Catharsis, where the individual finds ways and exercises that purges them from repressing feelings and emotions. Music is a good catharsis to some people, others involve other exercises.
Enhancing individual strengths and weaknesses.
Create a redirection of emotions to some other objects instead of self.
Involvement of non-governmental organisations.
Discouragement of luring press reports of suicide cases, to prevent the “copy cat phenomenon”. It has been noticed that the press embellishes suicide in the manner with which they report suicidal cases. Other vulnerable individuals may seek to gain fame even after death by taking their life since they are sure it works that way.
Clubs, anti-suicide clubs
Interpersonal community relationships
Mental health care
The national response, in line with the SDG for non-communicable diseases
Legislation to de-criminate suicide attempt and focus more on prevention and rehabilitation.
It is worth noting that there is a role of the individual as well as the general community in preventing suicides. Discouraging discriminatory activities and encouraging social bonding will go a long way to reduce the incidence of suicides in any given place. Smiles, hugs, and other social expressions have been shown to have suicide-preventive abilities.
A note on the individual, catharsis is grossly useful. Every individual must find a way to diffuse stress from internal and external stressors. Depression can be overcome if people know when to seek help, that is when their own coping mechanisms have been exceeded. Someone recently described that one reason why people get depressed is their inability to find answers to their inner questions and challenges. And their refusal or otherwise to consult someone higher for help when they are exhausted.
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