Cry for Pain: Silent Grief of Suicide, the Need for a Robust Health System Strengthening

The apparent rise in reported cases of suicide in Ghana have become a matter of concern. What makes it more worrisome is the fact that, a significant number of cases reported involve the younger generation, the youth. There have been very shocking reports of suicide cases among young and promising university students in Ghana. Our deepest condolences to the families and friends of suicide victims. Counselling services are urgently required for family members of suicide victims to support them to cope and avert this unfortunate event happening in other family members. The burden of suicide requires urgent attention and is high time for all relevant stakeholders to come together to ensure accessible quality mental healthcare delivery within a resilient health system.

The World Health Organization (WHO) states that by the year 2020, 1.5 million people will kill themselves annually worldwide. This information is alarming by all standards. This make suicide and suicidal behaviour a top health issue that needs urgent attention of the leadership of all countries, policy makers, healthcare providers, civil society and the larger society amongst others.

According to Professor Brian Mishara, a former President of the International Association for Suicide Prevention, in a survey conducted by his institution, it was revealed that "more than a million people worldwide die by suicide each year, many millions make suicide attempts severe enough to need medical treatment and many more millions are affected by the disastrous impact of a suicide with a global mortality rate of 1 death every 40 seconds." He added that "in this age of preoccupation with global violence, terrorism and homicides, an often ignored fact is that, worldwide more people kill themselves than all those who die in all wars, terrorist acts and interpersonal violence.’’

Section 57 Clause 2 of the 1960 Criminal Code of Ghana clearly states that attempted suicide is a crime. Committing suicide or attempting to commit suicide is therefore a criminal act. Unfortunately, the unintended negative effect is that, this prevents persons who have the intention to commit suicide to come forward for help! Family members of suicide victims indicate that they would have sought health for their suicide victims if they were knowledgeable enough about suicide and the help available for it aside other mental health conditions.

Currently a lot is being done by the Mental Health Authority, the Mental Health Department of the Institutional Care Division of the Ghana Health Service with regards to mental healthcare in collaboration with key stakeholders in Ghana. A lot can be done to complement their efforts to prevent the silent grief of suicide with reduction in suicide prevalence and for that matter this cry of pain.

A deep understanding of mental health conditions and related issues of concern can inform how Ghana can contribute to changing the silent grief of suicide. Mental health disorders and their repercussions such as suicide, affect all people regardless of age, socioeconomic status, and gender amongst others. Recognizing the prevalence of mental health disorders, specifically suicide, helps us to see that the problem is widespread. Awareness of educational institutions, civil society organisations and others of the need to improve mental health awareness may seem small, but it is the first crucial step.

As often said knowledge is power. Expanding the mental health knowledge of citizens is very important. Mental health clubs and courses should be introduced in schools, communities and corporate organisations. This will expand basic knowledge about common but prevalent mental health conditions. Learning the potential risk factors of suicide can be helpful. To learn more about risk factors you can visit the National Suicide Prevention Lifeline and the Suicide Awareness Voices of Education . To learn more about protective factors, you can view the Centre for Disease Control and Prevention’s Technical Package of Policy, Programs, and Practices .

Furthermore, the need to seek help is important. Mental health knowledge acquired can enable you recognise when help is needed. Expanding knowledge will enable individuals to identify early warning signs of the menace and immediately seek help or encourage others to seek help. Mental Health America provides a helpful toolkit to help you take care of your own mental health. It needs not to be over-emphasized that, providing support for people at risk of mental health is helpful to suicide prevention.

Recognising barriers to seeking care is essential. The stigma and various forms of stereotypes about mental health and its treatment can be major obstacles for seeking help when people are in crisis. Individuals with suicidal ideations or mental health issues worry when seeking help, because they usually feel or see themselves as a burden or attention-seeking individuals and hence may shy away from care. Although pervasive stigma often serves as an obstacle, it is not the only common barrier to consider. An individual may be aware of concerns and may wish to make a change; however, there may be obstacles that inhibit their accessibility to services . For example, lack of financial resources, lack of access to mental health services and lack of access to transport amongst others are potential barriers.

Importantly, suicidal ideations happen to be one of the ways a mental health disorder may present, for example severe depression is associated with pessimistic delusions and suicidal thoughts. Therefore, as aforementioned knowledge about mental health disorders, access to mental healthcare and ease of availability of psychotropic medicines would help in the early and proper management of diagnosed mental health disorders. The need for emotional support by families, communities, schools, corporate organisations cannot be overstated. Pertaining to the youth, especially those in schools, the various Parent Teacher Association and University Authorities should put in place management arrangements that help students to build good self-esteem, skills for self-awareness, social awareness, self-management and relationship management. This would engender skills for identifying triggers to suicidal ideations that need to be avoided and positive habits which if adopted largely avert suicidal ideations. In addition, especially for tertiary students coaching, mentoring and guidance programmes should be instituted, whereby “no student is left behind” as captured succinctly by the SDGs.

If you someone is in crisis, call National Suicide Prevention Helpline 0509497705/ 0558424645 or text the crisis text code *711*88# and they will get right back to you. Both services are available 24 hours a day, seven days a week.

By Mr. Pascal Landindome Navelle and Dr. K. Boateng Boakye