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00:00Hello and welcome to Guardian Talks. My name is Fadima Rachel. Every year the world comes
00:05together to mark the World Suicide Prevention Day every 10th of September. This year's
00:11theme is changing the narrative around suicide. Now the question is not if we should talk
00:17about suicide but when we should talk about suicide because according to the Federal Ministry
00:22of Health and Social Welfare, 15,000 Nigerians die by suicide every year and suicide is one
00:29of the top cause of death among young Nigerians between the ages of 15 to 29.
00:44Today we'll be having the conversation around suicide with a certified clinical psychologist
00:49Dr. Mirako Iyoma. Thanks for joining us. Thank you very much for having me. Now to begin
00:54the question, you know, the CS team is changing the narrative around suicide and we know that
01:00Nigerians out there battling with pressures of this life, joblessness. I mean, from your
01:06own perspective, what does this mean? Yes, so the CS team is changing the narrative around
01:15suicide and it's very important because even with your question, it shows that a lot of
01:22times people think that when one is jobless or when one is facing pressure, then the next
01:29thing to do is to take one's life, which is suicide, right? Because suicide means taking your own life.
01:37Yeah. And it's important to note that suicide in itself is a mental health condition. So it is not as a result of life's pressure.
01:49Because if suicide is a response to life's pressure, then every one of us should be dead. Because I'm sure that there
01:56is nobody here or listening to me right now who hasn't at one point or the other faced the pressure of life.
02:03And yeah, there are only three categories of people when it comes to challenges. People currently in a challenge, people just coming out of a challenge, people about to go into a challenge.
02:12Everyone belongs to at least one of these categories. So suicide is not the response to life's pressure. Right? Suicide is a mental health condition many times emanating from your perception of life's pressure. Yeah. So that narrative is something that we need to adjust when talking about suicide.
02:31Alright, well said. So let's look at the theme, changing the narrative around suicide. From your own perspective, do you think this theme captures the whole essence of, you know, this issue, suicide?
02:42Yes, just like I said earlier, we need to change the perspective of people have about and around suicide. Because a lot of people have the wrong, in fact, before now, and even till now, a lot of people will say things like he committed suicide, or she committed suicide.
03:01But that's a wrong narrative. That's a wrong word or sentence to use when talking about people who died by suicide. Because when you say he or she committed suicide, what you are trying to say, or what you're trying to communicate is suicide is a crime. So they committed a crime. But no, they did not commit suicide. They died by suicide. That's the right narrative. That's the right way to put it.
03:24That shifts our perspective from it being a crime to it being what it should be, a mental health condition. So say, people do not commit suicide, but people die by suicide.
03:37Yeah. So there are narratives like that, which even now seeps into the issue around it being a crime. For example, in Nigeria, if you die by suicide, you're seen as a criminal. And if, because there are three levels of suicide, there's suicidal ideation, there's suicidal attempt, there's suicidal
03:54So suicidal ideation is suicidal thoughts, having a thought of suicide, thinking about suicide. Then the suicidal attempt, that's attempting to take your own life. And then the suicidal completion, that's the act of actually now dying by suicide. So not everybody who attempts or who thinks about suicide, attempts suicide.
04:11There are a lot of people, for example, who have come across both in therapy sessions and, you know, everyday life, who think about suicide, who have thought about taking their life, but have never attempted to take their life.
04:25While there are people who have attempted to take their life, they have thought about it, and then proceeded to attempt to take their life, and they have never succeeded. So maybe they were caught, maybe they changed their mind, the process, you know, whatever it is.
04:37But then there are people who attempt and then complete it, and will actually die by suicide. So in Nigeria, for example, if you attempt suicide, and you're unsuccessful, you would be prosecuted. That doesn't make any sense, at least to me, as a mental health professional.
04:53Yeah, that's just like, just like saying, if someone is having schizophrenia or depression, they should be persecuted.
05:01You know, it doesn't make any sense to me, why someone would be prosecuted for wanting to take their life.
05:07Such a person definitely and obviously needs mental health attention, and not incarceration.
05:13Well said. Thank you so much. Okay, now let's look at this from the angle of suicide being a silent menace in the society.
05:21You know, when you talk about suicide, people are like, oh, please, you're not the only one going through things in life.
05:26And as a result, people don't want to share their thoughts with others.
05:29I mean, what can be done to change the narrative around this?
05:33Yes. So very beautiful question. Again, awareness is like this would definitely help in creating or changing the narrative like we put it.
05:44Because the more people know about this, the more they understand how it works, the more they understand how they're supposed to approach this type of issues.
05:52Right. So it's very important that we are open to listening to people, right, hearing them out and not being judgmental.
06:01Yeah. What is easy for you might not be easy for somebody else.
06:04The fact that it comes natural for you does not mean it comes natural for somebody else.
06:07For example, you are here doing an interview, you know, and if there's somebody who says, I can't, I can't seem to face the camera.
06:14It sounds strange to you. Like I was there just to face the camera.
06:17But the fact that it comes natural for you doesn't mean it comes natural for somebody else out there.
06:21Yeah. So we must appreciate that. And then that helps you to employ empathy because empathy is understanding the other person,
06:28seeing things from their frame of reference. Yeah. And putting yourself in their shoes.
06:33Empathy is not sympathy. Sympathy is feeling what the other person is feeling.
06:36Empathy is understanding what the other person is feeling.
06:39When I understand you, I don't need to agree with you. Right. Empathy is not agreement.
06:44All right. I don't have to agree with you, but I can understand you.
06:47For example, if you come to me and say that you want to take your life, I won't agree with you.
06:51I won't want to take your life, but I can understand where you're coming from.
06:54I can understand why you want to take your life.
06:57That way, I have more chance to influence you to change your mind than if I was without empathy.
07:04Without empathy, it is much more difficult to influence people. Yeah.
07:08All right. Um, okay. Well said.
07:10Well, speaking about empathy now, I mean, report has it that 15,000 Nigerians died by suicide.
07:16And of course, suicide is one of the top cause of birth among Nigerians between the ages of 15 to 29.
07:22Now, those figures, what does it speak?
07:24Does it speak about the fact that, I mean, we are emotionally disconnected from each other as a community?
07:31Is it that? Does it mean that? Does it mean now like the world is now a silent village?
07:35I mean, you don't have anyone to share your thoughts with.
07:37You don't have anyone to share your views with. Why these high figures?
07:41Yeah. Um, yeah.
07:43Uh, you know, before now, one of the myths, you know, surrounding mental health in Nigeria and Africa,
07:48was African man needed to get mental health issues.
07:51You know, African man, say, African man needed to get depression.
07:54African man is a strong man.
07:55Exactly.
07:56Say, African man a hunger.
07:57If you don't chop a little food, we think they think again.
08:00You know, that's a narrative.
08:02So, it prevented a lot of people, in fact, even till now, to a very large extent,
08:07there's still a level of stigmatization around mental health issues.
08:10If you tell somebody, for example, that I'm speaking to a therapist,
08:13they might be thinking aback, like, are you okay? Is there anything wrong with you?
08:17But it doesn't mean there's anything wrong with you in that sense.
08:20Because I tell people, mental health is in the continuum, right?
08:23Where we have mental health and mental illness.
08:25So, somebody, you don't have to be on one, either side of the extreme.
08:29So, you don't have to be totally mentally healthy or totally mentally ill.
08:32Sometimes, it could be somewhere in between both of them, right?
08:35So, we must understand what mental health is.
08:38And thank God, mental health is evolving.
08:40People are becoming more aware.
08:41Which is even why it looks like we have the figures.
08:44Because before now, which is why a lot of people thought Africans don't have mental health issues.
08:48Because there were no records.
08:50So, people didn't really know that, okay, these things exist.
08:53But right now, with awareness, people are becoming more aware that, okay, these things exist.
08:57People go through it and things like that.
09:00So, back to the question. What was the question again?
09:04The question is, does it mean we're alienated from each other as a community now?
09:07Yes.
09:08So, now, it's not very important that with this awareness, we become more open, right?
09:17With discussing our mental health.
09:19And also, more open with how we, you know, receive people and allow them to be vulnerable.
09:28You know, let me even shock you.
09:30I'm sure you know that more men die by suicide than women.
09:36Okay.
09:37So, men are four times more likely to die by suicide than women.
09:41Four times.
09:42So, it means for every one woman who dies by suicide, four men have died by suicide.
09:46Why is that so?
09:47There are a lot of reasons.
09:48But one that stands out is the fact that women are a lot more vulnerable than men.
09:52Women, you know, if a woman is having an issue, they will open up.
09:55They will call their friends.
09:56They will talk about it.
09:57But if a man is having an issue, he would rather keep it to himself.
09:59He will man up.
10:00Like we like to say, he will be a man.
10:02He will bottle it until he can no longer handle it.
10:04And then he will take the suicide route.
10:06Yeah.
10:07So, we must encourage people to become more vulnerable, right?
10:11And more open and talk about their issues so that we can reduce this sting of suicide.
10:17Thank you so much.
10:18Well said.
10:19Okay, let me draw the next question from this.
10:22I mean, we know Africa is a spiritual community.
10:25We believe a lot in the spiritual.
10:27And many believe that, oh, once you complain that you are depressed or you are having suicidal thoughts,
10:31you think, oh, Rwanda is a spiritual attack.
10:33What other myths do you think Nigerians need to online aside from suicidal thoughts being a spiritual problem?
10:40Yes.
10:41So, just to even address that particular myth, I tell people that mental health related issues are as spiritual as physical health related issues.
10:50Yeah.
10:51So, when people ask me about, okay, how spiritual are mental health issues?
10:54I tell them the extent to which physical health issues are spiritual is the extent to which mental health issues are spiritual.
10:59Now, make of that whatever you want.
11:01You know, gauge how you think physical health issues are spiritual and then relate it to how mental health issues are spiritual.
11:08So, if you think, for example, when you have type of malaria, if you think there's a woman in your village disturbing you,
11:12then it's okay to think that when somebody has, you know, depression.
11:16So, really, because they mirror each other.
11:18Physical health mirrors mental health.
11:20Mental health mirrors physical health a lot.
11:22For example, if you know that physical health issues are a heavy degree in nature.
11:26So, if somebody in your family has high blood pressure, there is maybe a 40% chance that you might as well have it in your lifetime.
11:31But the same thing with mental health issues.
11:33If somebody in your family has a mental health related issues, there's about a 40% chance you also have it in your lifetime.
11:37So, that's really how mental health related issues are.
11:42So, talking about myths surrounding suicide, right?
11:47Example, I've said that people have a myth that when you die by suicide, it is because of life stressors.
11:59It's because, oh, you are going through a particular challenge.
12:02But that's not necessarily so.
12:03Your perception of life's pressure is a better causative factor than life's pressure in itself.
12:12Yeah.
12:13So, how you see what you are going through is more important than what you are going through.
12:17Because that same, I will give you a typical example.
12:21So, many years ago I read in the newspaper that a lady died by suicide because she failed jump.
12:27Earlier this year.
12:28Yeah.
12:29Not even the one of this year.
12:30This was even many years ago.
12:32There was a case of this year as well.
12:33In fact, there was a recent report of somebody, an OAU student who also died by suicide.
12:37A medical student.
12:38Yeah.
12:39So, there are reports like that.
12:40But this particular one was many years ago.
12:41This lady was 17 years old.
12:43This lady, that was her first jump that she was writing.
12:46And she died by suicide.
12:48Do you know?
12:49But then the question would be, are there or were there not other people who were her age
12:54who were writing jump for the first time and who failed, who did not die by suicide?
12:59For example, using myself as a case study, in fact, I didn't just fail jump.
13:04I failed O-level.
13:05I failed O-level.
13:06I wrote O-level four times.
13:08I failed Wayek.
13:09I failed Neko.
13:10I failed every kind of O-level in Nigeria.
13:12Wayek.
13:13Neko.
13:14GC.
13:15I failed three of them.
13:16I wrote jump three times.
13:17Yeah.
13:18And I failed two.
13:19I failed jump twice.
13:20And I never thought about taking my life.
13:23Yeah.
13:24So, I was even, I was better qualified to take my life than a lady.
13:28But I decided not to.
13:29So, it is really not what happens to you that determines your response.
13:33It is how you perceive what happens to you that actually determines your response.
13:38Yeah.
13:39All right.
13:40Well said.
13:41Okay.
13:42So, during this conversation, you said something about women being expressive, you know,
13:46and men bottling things up.
13:48So, if there's one thing you want to say to a young Nigerian out there, a male gender,
13:53what would it be?
13:54Yeah.
13:55So, to the male gender, what I would say to you is, be more open, be more vulnerable.
14:00I understand.
14:01The society doesn't even make it easy for us, really, because a lot of the times people,
14:07ladies particularly, would say, oh, I need my man to be vulnerable.
14:10I need men to be vulnerable.
14:11The question I always ask is, can you handle their vulnerability?
14:15Yeah.
14:16Because, for example, when a man begins to talk, to a point, they say, why are you talking
14:19like a woman?
14:20So, actually, they expect that men are not supposed to talk so much, right?
14:24You're supposed to be a man of few words.
14:25That's when you're seen as a man, you know.
14:28But all of that is a myth, right?
14:30All of that is a myth, and it's not necessarily true.
14:33For your own mental health, look for one, two, three trusted people that you can be totally
14:38vulnerable with, that you can vent with, that you can share your challenges with.
14:42Because a problem shared, like they say, is a problem half solved.
14:46I like to add to that, that a problem concealed is a double problem.
14:50What that means is that when you conceal a problem, that problem can actually graduate
14:58to become other types of problem just by concealing it.
15:02So, it's important that you open up, you're vulnerable, and you speak out more.
15:07Understand that women speak for support.
15:10Men, most times, will speak for solutions.
15:12But it doesn't have to be you.
15:14You can speak for support as well.
15:16Because if a man is speaking to you, for example, and he sees that, okay, let's say,
15:19he needs four million there.
15:21He sees that this person cannot give me four million.
15:22You wonder, why would I be talking to him or talking to her?
15:24Can he give me the money, you know?
15:26But then, if it's a woman who needs four million, the woman will talk to you whether
15:29or not you can give her the four million.
15:31She will just talk to you because she feels like talking.
15:34But that talking would have reduced the emotional pressure that is on her.
15:38That is something we can learn from women.
15:41Men become more open, more vulnerable, and seek support more.
15:45Thank you, Doctor.
15:46All right.
15:47Let's look at it from infrastructural deficiency now.
15:50Okay.
15:51So, we have about 350 certified psychiatrists in Nigeria.
15:55I mean, and we have, I think, in Nigeria now, the latest report as it does were over 200 million in Nigeria.
16:01So, with this shortage of staffing, I think I would say staffing, yeah.
16:05With this shortage of staffing, I mean, how does an average Nigerian access its support system?
16:12Well, to start with that is an outdated report, actually.
16:14Okay.
16:15You know, the 350 to 200 million, that's many years ago.
16:18Okay.
16:19Not, it's not updated.
16:20Um, we have a lot more, uh, psychiatrists, um, to, that, that, that we have, we have a lot, a lot more psychiatrists now than we used to have before.
16:29Yeah.
16:30And coupled with that.
16:31Sorry, sorry to cut into your conversation.
16:32We have more now.
16:33Yes.
16:34But can an average Nigerian assess it in terms of finances?
16:37Yes.
16:38So, good question.
16:39And we must understand that psychiatrists are not the only mental health professionals that
16:44we have.
16:45Yeah.
16:46For example, I mean, I'm not a psychiatrist.
16:47I'm a clinical psychologist.
16:48Okay.
16:49Right.
16:50And, um, I'm a mental health, that, that, that qualifies me to be a mental health professional.
16:54Okay.
16:55Right.
16:56Whether formally or even even formally.
16:57Right.
16:58So, for instance, in the typical psychiatric hospital, you will find, um, a psychiatrist, doctor, you will find a psychiatrist nurse.
17:06You will find a clinical psychologist.
17:08You will find a social worker as well.
17:11You would, um, uh, most likely also find, um, uh, there was also, there's one other, because there are, there are about five, five months.
17:21Yeah.
17:22Um, I think a, a pharmacist.
17:23Okay.
17:24Right.
17:25A psychiatrist pharmacist within the, the poor view of, of a psychiatric setting.
17:30So, we must understand that, uh, mental health professionals are not just limited psychiatrists.
17:36There are a lot of other mental health professionals, right, out there.
17:39I understand, like I said before, that this mental health is still evolving.
17:45We are still getting to know about it.
17:47So, for example, when I went to school, um, even my undergraduate, my first degree, um, and I wanted to study psychology.
17:56Um, and I wanted to study psychology.
17:57I put in, in jump, I put in psychology as my first choice and my second choice of what I wanted to study.
18:03A lot of what people were asking me is, ah, why would you want to study psychology?
18:06How does that make sense?
18:07You know, in fact, even my family were asking me, what is wrong?
18:10Are you okay?
18:11Why do you want to study psychology?
18:12People kept asking me, where would you work?
18:14I didn't even know.
18:15Honestly.
18:16What's ignited the interest?
18:17What ignited the interest was, I love to help people.
18:20Mm-hmm.
18:21And after doing my research, I realized, oh, psychology was a very good course to study if
18:25you really wanted to help people.
18:27But I said, okay, fine, that's what I want to do, you know.
18:30And I didn't know I was going to make money.
18:32I just said, this is what I love, you know, and that's what I was going to do.
18:36Because I've always believed that where the heart of a man is, that's where his treasure would be.
18:40So if my heart isn't something, my money is there.
18:42So I just decided to go for it.
18:45And, you know, when I even gained admission to study psychology, half of my class, or maybe even more than half,
18:51we were not even many, but as few as we were, more than half did not put in for psychology.
18:56More than half put in for something else, and they were thrown to psychology.
19:00Some wanted to study law, some wanted to study economics, some wanted to study different things.
19:04And, you know, that slot was, those places were filled up, they threw them to psychology.
19:09That's how things were in those days.
19:13But now, it's a lot different.
19:16A lot more people want to study psychology.
19:18And it's okay, you know, people are even encouraged to say, oh, why not study psychology?
19:22So it means that we are getting there a little bit more than we were before.
19:27So people are becoming more aware of mental health.
19:30The Gen Z's right now, who say, oh, my mental health, my mental health, my mental health.
19:34Right?
19:35Yeah.
19:36So people are becoming more aware.
19:37And that's a good thing, right?
19:38So the more aware people are, the more professionals we are going to have,
19:43and the more those needs are going to be met.
19:45Thank you, Doctor.
19:46All right.
19:47The last question.
19:48If there's one thing you'd like to tell our viewers out there about World Suicide Prevention Day,
19:54what would it be for those having suicidal thoughts or those that are under the pressure of life?
20:00Yes.
20:01So what I would say to you out there is seek help, right?
20:06Seek professional help.
20:08Talk to a professional today.
20:10Don't postpone it.
20:11Don't procrastinate.
20:12Talk to a professional today.
20:14Right?
20:15Yeah.
20:16Because help is available.
20:19Help is available.
20:21So if help is available, you want to grab it.
20:23You want to take the opportunity to seek that help.
20:27No matter how bad it is, you know, I've seen people who have dealt with suicidal thoughts,
20:32who have gotten better.
20:33Because you must realize that suicide for a lot of people, right, is an escape route.
20:40They are trying to escape from pain, the emotional pain and torture that they feel.
20:46So I usually like to tell them, what if you have an alternative route to meeting or achieving the same goal?
20:52You have an alternative route of actually militating that pain, dealing with that pain, that emotional pain that you have.
20:59Would you embrace it?
21:00A lot of times they want to embrace it.
21:02Because I ask, have you been dead before?
21:05The answer is no.
21:06I have not been dead before as well.
21:08So you never know what happens, you know, after you die.
21:11Because you might not actually have the peace you thought you were going to have when you die.
21:16So since you have not been dead, have not been dead, and we are uncertain about what happens when we die,
21:21why not embrace what we know here and now?
21:24Which is therapy.
21:25Yeah.
21:26We've seen people who have gotten better with therapy.
21:29Just by talking to a professional, they have felt better, they have dealt with the challenges they are going through,
21:36and they are better today.
21:38That can also be you.
21:40Thank you, Doctor, for this insightful conversation.
21:43Yeah.
21:44It's a pleasure having you here.
21:45Thank you very much for having me.
21:46We've just had this insightful conversation with Dr. Miraku Uyoma, a certified clinical psychologist.
21:53Remember, suicide is not the cure.
21:56For everyone out there listening to us, every life matters, and hope is better than silence.
22:03I'm Fadma Rachel for Guardian TV.
22:10I'm Fadma Rachel for Guardian TV.
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