Mental Health Authority | Press Release | Monday, 13th March, 2016

The Mental Health Authority (MHA) has observed with great concern and disquiet, the increasing spate of youth and student suicides that are being reported in the media and have become the main issues of discussion across media houses in the nation.

The MHA commiserates with the families of the persons who have been let down by society and have allegedly fallen victim to suicide. We share in their grief, and pray that the nation faces no such tumultuous occurrences again.

The Authority finds the trend disturbing and considers it a failure of the society to support its youth by ensuring that efficient and accessible support systems are in place to help build the mental fortitude of the youth and students in particular in their times of weakness and susceptibility. Another disturbing trend is that normally, though more females attempt suicide than males, while more males do succeed, what we are seeing of late is that more females than males are completing suicide, and they use lethal methods like hanging and throwing themselves down from a height. There is the need to stem the tide.

Suicide has of late become the most common cause of death among students in Ghana’s tertiary institutions and the incidence is rising, particularly amongst female students. For most students and young people who attempt suicide, they are actually crying for help, to end some unbearable feelings or a situation that seems intolerable.  Young people easily develop suicidal thoughts when they feel trapped, confused, hopeless, helpless and distressed, and are desperate to escape from their suffering rather than actually wanting to die. Unfortunately, the desire to escape from the suffering in order to avoid shame and disgrace is often stronger than the any considerations of its outcome, and to their young minds, suicide often feels like the only way out, as all coping mechanisms at that time have broken down.

We are not oblivious of the fact that most institutions of higher education have guidance and counselling centres where students go to resolve problems and challenges. It is obvious, however, that these centres have not been effective or adequate in numbers. Students may also not be patronising them on account of stigma.

For most students, suicide will follow a period of depression while for others it is an impulsive act which may be triggered by a traumatic experience. Experiences such as loneliness, feelings of hopelessness, helplessness, worthlessness, depression, being jilted, failure to achieve academic goals, high levels of stress and a history of mental or physical illness may drive a student to attempt or commit suicide.

It is important that as a society, we pay particular attention to young people because those who attempt suicide are more likely to finally die by their own hands, whether by intent or accident.

On a daily basis, young people, particularly students in tertiary institutions are likely to feel distressed, aggrieved or depressed in response to the difficulties, disappointments and stresses that they encounter in the course of their daily lives. Persons with a history of trauma, hurts or disappointments that have gone unnoticed are likely to respond by making a suicide attempt. Young people are more likely to be overwhelmed by stressful life events.

The MHA believes that tackling the issue of suicide among the youth should be holistically looked at as a national agenda. Guidance and Counselling centres should not only be on campuses, but should be spread throughout the nation such that the youth and especially students will be able to visit such facilities at locations of their choice. Young people should be able to call up and meet with their counsellors, psychologists and psychiatrists when they have problems to discuss with them.

It is about time we looked out for each other as a society, particularly our youth. It may not be easy to conclude that a student is suicidal, but if you notice that a student suddenly becomes a lot more reserved than they usually are, it should raise a red flag, and you may be doing some good service to the person if you contact the Counselling Service in their school or call the Mental Health Authority on 0206814666/ 0503444793 for a session with an expert.

The MHA calls on our lawmakers to decriminalize attempted suicide in the statutes of Ghana if the fight against suicide is to be won. Attempted suicide is not a criminal issue. Neither is it a moral issue or spiritual problem. It is simply a cry for help to resolve psychosocial issues and therefore more appropriately is a medical problem. Decriminalizing attempted suicide will give the youth and people who have suicidal thoughts an opportunity to talk about what they feel without having to look over their shoulders or having to think they will be prosecuted should they talk about their suicide tendencies.

We also call upon the law makers to pass the legislative instrument to the Mental Health Act, 2012 (Act 846) to enable the Mental Health Authority to institute its programmes of massive public education and mental health promotion. Let this unfortunate situation galvanize us to come together as a nation to fight the canker.

Dr. Akwasi Osei
CEO, Mental Health Authority

Issued in Accra on this day, Monday, 13th of March, 2016.

An article written by the Chief Executive of the Mental Health Authority, and published by the Daily Graphic in its Tuesday, June 28, 2016 edition. The article was on why hard drugs such as cannabis should not be legalized by the nation.

By Dr. Akwasi Osei | Daily Graphic | Tuesday, June 28, 2016.

The arguments for and against the legalization of cannabis in Ghana has been raging on for some time now. We as an Authority see for see interesting times ahead as discerning individuals, statesmen and the intelligentsia of our society pitch camps on which side of the divide will be of most benefit to our nation.

Sunday 26th June was World Day Against Drug Trafficking and Illicit Drug Use. Ghana, led by Narcotics Control Board (NACOB), commemorated it. Some people are, however, campaigning for legalization of cannabis. Mr. Kofi Annan raised the call a few months ago and the Rastafarian Council of Ghana has supported the call.

Arguments for legalization

The proponents of legalization argue on seven premises: that as a society we have lost the drug war so let us liberalize it; that there are economic benefits to be derived; that there is no proven harm in its use; that there are some medical benefits; that when one is dependent on it he uses it compulsorily so do not jail him but rehabilitate him; that those countries which have legalized it are not experiencing any adverse effects and legalization will reduce its use so regulate it rather than criminalize it; that alcohol which is legal is more dangerous than cannabis so why criminalize cannabis?

Counter arguments

Let us analyze the claims: That since we have lost the war, let us legalize it. The truth is, we have not waged the war sufficiently so we cannot claim that we have lost it. NACOB, the statutory body responsible for the drug war, has not been resourced enough. They do not have enough personnel in all the districts; not enough vehicles, no scanners to detect drugs at the ports of entry or exit, no sniffer dogs to sniff drugs; budget has always been very scanty; our narcotics law is not stringent enough and easily allows culprits to sneak through. We have been concentrating too much on law enforcement without adequate attention to rehabilitation or public education for prevention. In US, for every one dollar one spends on drug war, one gets eight dollars back. So we here have not fought it enough.

No harm associated with cannabis use?

That is false. Cannabis causes mental and behavioral disorders amply documented in the literature. Both DSM and ICD (diagnostic manuals) have it. Every nursing or medical student knows it. The effect ranges from psychosis to amotivational syndrome in which the chronic user feels demotivated to pursue schooling or any ambition. Thus even if one does not get frank madness, he may drop out of school or quit his job leading to streetism. 30 percent of our outpatient cases at the psychiatric hospitals are cannabis related while 10 percent of inpatients is from cannabis. School teachers know how adversely it is affecting students.

Other users develop aggressive and violent behaviors and come into brush with the law, engage in reckless behaviors including motor crashes, armed robbery and unnecessary fights leading to jail.

Some users will progress to other hard drugs like cocaine and heroin so cannabis then becomes a gateway drug. Physical health problems include lung cancers and chest infections. Family disruption is high amongst cannabis users. Cannabis can reduce fertility and increase incidence of miscarriage and fetal cannabis syndrome, much like fetal alcohol or tobacco syndrome.

The countries which have legalized cannabis are beginning to experience high rates of behavior disorders from cannabis and earlier onset of schizophrenia and other psychosis.

Economic and medical benefits?

Proponents of legalization have argued that Ghana can massively grow cannabis for export, that this would provide job for growers and distributors. The truth is that there would be spill-over unto the Ghanaian market; one cannot control its use and adverse effects. The dangers of cannabis use far outweigh any potential benefits.

Yes, there could be some economic benefits. The fiber of cannabis plant can be processed into textiles for clothing. Medical benefits include producing medicines from cannabis for glaucoma and to boost appetite in terminal cancers and HIV/AIDS. A component of cannabis called Cannabidiol is known to be medically beneficial. In all these it is extracts that are used not the raw open market cannabis. We have no qualms with medical uses of processed cannabis or even medically allowed use of cannabis. The law already provides for that [Narcotics Drugs Law, 1990 (PNDCL 236, S.(4) and (5)] but that neither justifies, nor is it the same as, cannabis liberalization or decriminalization.

Alcohol is more dangerous but legal

In some sense alcohol is more dangerous damaging practically every part of the mind and body, so why worry about cannabis? The truth is that alcohol was legalized when its dangers were not so much known. Now we know for cannabis and other drugs so why legalize them only to regret later?

Call to decriminalize addiction

There is the argument that many people who abuse cannabis are compulsory users because they are addicted and therefore should be rehabilitated rather than jailed. That argument is valid. Many of such people in jail need not be there. Once somebody is addicted he is a slave to the drug. Such a person has a disease and not criminal intent. That, however, is not to say that cannabis should be liberalized or legalized. One can smoke even when he is not addicted. When somebody is found with personal quantities of cannabis he should be sent for medical or psychiatric assessment. If found to be addicted he should be sent for mandatory treatment and rehabilitation. If found not to be addicted then the law should take its course.

In conclusion

Let us redirect our argument and ask government to resource NACOB if we are to win the drug war. Government should reconstitute the governing Board of NACOB; parliament should pass the narcotic law before it, raise NACOB to an independent Commission and confiscate all properties of convicted traffickers irrespective of how one acquired it. NACOB should be provided with adequate budget, its own scanners and adequate numbers of sniffer dogs. It should be able to conduct aerial surveys. We need to implement alternative cropping for cannabis growers and establish more rehab centers. Then we shall win the war. Addicts should be sent for mandatory treatment but do not legalize cannabis.

ARTICLE FOR THE DAILY GRAPHIC

Kwaku Brobbey, Head of Communications, Mental Health Authority | Daily Graphic | Tuesday, June 28, 2016.

Saturday September 10 was World Suicide Prevention Day (WSPD). It is an awareness day observed on 10 September every year to provide worldwide commitment and action to prevent suicides around the world. In Ghana, the day was marked with an education and awareness creation program put together by the Ministry of Health and the Mental Health Authority at the Southern Ghana Conference of the Seventh Day Adventist Church in North Ridge.

Reflecting on the day and its significance always gets me wondering; why on God’s earth will anyone want to take their own lives? If indeed “Life’s Good” as has been touted in some quarters and to even consider the downside of life; have we all not come to accept that “life is not a bed of roses” which ascribes life as not always being smooth sailing, hence characterized with ups and downs? So if we, as “reasonable beings” have been imbibed with these realities of life, then the million dollar question is what at all drives humans to the point of taking their own lives.

THE REALITY

Thursday 8th September began as an ordinary day. I was rudely awoken by the barking of dogs in my Ogbojo home very early in the morning. The barking of the dogs was not very unusual, but its persistence got me somehow anxious, hence the resolve to go check out what could have been happening out there. On stepping out, across the street in front of my house was Papao (not real name) a calm quiet young man who lived as a caretaker in the house directly opposite that of my next door neighbor. We had not been the best of acquaintances, but had shared a few “hellos” and “how are yous”.

Papao was his usual quite self that morning, and as I walked into the backyard to find out why the unusual barking, he strolled down the street away from the house he catered for. Finding nothing unusual, I returned indoors and got myself ready to drop the little one at school and then proceed to work.

I got back home that evening and found an unusual gathering of people in the neighborhood, calls coming across from one person to the other. Again, this was unusual so I thought I would enquire about this artificial chaos that seemed to be rearing its head in a rather quiet settlement. After all, it was close to the place I call my home. Papao had hanged himself from a mango tree standing right in the middle of the house he catered. I was distraught. I had just seen him this morning strolling down the street. What could have gotten over him to do this to himself? Could I have prevented this? What could I have done? Papao, the young man I saw to be resourceful and productive because he would farm every piece of land that lay fallow in the area with food crops had committed suicide, and his body was being moved from the “crime” scene to the morgue.

THE NUMBERS

It is quite intriguing and almost unbelievable when the numbers on suicide crunch. The World Health Organization indicates that over an estimate 800,000 people die by committing suicide each year. The reality of this statistic works out to one person taking their life every 40 seconds, and to add the toppings to the bagels, 20,000,000 other people make a suicide attempt every year. The tragic ripple effect of this phenomenon means that many more people have been bereaved by suicide or have been close to someone who has tried to take his or her own life. The statistics is staggering. This brings to the fore the myriad of people who indirectly are suffering in silence having lost a loved one, be it the breadwinner of a household, the father of a family, the mother who runs the home or the caretaker who takes care of the house.

SUFFERING IN SILENCE

I describe relations of people who have died by taking their own lives in our part of the world   as suffering in silence because in our part of the world, death by suicide is “sacred”, perhaps an abominable reverence. It has a tendency to seclude the victim’s family or community from where he/she hails, from other families or communities. In other words, the family may be seen as “curst” or ill-fated and as such laden with an abomination. Consequently, people from such families or lineages should not be mingled with (as in marriage) since they bear the trait of abomination. This sometimes extends to the community, breeding chords of ostracization on people from the community.

To prevent such victimization from hanging on the neck of the family or the community, elders of such communities either cover up the cause of death of suicide victims, or in cases where the act was committed in the open, various reconciliatory acts or appeasements are undertaken to pacify the gods and to cleanse the community and its people from the effects of the abominable act.

WHAT DRIVES PEOPLE TO ATTEMPT OR COMMIT SUICIDE

There are a thousand and one reasons in today’s crisis hit economies around the world that will tip one off into the abyss of pain and hopelessness and drive them to do the unthinkable. It has been said time and again that each individual has a limit to which they are able to cope with the stresses of life, and each individual may react differently to a certain degree of stress they may be going through. The WHO definition of mental health as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”, is very precise on the individual’s ability to “cope with the normal stresses of life”. The extent to which every individual can cope with the “normal” stresses of life varies, hence, the presumed overreaction by some people which in most cases have turned out to be fatal, resulting in attempted suicides and in worst cases completed suicides.

The second part of this article will focus on why suicide is often the option of choice and what as a society, we can do to reduce or better still prevent the incidence of suicide.

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Part 2

MY HAND IN HIS SUICIDE ACT; BRINGING HOME THE REALITY OF SUICIDE

BY: KWAKU BROBBEY, HEAD OF COMMUNICATIONS, MENTAL HEALTH AUTHORITY.

 

WHY IS SUICIDE OFTEN THE OPTION OF CHOICE

For every incidence of suicide act carried out, society should be held responsible for not in the least reaching out or connecting to victims in their moments of depression, pain or agony that led them to commit the act. This disconnect has however been compounded by the current state of Ghana’s Criminal Code, which criminalizes suicide and attempted suicide in the country. People with suicidal thoughts are compelled to keep their thoughts to themselves for fear of being victimized and perhaps prosecuted if they disclose such thoughts, or should they fail to successfully complete the act of suicide.

In an individual’s desperate moments, death may sometimes seem the easy way out. That is why many people have attempted suicides and others unfortunately have completed it. Ending one’s life does not come that easy. The explosion in the incidence of suicides in modern times in my view seems to emanate from the “ease” of carrying out the act or acquiring tools and implements that could be employed to put an end to one’s life and as such his/her “suffering”. Methods of committing suicides the world over vary between countries. Some of these methods are hanging, consumption of poisonous substances, stabbing, jumping from heights and the use of firearms. Victims in various countries have predominantly used methods and tools that are readily available and fit into the country’s economic, social and cultural indulgence. For example in advanced economies, methods such as use of firearms and jumping from heights have been commonly used while methods such as hanging and the consumption of poisonous substances are widely used in less developed economies or lower middle income nations like Ghana.

So this is happening in spite of the fact that suicide is preventable. ‘Connect, communicate, care’ is the theme of the 2016 World Suicide Prevention Day celebration. These three words are at the heart of suicide prevention, and I reproduce below the International Association for Suicide Prevention’s assertion on the essence of connecting, communicating and caring.

WHY CONNECT, COMMUNICATE AND CARE

Connect

Connecting with people who have lost loved ones to suicide or those who have attempted suicidal themselves may provide insights that are crucial to furthering suicide prevention efforts. People who have attempted or have planned it may help us understand the complex interplay of events and circumstances that led them to that point, and what saved them or helped them to choose a more life-affirming course of action. Again, those who have lost someone to suicide, or supported someone who was suicidal, can provide insights into how they moved forward on their journey. The sheer numbers of people who have been affected by suicide would make this a formidable network. Of course, these connections should be two-way.

There will often be times when those who have been bereaved by suicide, and those who might be feeling suicidal themselves, need support. Keeping an eye out for them and checking that they are okay could make all the difference. Social connectedness reduces the risk of suicide, so being there for someone who has become disconnected can be a life-saving act. Connecting them with formal and informal supports may also help to prevent suicide. Individuals, organizations and communities all have a responsibility here.

Communicate

Open communication is vital if we are to combat suicide. In many communities, suicide is shrouded in silence or spoken of only in hushed tones. We need to discuss suicide as we would any other public health issue if we are to dispel myths about it and reduce the stigma surrounding it. This is not to say that we shouldn’t exercise necessary caution; we don’t want to normalize suicide either. Careful, considered messages about suicide and its prevention are warranted, as is an awareness of how different groups of individuals may receive and interpret this information. Equipping people to communicate effectively with those who might be vulnerable to suicide is an important part of any suicide prevention strategy. Broaching the subject of suicide is difficult, and these sorts of conversations are often avoided. There are some simple tips that can help, however. Most of these relate to showing compassion and empathy, and listening in a non-judgemental way. People who have come through an episode of extreme suicidal thinking often say that sensitively managed conversations with others helped them on their course to recovery. The media also have an important role to play in suicide prevention. Some types of reporting on suicide (e.g., prominent and/or explicit stories) have been shown to be associated with ‘spikes’ in suicide rates, but others (e.g., those that describe mastery of suicidal crises) have been shown to have a protective effect. Media recommendations have been developed by the International Association for Suicide Prevention and the World Health Organization to assist journalists in getting stories right.

Care

All the connecting and communicating in the world will have no effect without the final ingredient – care. We need to make sure that policy-makers and planners care enough about suicide prevention to make it a priority, and to fund it at a level that is commensurate with its significance as a public health problem.

We need to make sure that clinicians and other service providers care enough about it to make suicide prevention their core business. And we need to make sure that communities care enough about it to be able to identify and support those who may be at heightened risk. Most of all, we need to ensure that we are caring ourselves. We need to look out for others who may be struggling, and let them tell their story in their own way and at their own pace. Those who have been affected by suicide have much to teach us in this regard.

But at the center of this all will be the urgency in repealing the law that makes suicide a crime and not see it as a social and psychological issue. We will be able to make inroads in effectively connecting, communicating and caring if there is the freedom to share and talk about suicide and suicidal thoughts without having to look over our shoulders.