Rising suicide crisis: How 250 psychiatrists battle Nigeria’s 60 million mental cases

He just returned to his parents’ home after being away for a year. His mother realised that he was not his usual self as he had become withdrawn and always seen staring at nothing in particular for several minutes with a distant expression indicating that he was in a world of his own.

Whenever his siblings offered to take him out, he would refuse all entreaties, insisting that he wanted to be alone as he was unhappy and sometimes complained about his inability to get a job.

It was learnt that the mother woke up at midnight on that day to see if the house doors were locked and no electrical appliances left on as she usually did.  To her utter shock, she saw her son lying in a pool of his blood in the kitchen with a knife tugged at his body and his bowels ripped out, suggesting suicide.

This is the heart-rending story of Chidike Oyeka, a 25-year-old graduate of Madonna University, who just returned to his parents’ home in the Aguda area of Lagos State after the compulsory one-year National Youth Service Corps programme.

SUNDAY PUNCH gathered that when he began showing signs of depression, Oyeka was taken to a hospital to see a general practitioner and not a psychiatrist. There could have been substantial help if he received the right help on time.

The story was similar to that of 49-year-old Abolarinwa Olaoye, a civil servant, who hanged himself within the Ekiti State Secretariat in Ado Ekiti in November 2018.

The body of the father of five, who was a night guard at the Ekiti State Scholarship Board, was found dangling with a clothing material tied to the railing of a building at the state Ministry of Education.

Olaoye, according to his co-workers, lamented the financial problems he was facing.

He had told his sister-in-law, Mrs Elizabeth Babalola, a day before that he was tired of life but she only offered words of encouragement while no medical help was sought.

For Lagos-based disc jockey, Seun Omogaji, popularly known as DJ XGee, his reason for committing suicide was not clearly stated in his suicide note which he posted on Instagram.

He simply bade his siblings and mother farewell and asked friends to wear white to his funeral instead of black.

However, friends close to him claimed he had lamented the marital crisis he was facing and felt the best way to overcome the emotional trauma was to take his life by gulping an insecticide, ‘Sniper’.

Another victim, Tolulope Abodunrin aka Don Tee, a bank worker, who admitted on Twitter to have been plagued by thoughts of suicide for two years due to depression, promised to write a book about surviving the pains.

He wrote, “I contemplated ending my life several times. For over two years, I battled suicidal thoughts but today, I am thanking God for life.”

Two months after, however, Abodunrin, who was a 2006 graduate of Accounting from the University of Ilorin, Kwara State, relapsed into depression and took his life on November 21, 2018.

On May 14, 2019, a gospel artiste formerly with the Redeemed Christian Church of God, Michael Arowosaiye, committed suicide by strangling himself with his belt in his home Sunnyvale Estate, Lokogoma District, Abuja.

It was learnt that the deceased was allegedly depressed over undisclosed personal issues.

The Head, Media and Public Relations, RCCG, Pastor, Olaitan Olubiyi, said the deceased had quit the church before the incident. He noted that it was the church tradition for every parish to assist every member experiencing stress.

Lecturers, students major casualties 

Information obtained from several news reports show that students and lecturers of higher institutions constitute the highest victims of suicide cases in the last eight months.

Adigun Emmanuel, a 27-year-old final year student of the Faculty of Agriculture at the University of Ilorin, also committed suicide by ingesting a bottle of Sniper after he failed his final year project for the third time.

In a social media note left behind, he indicated that he had been accused of plagiarising his current research work.

According to his WhatsApp chats, he uploaded a picture of the Sniper at about 5.14pm, about two hours after he lamented online about his situation to his friend.

He opened the conversation at about 3.39pm when he said in short statements: “Same research work. He said I did copy and paste. I am in a deep mess at the moment. My life don tire me (sic). I feel like dying. I wish I could sleep and not wake up again.”

His friend however responded with words of encouragement, “Don’t give up bro, it gets better.”

The deceased then responded, “I pray so, thanks a lot for your concern. I appreciate it a lot. May God continue to bless you! Amen.”

However, a few hours later, he uploaded a picture of Sniper on social media and his friends pleaded with him again but this time, it was too late.

Hikmat Gbadamosi, a 100-level student of the University of Port Harcourt, Rivers State, had also been showing signs of depression and had opted to live in a private apartment off school campus, away from her colleagues.

Gbadamosi, a student of Chemical Engineering Department, was said to have barred friends from visiting her.

The young lady, who was the assistant course representative of students at her level, recorded a short video in which she was seen crying and saying, “It worsens every time and I don’t know who to call” which was posted online. That was the last anyone saw her alive.

Her bloated corpse was discovered in her room some days after some of her classmates went to check on her. She consumed Sniper.

A friend of the deceased, Paul Okhare, noted that she complained of depression for a long time.

He said, “When we talked months back, all she told me was how depressed she was and we had a serious and deep talk that took the whole night. I gave her a sermon on how to measure up with the state she was and I pleaded with her; she said she would be fine.”

A lecturer in the Department of Urban and Regional Planning, Federal Polytechnic, Auchi, Edo State, Mr Patrick Okojie, also committed suicide after two failed attempts.

Another lecturer at the Department of Crop Production, College of Agriculture, Kwara State University, Malete, Dr. Solomon Osunlola, also took his own life after his request to be made a full-time lecturer was declined.

Osunlola was said to have fallen into depression after which he took his life.

Kolapo Olowoporoku, a student of the Obafemi Awolowo University, Ile-Ife, Osun State, also took his life last month after repeatedly failing some courses.

Olowoporoku was an ‘extra year’ Computer Science student who ought to have graduated two sessions ago but was delayed as a result of two outstanding courses.

The deceased, who served as the general secretary of his departmental association in 2016, swallowed a poisonous substance, which led to his death.

Also on May 13, 2019, a final year student of the University of Nigeria, Nsukka, Chukwuemeka Akachi, committed suicide after stating the reason for his action in a poem he posted on Facebook.

He wrote, “Forgive me. In case you are the one who finds the body. I am really sorry. It had to be someone, you know. I have chosen Jo Nketaih’s poem as my suicide note: ‘They said you came looking for me. I did not drown; I was the water.’ Where do atheists go to when they die? Lol. Amen.”

Akachi was said to have battled dementia for over two months and survived a previous suicide attempt.

Two lecturers had been asked by the university to monitor and counsel him but this proved futile as the English and Literary Studies student carried out his threat by taking a poisonous substance.

A 300 level student of the Ahmadu Bello University, Zaria, Aisha Omolola, also committed suicide in her apartment at the Samaru area of Zaria on December 26, 2018, after informing friends of her depression.

Omolola drank a bottle of insecticide on December 26, 2018, leaving a note where she stated the reason for her action. In her suicide note, the deceased blamed her parents for her action, saying they made life a hell for her.

The suicide note read in part: “If I am no more, please hold my family, especially my mum and dad, responsible. I have tried to be the best I can be, stayed away from them just because they blamed me for their mistakes and they can’t love, help and take care of me like their own.

“My mum has made life a living hell for me because she is bipolar and frustrated, accusing me of being a witch, and a cursed child even though my brother is responsible for my education and upkeep.”

On May 7, 2019, a 20-year-old senior secondary school student, Moji Agboola, died in Omu-Aran, Kwara, after taking poison.

The deceased, an SS1 student, died at Adeyemo Hospital in the town due to complications in her body system as a result of the poison she ingested

She confessed to have taken the poison by herself due to poor grades before giving up the ghost at the hospital.

60 million mental cases

According to the Federal Ministry of Health, 30 per cent of Nigerians suffer from mental illness.

The Permanent Secretary of the ministry, Abdulaziz Abdullahi, says with a population of about 200 million, Nigeria has a high rate of mental illness. This implies that Nigeria has about 60 million persons with mental illnesses.

Nigeria, in essence, has more mental cases than the population of every West African country.

The figure also implies that were all the mentally-ill people in Nigeria confined to a definite territory and classified a distinct country of their own, they would be more populous than Spain, 46 million; Canada, 36 million; Morocco, 35 million; Ghana, 28 million; Australia, 24 million; and The Netherlands, 17 million.

According to Abdullahi, the mental disorders are characterised by a combination of abnormal thoughts, perceptions, emotions, behaviour and relationships with others.

“Mental disorders include depression, bipolar affective disorder, schizophrenia and other psychoses, dementia, intellectual disabilities and developmental disorders including autism,” Abdullahi said.

Also, the Director of Public Health, Dr Evelyn Ngige, said mental illness could destabilise a person more than HIV, heart disease, accidents, and wars combined.

Ngige noted that Nigeria’s mental health statistics was too bad, adding that the high rate of suicide in places like Lagos might just be a tip of the iceberg.

She linked the recent spike in suicide to the worsening state of the economy even as the National Bureau of Statistics noted that over 20 million Nigerians were unemployed.

In 2017, the World Health Organisation said 7,079,815 Nigerians suffered from one of the most ignored and misunderstood forms of mental disorder in the country — depression.

The figure, according to the world health body, was 3.9 per cent of the country’s population, thereby making Nigeria the most depressed country in Africa.

250 psychiatrists in Nigeria

Despite having the largest number of mental cases in Africa, Nigeria has one of the lowest numbers of psychiatrists in the world.

The President of the Association of Psychiatrists of Nigeria, Dr. Taiwo Sheikh, told SUNDAY PUNCH that three out of every five Nigerian psychiatrists left the country after their education for greener pastures.

He said Nigeria had only about 250 psychiatrists providing mental health care.

Sheikh stated, “The important thing is that we are training psychiatrists, both at the West African College of Physicians and the National Postgraduate Medical College, but three out of every five psychiatrists we produce leave the country for greener pastures. One major thing that is eating the field of mental health is brain drain.

“People even use training in psychiatry to get visas to move out of the country. They know, once they have this certification, they can easily move to Canada, Australia or the United Kingdom.

“The UK has even lessened its once stringent conditions to recruit psychiatrists now, indicating that more Nigerians are likely to move to the UK. Today, based on what we have on our own platform, we have about 250 psychiatrists, plus/minus 10 or 20.

“We are still working on our directory, but based on what we are seeing every day, it should be an average of 250 psychiatrists. But you should also know that we have psychiatrists in training.”

The APN president stated that there were also resident doctors training to become consultant psychiatrists at various stages. He added, “We also have medical officers who are working in areas of psychiatry; they are not psychiatrists, but they have the skill to deliver some mental health intervention. We have a ratio of close to one (psychiatrist) to one million Nigerians, which is far from what we expect.”

Archaic laws on mental health

Experts opine that the Lunacy Act of 1958, which has been in operation for over 60 years, is not only outdated but also does not take into cognisance the rights of persons suspected to have mental illnesses.

It is also believed to be at variance with the recommendations of the WHO which prescribes modern approaches in battling mental disorders.

Experts say the legislation makes provisions for the detention of mentally unstable persons by medical practitioners and the courts in designated hospitals. It is, however, blank on salient issues of consent to treatment, appeal against detention and grossly inadequate on important issues on the management of the affairs and property of a person believed to be mentally unstable.

A former Chief Judge of Lagos State, Justice Oluwafunmilayo Atilade, emphasised the need for an urgent and comprehensive review of the Lunacy Act of 1958 to make it current with global standards.

She said, “Currently, the Lunacy Act of 1958 requires a comprehensive makeover, not simply to get rid of the cobwebs or shed the toga of an antiquated legislation but to truly address what is a most serious issue underlying most dysfunctional behaviour in our society, which, due to our misunderstanding, receive the wrong or poor attention.”

A research published on Omni International indicates that the Act confined the mentally ill people in non-therapeutic, overcrowded, unsanitary, and dilapidated facilities.

A bill was introduced to the National Assembly in 2003, but was not passed into law. In 2013, it was re-introduced but was not signed into law.

On his part, the Campaign Director and Communication Officer of Mentally Aware Nigeria Initiative, Jolaade Phillips, stated that promulgation of a new law would promote and strengthen mental health in the country.

He said the rate of stigmatisation and discrimination against mentally infirm would reduce and ultimately improve the nation’s state of affairs if the bill was enacted.

Phillips pointed out that many hospitals in Nigeria had no focus on mental health.

 “As a country, we should have a mental health Act if we want to improve the status quo. People should have more access to mental health treatment at a more affordable rate,” he added.

Some states have, however, been able to introduce legal frameworks to make up for the inadequacies in the Lunacy Act.

Attempting suicide is a criminal offence in Nigeria, under Section 327 of the Criminal Code Act, and carries a penalty of up to one year in prison. A holdover from when Nigeria was a British colony, the law was abolished in Britain under the Suicide Act of 1961, which happened after Nigeria gained independence in 1960.

Poor funding and lack of facilities

The Federal Government owns eight hospitals dedicated to psychiatry across the 36 states. They include the Federal Psychiatric Hospital, Enugu; Federal Psychiatric Hospital, Kaduna; Federal Psychiatric Hospital, Calabar; Federal Psychiatric Hospital, Maiduguri; and the Federal Psychiatric Hospital, Benin City.

Others are the Federal Neuro-Psychiatric Hospital, Kware-Sokoto; Federal Neuro-Psychiatric Hospital, Yaba; and the Federal Neuro-Psychiatric Hospital, Aro, Abeokuta.

There are less than 10 state-owned psychiatric hospitals. Although the total amount budgeted for health in the 2019 proposal was N365.7bn, the amount dedicated to the eight psychiatric hospitals stood at N16.2bn which is less than five per cent of the federal health budget.

However, it was learnt that most of the funds budgeted for were hardly released.

For instance, according to the 2017 capital release document released by the Office of the Accountant General of the Federation and obtained by the ICIR, the Federal Neuro-Psychiatric Hospital, Kware, Sokoto, earmarked N89.8m for capital projects but only N44.8m was released.

The Assistant Registrar, Counselling, at the University of Lagos, Mrs. Aderonke Asiwaju, who noted UNILAG had mental health facilities in place, said schools should make counselling centres functional to curb the increase in suicide cases in the country.

Asiwaju stated, “Schools need to employ an adequate number of counsellors and ensure that counselling centres are fully functional. There are three support centres for students which are held in high esteem – medical, sports and counselling centres. Unfortunately, many universities are more interested in sports centres and play down the role of counselling centres.”

The Director-General of the National Agency for Food and Drug Administration and Control, Prof. Moji Adeyeye, said there was a need for parents and religious institutions to do more in discouraging youths from abusing drugs especially controlled substances.

She also called for the creation of more rehabilitation centres to cater for drug addicts.

“We don’t have enough rehabilitation centres for our youths and people addicted to drugs. Right now, we have only 10 centres in the country. We need like 10 centres in each geo-graphical zone. We need to provide more rehabilitation centres.”

The Spokesperson for the National Orientation Agency, Paul Ogenyi, however, blamed the incessant suicide cases on the disintegration of societal values including an increase in mental cases.

He said the NOA, charged with the duty of promoting patriotism, national unity, and development of Nigerian society, was already collaborating with schools and religious centres in the fight against suicide since most suicide cases were recorded among youths.

Ogenyi said in the past, people remained positive even when faced with financial crisis but the new culture of making money through any means and the glorification of money over values had made people to see money as a life or death matter.

The NOA spokesman said, “Societal values have disintegrated and parents have failed. Also, institutions in charge of moulding the minds have also failed.

We have been monitoring these cases and we are trying to see if we can introduce programmes at the level of secondary and university schools; programmes that will promote hard work and patience.”