10 out of 100 Ugandans commit suicide every year

SUICIDE    MENTAL HEALTH

On October 10, Uganda joined the rest of the globe to commemorate World Mental Health Day under the theme; Focus on suicide prevention.

Professor Eugene Kiyanda, who is a suicidologist who works with Medical Research Council at Makerere University describes suicide as a spectrum of behaviors and ideas.

"At one extreme, people just have ideas, for example, one my say living in this world is painful, I just need to get out.

Later the ideas become stronger and even develop a plan on how to achieve suicide by either using a rope, tablets or a gun," Kiyanda explains and is quick to add; that this may later be followed by attempts that may be successful while others may be unsuccessful.

Godfrey Zari Rukundo says often when talking about suicide, people quickly think of struggling or hanging oneself by a rope.

However Rukundo says suicide involves many other forms, for example, one may fall over a cliff, take poison, jump into a running vehicle, drive recklessly, cut or shoot themselves.

Statistics

Data from World Health Organization indicates that globally close to 800,000 deaths resulting from suicide are recorded. This translates into one death every 40 seconds.

It is also worth noting that suicide is rated as the second leading cause of death globally among young people aged between 15 and 29, with 79% of these young people coming from low and middle-income countries including Uganda.

Specifically, Uganda takes the 68th position in terms of suicide prevalence at 9.9% according to the WHO estimates 2018.

About 10% of suicide prevalence is quite on the higher end. Much higher than the national HIV prevalence rate at 6.2%.  This means we are having more people dying as a result of suicide than HIV/AIDS.

Why should we care?

Derrick Kizza who is the executive director at Mental Health Uganda explains that 10% suicide rate is symptomatic of bigger unresolved socio-economic factors which of course cost the economy and not to mention causing stress and pain to bereaved families.

Many suicide cases still go unreported

Kizza argues that suicide prevalence could be higher than what is reflected. But often, suicide cases go unreported because people fear to be subjected to investigations as suspected accomplices.

Secondly, the stigma issues associated with the crime are still a big barrier coupled with the burial rituals performed for the victim. For instance, for most cultures in Uganda, a suicide victim is never accorded a decent burial. A grave is dug at the scene of crime where they are buried, he notes.  

Who is likely to commit suicide?

Dr. Hilary Irimaso a psychiatrist at Kampala Medical Chambers says depending on different circumstances both the young and old commit suicide.  However, lately, there are many more cases of young people between 15 and 24 committing suicide.

This is because there are so many changes in their lives, so many disappointments such as relationship heartbreaks, others have completed university and do not have jobs and they become frustrated yet their parents expect them to take over responsibilities and are not able to.

Additionally, Dr. Irimaso says being old; above 60 is a risk factor for suicide. "People who have retired and their income has gone down, their pension has not been processed or have lost the social networks, or they have given up on their goals and objectives or they are being taken advantage of by their children. So they become depressed, consequently contemplating suicide," he notes.

Drugs addicts are at increased risk since the substances may interfere with their judgment and reasoning. Consequently, they end up frustrated and only think of suicide.

Irimaso adds that people who are isolated, lack social support or do not have friends and are at risk because they have no one to talk to. So when they come up with their plan they are able to execute it. This category includes people who are single, divorced or those who separated from their spouses. 

Telltale signs of suicide

Kizza says a person who is contemplating suicide may communicate about it directly or indirectly. For example, they can say things like I will disappear and you will never see me again.  I will leave you in your peace or say they directly say they will end their lives. Sometimes they start giving away their property.

For instance, someone may choose to give away their nice clothes, withdraw money from the bank and give it away. Others choose to isolate themselves, choose not to eat or give up things they were interested in, a sign that they have lost hope.

Others will have an organized death plan, for instance, they say they want to die on their birthday and towards that day they start to give away their property.

How to help someone contemplating suicide

It is important to take someone contemplating suicide serious and not to ignore what they have said, Rukundo cautions. You should also find out why they think suicide is the best solution and then help them to address that problem they are trying to deal with by committing suicide. ‘

Then take away anything that is likely to be used for instance a rope, poison or a gun. Alternatively, take the person away from the weapons. After you can deal with their problems until they have overcome them.

Prevention

Kiyanda says early intervention is the best preventive measure against suicide.  For example, he says if someone is depressed or has excessive sadness, or someone has been running a big business, bank loans have overtaken him and is struggling to pay back, people should provide support and counseling.

In addition, people should learn to take threats seriously. For instance, when someone says they are going to kill themselves, it should not be dismissed as mere threats.  Instead, Kiyanda says they should help such a person seek mental health assessment.

Rukundo says when a depressed person starts giving away their property, it could be a sign that they are preparing to take their life. It is therefore important that close people try to engage this person as you might find there is an underlying suicidal risk.

Kiyanda urges people to be alert and closely monitor relatives or friends who have gone through a major crisis.

"They should try to help and not to leave them to sort out issues on their own," he advises and adds; if people suspect someone is harboring suicidal thoughts, they should help them seek mental health services. 

 Rukundo says suicide is preventable and because no one would want to die, people who commit suicide usually have challenges that they fail to sort out. Supporting them to look at their issues differently, providing them with solutions, social support or dealing with the risk factor are some of the measures to prevent suicide.

Does suicide run in families?

Although, there is a genetic disposition in how we cope with stress and the way we solve problems, notes Rukundo. But also people tend to learn from the people they relate with on how to solve problems. For instance, if the auntie committed suicide to solve a problem, the others will tend to emulate the same.