Suicide prevention: Strategies to improve Kenya's mental disorders intervention

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Low and middle-income countries account for 79 percent of suicides worldwide. However, their governments and lack of appropriate policies place a low priority on suicide prevention.

World Health Organisation (WHO) estimates that for each person that dies by suicide, at least 20 more people attempt suicide. Furthermore, attempted suicide is a risk factor for subsequent completed suicide.

Suicides have long-term ripple effects on society. WHO approximates that for each suicide, at least 135 people are affected to some capacity which translates to 108 million people globally who are severely impacted.

Only 40 countries worldwide have national suicide prevention strategies, with Kenya being one of only five low and middle-income countries to have one.

The vast majority of suicides are preventable, and much can be done to prevent suicide at individual, societal and national levels.

Recognition and treatment 

Research shows that the majority of people who die by suicide are suffering from one form of a mental disorder at the time of the act.

Clinical depression is, by far, the most common mental disorder in those who die by suicide. Hence, early recognition and treatment of mental disorders, especially clinical depression, is an important suicide prevention strategy.
In Kenya, the prevalence of common mental disorders (CMDs) (mild to moderate cases of depression and anxiety) is estimated to be about 10.3 percent.

It is also estimated that one in four people who seek health services in Kenya have a mental health condition.

It is important to identify such people and refer them to a specialist who can assess and treat them, preventing them from reaching a point where they may become suicidal.

Responsible reporting 

Suicide is a sensitive issue that should be reported with care. There are world standards on how suicidal acts should be reported by the media.

For instance, sensitive information about the person and their location, the means of suicide and the contents of a suicide note, should not be published.

This maintains the dignity of the bereaved family and avoids giving any ideas to people with suicidal ideations. 

Multiple studies have also found that responsible reporting of suicide can reduce the risk of additional cases (contagion effect).

Responsible coverage of suicide can help change views, dispel myths and be a source of information on the complexities of suicide. 

Suicide should be reported as a public health issue that needs to be addressed urgently and should be accompanied by information on risk factors, warning signs and resources for help such as helplines and mental health organisations.

This will also help in raising awareness, decreasing stigma and sensitising the public on mental health issues and suicide behaviour.

Research and data collection

Research and data can help build a comprehensive picture of mental health morbidity. Suicide data that is timely, reliable, and of high quality is crucial for informing policy, decision-making, preventive programmes development and funding.

Research also generates knowledge and evidence of patterns of suicide and self-harm and changes over time.

In Kenya, even though statistics from WHO estimate the suicide rate at 6.1 per 100,000 people, there is little or no official national data on suicides; at times, available data has some crucial variables missing, such as the means of suicide.

This necessitates the development of a high-quality system of reporting and recording data that is timely and robust.

Conclusions drawn from this data can help create interventions for prevention and treatment, development of mental health programmes and necessary policies that promote suicide prevention.

Identify common methods of suicide and prevent them

One key method of preventing suicide deaths is to control access to the common means of suicide. Knowledge of these methods, gained from good data, will help in the development of targeted interventions such as restricting access to lethal means, for example, firearms or pesticides, and implementing safety measures such as barriers on bridges and high buildings.

The Kenya National Suicide Prevention Strategy also recommends collaboration between the Ministry of Agriculture and other stakeholders in creating a pesticide control policy as a means of suicide prevention.

Life skills in school

Life skills programmes provide young people with strategies to manage their mental health. Students can be taught a variety of techniques to deal with stress, prevent mental ill-health and promote good mental health.

These programmes also improve communication skills, making them more willing to open up and seek help when they are struggling.
They will also help educate young people about mental health risk factors, symptoms, and warning signs of suicide.

This education will serve to improve mental health awareness, de-stigmatize mental illness, encourage empathy, and support early intervention systems in the prevention of suicide.
Suicide prevention is complex and requires broad-scope cooperation from all levels to come up with the interventions, preventive measures, policies and means to destigmatise the conversations around suicide.

When everyone plays their role, the Sustainable Development Goal (SDG) 3 of reducing one-third of premature deaths from non-communicable diseases through prevention and treatment and promotion of mental health and wellness by 2030 can be achieved.

The reduction of the suicide rate is an indicator of the achievement of this goal.

Prof Murad Khan is a Suicide prevention and mental health scientist at The Aga Khan University’s Brain and Mind Institute (BMI).
Any opinions expressed are solely those of the writer.

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