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World Health Organisation (WHO) defines suicide as the act of deliberately killing oneself.
Suicide can also be defined as an act with a fatal outcome that is deliberately initiated and performed by the person in the knowledge or expectation of its fatal outcome.

Suicide is a phenomenon that is well known even prior to civilization. In many cultural or ethnic groups, it is a taboo/abomination for one to take his/her life. These cultural beliefs make it difficult for people to volunteer information about suicide cases. In developing countries like Nigeria, this and other factors makes gathering of accurate data about suicide difficult. However, it has been found that generally, Suicide rates are lower in times of war and revolution and increased during the period of both economic prosperity and economic depression.

Types of suicide

People who commit suicide have been found to have different motives or reasons. A renowned French sociologist; Durkheim in 1897 described four different types of suicide based on the motive behind the act; they include:

Anomic suicide: This group of people are said to have lost their sense of purpose in life and have a feeling of moral bankruptcy. There might be an intense feeling of guilt and worthlessness in which the victim may believe that his or her sins are unforgivable. This kind of suicide is common among the victims of sexual assault or rape.

Egoistic suicide; this type of suicide is committed by people who feel detached from their community. They are mostly elderly people who have lost their relevance and are consumed by a feeling of alienation from their society. This group might actually live in despair at this stage of their life.

Altruistic Suicide; this kind of suicide is usually committed by people in armed forces, cults, or terrorist groups. They believe ultimately in the cause of what they are fighting for. In most cases, they see themselves as heroes for their country or martyrs for God.

Fatalistic Suicide; People who commit Fatalistic suicide do so as they feel oppressed by those in power and believe that the only way out of such oppressional system is to take their life. For example prisoners and people who are governed in oppressive and repressive regimes.

Risk factors:
The risk factors for suicide include;
A. BioPsychological risk factors;

These are usually;

1. Mental disorders

2. Alcohol and drug dependence (addiction)

3. Depression

4. Schizophrenia

5. Anxiety disorders

6. Chronic /terminal illness like cancer, HIV Infection, sickle cell disease, etc.

7. Genetic predisposition / family history

B. Social Risk factors;

1. Loss of loved one

2. Loss of means of livelihood

3. Divorce or separation

4. Financial downturn

5. Poverty

6. Unemployment

7. Inability to meet one’s goals and aspirations in life.

8. Inability to meet basic needs of life.

9. Oppressive and repressive regimes/governments.

10. Gross inequality in the way the national wealth is distributed.

Who is at RISK?
1. Victims of rape

2. Victims of natural and manmade disasters

3. Prisoners

4. People who have chronic illness

5. People who suffer from psychological and neurological illness.

6. Gays, lesbians, transgender, Bisexuals.

7. Alcoholics

8. Drug abusers

9. Some professionals e.g. Doctors

10. People with a previous suicide attempt.

11. Refugees, Internally displaced people (IDP’s) and migrants

1. Use of pesticides

2. Drug Overdose

3. Hanging

4. Firearms

5. Drowning

6. Wrist cutting

7. Setting self ablaze

8. Jumping from heights

9. Deliberate injury to head

10. Starving

11. Suffocation

12. Car exhaust fumes

Prevention of Suicide:
Suicides are preventable. According to the World health Organisation (WHO), the following strategies can be implemented to prevent cases of suicide attempts and completed suicide;
1. Reducing access to the means of suicide (e.g. pesticides, firearms, some medications).

2. Reporting by media in a responsible way.

3. Introducing alcohol policies to reduce the harmful use of alcohol.

4. Early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress.

5. Training of non-specialized health workers in the assessment and management of suicidal behavior.

6. Follow –up care for people who attempted suicide and provision of community support.

7. Providing crisis centers and “hot lines” for people who have suicide ideations or thoughts.

8. Public education campaigns to educate the public about mental illness and its treatment.

It has been noted that during economic crisis (Recession and depression), rates of suicide increases. During this period, genetically prone individuals and vulnerable persons do not have access to basic needs of life, and there are also financial inadequacies to access appropriate and quality mental & medical health services.

The situation is more critical in a country like Nigeria where mental health services are not given enough attention by both federal and state governments. The situation is being worsened by the belief system of the society and pervasive and prevalent stigmatization of mentally ill persons.

It is unfortunate to note that existing laws in Nigeria today, criminalise persons who attempted suicide and the society abhors and stigmatizes the families of an individual that commits suicide. To stem the rate of suicidal attempts and completed suicide in our society, the stakeholders in both governmental and non-governmental institutions have to step up actions towards effective prevention strategies.

It should also be noted that good governance which abhors corruption in its entirety, equitable distribution of resources in terms of infrastructure, social amenities, and creation of employment by merit, social justice and fairness to all will go a long way in enhancing the standard of living of the populace thereby reducing the incidence of suicide in our society.

Dr. Uchendu Ifedilichukwu Uzoeghe

Consultant Neuropsychiatrist

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