Professor Taiwo Sheikh, Coordinator of the Nigerian Suicide Prevention Advocacy Working Group and Consultant Psychiatrist, in this interview with Sade Oguntola, examines Nigeria’s suicide crisis and the urgent need to change the narrative from criminalisation and stigma to prevention, compassion and public health intervention.
The theme of this year’s World Suicide Prevention Day is changing the narrative on suicide and addressing stigma. What is the dominant narrative around suicide in Nigeria today, and what should the new narrative be?
The present narrative around suicide in Nigeria is shaped by legal, cultural, religious and social forms of stigma. First, there is the legal narrative. Nigeria still has a law that criminalizes attempted suicide. This means that people who attempt suicide can be treated as criminals. That creates systemic and official stigmatisation. Nobody wants to be labelled a criminal, and when someone is arrested, taken to a police station or brought before a court after a suicide attempt, the stigma can extend to the entire family.
Second, there are cultural attitudes. In some communities, people who die by suicide are not allowed to receive the same burial practices as others. In extreme cases, their bodies may be taken away from the community and abandoned. Such practices further stigmatisise suicide and discourage people experiencing suicidal distress from seeking help.
There are also religious narratives that stigmatise people who attempt suicide, people who die by suicide and their families. Some may be denied religious rites, labelled as condemned or believed to have been affected by evil spirits. Families may also be subjected to cleansing rituals or ostracised.
Then there is the social narrative, which often trivialises suicide. People may say someone died by suicide simply because they failed an examination, lost a job, experienced a relationship breakdown or lost money. This ignores the complexity of the factors that can lead someone to suicide.
Instead of showing compassion and empathy, society sometimes blames the individual: “Why would he do that? Is he the only person who has failed?” That attitude prevents people from receiving help.
The narrative we need to change is therefore the legal, cultural, religious and social narrative around suicide. Suicide should be understood as a public health issue, not a crime, and people experiencing suicidal distress should be supported rather than stigmatised.
Nigeria still criminalizes attempted suicide. How does this law affect help-seeking, reporting and suicide prevention?
The law is one of the major barriers to suicide prevention in Nigeria. When people know that an attempted suicide can result in imprisonment, they are less likely to report suicide attempts or seek help. Families and others who know about an attempt may also be afraid to report it because they could face legal consequences.
This creates a major problem: when cases are not reported, they cannot be properly counted, and when they cannot be counted, we cannot generate reliable national data. The law therefore not only stigmatises people; it also discourages reporting, treatment and data collection.
What do we actually know about the scale of suicide and suicide attempts in Nigeria? How reliable is the available data?
Nigeria does not currently have adequate national suicide data generated through a system that encourages comprehensive reporting. One of the major reasons is that we do not have a sufficiently effective platform for generating such data. The law criminalising attempted suicide also discourages reporting.
As a result, we rely substantially on WHO projections. Based on those projections, Nigeria’s average suicide rate across all age groups is about 6.9 per 100,000 people per year.
When that rate is applied to Nigeria’s population of more than 200 million people, it suggests that thousands of Nigerians die by suicide every year—a figure approaching 16,000 based on the calculation cited.
For every person who dies by suicide, there may be approximately 20 to 25 people who attempt suicide. That would mean hundreds of thousands of people could be affected by suicide attempts annually, with up to 450,000 people requiring care and support due to attempted suicide! These figures demonstrate that suicide is a major public health crisis in Nigeria.
What does the data tell us about young people and men?
Young people are among the highest populations at greatest risk. The suicide rate among young people is significantly higher than the national average in the estimates being used. The estimated suicide rate among men is also very high, at roughly 10 to 12 per 100,000, compared with the national average of about 6.9 per 100,000.
This should concern us because young people and men make up a significant part of the productive population. Any condition that disproportionately affects these groups has implications for Nigeria’s productivity and future.
With unemployment, financial pressures, school dropout, substance use and other social pressures increasing, could Nigeria see a rise in suicide and suicide attempts?
Yes. If current conditions continue and sufficient action is not taken, there is a risk of an increase in suicide and suicide attempts, particularly among young people. The determinants of suicide include mental health, psychological and social factors. Many of these pressures are increasing.
Among young people, we are seeing issues such as unmet aspirations, inability to find employment, dropping out of school, psychoactive substance use, disappointments, relationship or marital difficulties, and poor access to mental health care. If these conditions continue without adequate intervention, the prevalence of suicidal behaviour could increase.
Does someone have to have a diagnosed mental illness to become suicidal?
No. A person does not necessarily need to have a diagnosed mental illness to experience suicidal thoughts or attempt suicide. Studies indicate that the majority of people who die by suicide have a mental health or substance-use condition, but a proportion do not have a diagnosed mental illness.
Some people experience such intense distress from job loss, disappointment, bereavement, financial problems, unmet aspirations or other circumstances that they feel pushed to the point of wanting to end their lives.
This is particularly important when we talk about suicide attempts. Many people who attempt suicide may be experiencing significant distress without having a diagnosable mental illness. That means suicide prevention cannot be left exclusively to psychiatrists. Some people need psychosocial support, counselling, family support or community-based intervention.
What warning signs should family members, friends, teachers and neighbours look out for?
We should pay particular attention to people who are overwhelmed by significant social or personal problems. This could include someone who has lost a loved one, a student who is repeatedly failing examinations, someone who has lost a job or business capital, a person experiencing relationship disappointment, or someone who has experienced abuse, kidnapping, terrorism or another traumatic event.
Warning signs can include withdrawing from other people, appearing overwhelmed or persistently hopeless, repeatedly expressing distress, talking as though there is no future, making preparations concerning death, discussing what will happen to their children, business or family after they are gone, apologizing or asking for forgiveness unexpectedly, and saying things that sound like a farewell, such as, “I don’t know when I’ll speak to you again.”
When these signs appear in someone already experiencing significant distress, they should be taken seriously.
If someone believes a person is at immediate risk of suicide, what are the three most important things they should do?
The first step is conversation. Talk to the person. Ask what is happening and encourage them to open up: “My brother, you don’t look well. What is going on? Talk to me.”
The second step is to offer hope and support. Help the person understand that their current situation can change and that it is better to remain alive while seeking solutions to the problem.
The third step is referral. Connect the person with people who have the skills to manage the situation, such as mental health counsellors, psychologists or psychiatrists, particularly where there may be an underlying mental health condition. So the three steps are to start the conversation, provide hope and connect the person to appropriate professional help.
Is suicide preventable and treatable?
Yes. Suicide is preventable, and people experiencing suicidal distress can receive effective interventions. That is one of the reasons the criminalisation of attempted suicide should be removed.
The law was inherited from an earlier period when there was much less understanding of suicide prevention and treatment. Today, we know much more about suicide and have interventions that can help prevent people from dying by suicide. Imprisoning someone who has attempted suicide does not address the underlying problem. What is needed is access to appropriate intervention and support.
Nigeria has very few psychiatrists for a population of more than 200 million. How can suicide prevention reach rural and underserved communities?
Suicide prevention cannot depend only on psychiatrists. Intervention should begin within the community—in families, churches, mosques, schools and workplaces. Community members can be trained to recognise suicide risk and respond appropriately.
As the complexity of a person’s condition increases, they can be referred through the healthcare system—from the community to primary healthcare and then to more specialised services such as psychiatrists, clinical psychologists and mental health social workers.
We therefore need a system in which suicide prevention training is provided at different levels, from the community through primary, secondary and tertiary healthcare.
Parent-teacher associations, workplaces, religious institutions and community organisations can all become important points for training and intervention.
What impact have Nigeria’s mental health policies and legislation had on suicide prevention?
The Mental Health Act has not yet translated into the kind of tangible implementation that is needed. There is also a national suicide prevention policy, but a policy is not the same as an enforceable law. A policy represents a commitment, but it does not necessarily create the same obligations for government to provide services, funding, training and data systems.
For effective suicide prevention, Nigeria needs a comprehensive legal framework that addresses prevention, service provision, funding, data collection, training and support for families affected by suicide.
If you could ask the Nigerian government for three concrete actions this year to change the narrative around suicide, what would they be?
Number one is to remove the law criminalising attempted suicide. The law is stigmatising and prevents people from seeking help. It discourages reporting and prevents families and communities from supporting people who are at risk because people may fear legal consequences.
Number two is to pass a comprehensive Suicide Prevention Bill. It is not enough simply to remove the criminalisation of attempted suicide. Nigeria needs legislation that will require the government to provide suicide prevention services, funding, training, data collection systems and appropriate care for people affected by suicide and their families.
There is currently a suicide prevention bill before the National Assembly, and we want that legislation to be passed.
Number three is to establish an effective national system for mental health administration and data generation. The Mental Health Act provides for the establishment of a Department of Mental Health within the Federal Ministry of Health. That structure is important for coordinating mental health services and ensuring that programmes are not operating in isolated silos.
Without proper coordination and reliable data, it is difficult to know what is happening or to plan an effective national response.
Finally, why is changing the narrative on suicide so urgent for Nigeria?
Suicide is threatening the future of Nigeria. The most vulnerable groups include young people and men. When a condition disproportionately affects young people and men, it affects a significant part of the productive sector of the country.
If suicide continues to increase among these groups, it will have consequences not only for families but also for Nigeria’s productivity and development. That is why Nigeria needs a holistic, whole-population approach to suicide prevention.
We must change the narrative from criminalisation, stigma and blame to compassion, prevention, treatment, support and public health action.
WATCH TOP VIDEOS FROM NIGERIAN TRIBUNE TV