Suicide in Nigeria: observations from the content analysis of newspapers
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Open access Original research
Gen Psych: first published as 10.1136/gpsych-2020-100347 on 13 January 2021. Downloaded from http://gpsych.bmj.com/ on December 31, 2021 by guest. Protected by copyright.
Suicide in Nigeria: observations from
the content analysis of newspapers
Tosin Philip Oyetunji ,1 S M Yasir Arafat ,2 Stephen Oluwaseyi Famori,3
Timilehin Blessing Akinboyewa,4 Michael Afolami,5 Moyo Faith Ajayi,4
Sujita Kumar Kar 6
To cite: Oyetunji TP, Arafat SMY, ABSTRACT under-documented due to the non-existence
Famori SO, et al. Suicide Background Suicide is a global public health problem of a vital statistics system6–8 and the sensitive
in Nigeria: observations
from the content analysis of
and Nigeria is one of the epicentres of suicide in the nature of the subject.9 The dearth of data is
world. However, there is a dearth of research exploring the also shrouded in stigma, and cultural and
newspapers. General Psychiatry
epidemiological aspects of suicide in Nigeria. religious sentiments associated with suicide
2021;34:e100347. doi:10.1136/
Aim To examine the demographic information and
gpsych-2020-100347 in Nigeria. Deaths by suicide are perceived as
precipitating events for suicides in Nigeria by analysing the
sinful, a taboo and caused by evil forces, so the
Received 25 July 2020 contents of newspaper reports of suicide.
Revised 23 September 2020 Methods We searched, collected, and analysed published family are often times stigmatised and denied
Accepted 01 December 2020 news reports about suicide from 10 English newspapers social opportunities.10 People prefer to hide
in Nigeria. A total of 350 suicide reports were assessed the mode of death, declaring suicides as acci-
between January 2010 and December 2019 after dental deaths or as homicides.10 11 Many of
screening and sorting. the reported cases rely on police and hospital
Results The mean (SD) age of the reported cases was records, neither of which are comprehen-
36.33 (15.48) years. Majority of the reported cases were sive and might have been influenced by the
male (80.6%), married (51.8%), students (33.6%), living in bereaved.7 10 Suicide is still a crime in Nigeria
a semi-urban area (40.3%) and among the age group of according to section 327 of the country’s
25–34 (25.3%). Hanging (48.6%) and poisoning (32.2%)
Criminal Code.
were the most commonly reported methods of suicide.
Research evidence on suicidal behaviour in
Financial constraints and marital conflicts were most
commonly assumed precipitating factors. Nigeria document the use of chemicals, self-
Conclusion This study suggests that being male, married, cutting, burning with kerosene, hanging and
or living in semi-urban areas are associated with suicide in firearms as methods of suicide.12–14 Several
Nigeria. Further community-based studies are warranted other methods arose as persons who engage
© Author(s) (or their
employer(s)) 2021. Re-use to generalise the findings and adopt appropriate preventive in suicide are sometimes ambivalent and
permitted under CC BY-NC. No strategies. some are impulsive responses to psycholog-
commercial re-use. See rights ical stressors.6 Factors attributed to suicide
and permissions. Published by are personal risk factors including financial
BMJ. INTRODUCTION
1
constraints, family history of suicide, loss of
Department of Human Nutrition, Suicide is a global phenomenon having a deep
Faculty of Public Health, College
loved ones, mental illness, physical illness,
of Medicine, University of
consequence not just to the dying person but substance abuse and so on.15–17
Ibadan, Ibadan, Oyo, Nigeria also towards the bereaved, the community In Nigeria, the suicide phenomenon
2
Department of Psychiatry, and society.1 Despite being preventable, close remains under-explored, and there has been
Enam Medical College and to a million people die by suicide while the insufficient attention to the content anal-
Hospital, Savar, Bangladesh low and middle-income countries account for
3
Department of Geology,
ysis of Nigerian news portals on the demog-
University of Ibadan, Ibadan,
approximately 80% of the global suicides.2 raphy, methods and risk factors for suicide
Oyo, Nigeria Nigeria with a population of over 200 million in Nigeria. This study aimed at assessing the
4
Department of Psychology, is one of the epicentres of suicide in the world demography, methods and risk factors for
Adekunle Ajasin University, with a suicide estimate of 17.3 per 100 000, suicide in Nigeria by analysing the content of
Akungba-Akoko, Ondo, Nigeria which is higher than the global (10.5 per
5
Department of International
news portal reports of suicide.
Relations, Obafemi Awolowo
100 000) and Africa (12.0 per 100 000) esti-
University, Ile-Ife, Osun, Nigeria mates.3 According to global statistics, since
6
Department of Psychiatry, King 2012 there has been an increase in suicide METHODS
George's Medical University, in the country.4 Moreover, Nigeria, currently, This retrospective cross-sectional study uses
Lucknow, U.P, India has been reporting the highest number of data from 10 selected indigenous online
Correspondence to depression cases in Africa.5 media platforms in Nigeria. For selection, a
Tosin Philip Oyetunji; Like in many developing countries, suicide list of 10 online news portals was generated
tosinoyetunji123@gmail.com in Nigeria is grossly under- reported and and reviewed independently for content
Oyetunji TP, et al. General Psychiatry 2021;34:e100347. doi:10.1136/gpsych-2020-100347 1General Psychiatry
Gen Psych: first published as 10.1136/gpsych-2020-100347 on 13 January 2021. Downloaded from http://gpsych.bmj.com/ on December 31, 2021 by guest. Protected by copyright.
Statistical analysis
Analyses were done using Microsoft Excel 2019 version
and SPSS V.22 for data coding and entry. Descriptive
statistics, such as mean, SD and frequency, was performed.
Inferential statistics was done using χ2 and ANOVA for
association across gender and suicide methods. For
ordinal data, Kruskal-Wallis test was used to demonstrate
difference in ranked variables. Level of significance was
set at p valueGeneral Psychiatry
Gen Psych: first published as 10.1136/gpsych-2020-100347 on 13 January 2021. Downloaded from http://gpsych.bmj.com/ on December 31, 2021 by guest. Protected by copyright.
poisoning) were reported more in the semi-urban areas
Table 1 Demographic variables of suicides mentioned in
10 Nigeria online news portals (n=350) while electric shock, jumping in front of a vehicle/train,
burning, fall from height, gunfire, cutting, and drowning
Variable N Percentage (%)
were commonly noted in urban areas (χ2=12.081,
Age in years (n=300) p=0.017). Social status was not found to be associated with
0–14 9 3.0 mode of suicide. However, poisoning was reported more
15–24 65 21.7 among low social classes while hanging was more preva-
25–34 76 25.3 lent among the middle class (χ2=4.019, p=0.403). A signif-
icant difference was also observed between the choice of
35–44 72 24.0
method with the regions of Nigeria. In all suicide cases,
45–64 52 17.3 hanging and poisoning were most commonly reported
65 and above 26 8.7 methods in the North East and North Central regions
Sex (n=350) compared with other regions (χ2=22.547, p=0.013). A
Male 282 80.6 significant difference between risk factors and suicide
Female 68 19.4 methods was highlighted. Persons with financial
constraints chose to hang themselves while those with
Marital status (n=338)
marital conflict prefered to poison themselves compared
Married 175 51.8 with other methods. Place of attempt showed a significant
Unmarried 152 45.0 difference in methods of suicide; death by hanging was
Separated/divorced 11 3.3 more commonly reported at community centers, whereas
Habitat (n=330) death by poisoning was more commonly seen at school
Urban 39.7
and in the home (χ2=47.432, pGeneral Psychiatry
Gen Psych: first published as 10.1136/gpsych-2020-100347 on 13 January 2021. Downloaded from http://gpsych.bmj.com/ on December 31, 2021 by guest. Protected by copyright.
Table 2 Demographic pattern of suicides mentioned in 10 Nigeria online news portal (n=350)
Male Female
Variables Total (n=282) (n=68) Statistics P value
Age in years—mean (SD) 35.62 (15.51) 38.13 (14.15) 29.13 (18.36) t=4.130General Psychiatry
Gen Psych: first published as 10.1136/gpsych-2020-100347 on 13 January 2021. Downloaded from http://gpsych.bmj.com/ on December 31, 2021 by guest. Protected by copyright.
Table 3 Cross-tabulation with demographic characteristics and methods of suicide
Hanging Poisoning Others*
Variables Total (n=160) (n=106) (n=63) Statistics P value
Age in years (mean (SD)) 36.11 (15.51) 38.94 (16.93) 29.80 (12.22) 39.62 (13.33) F=12.006General Psychiatry
Gen Psych: first published as 10.1136/gpsych-2020-100347 on 13 January 2021. Downloaded from http://gpsych.bmj.com/ on December 31, 2021 by guest. Protected by copyright.
reported in Bangladesh where suicide reports were more about prioritising preventative interventions especially
among females than males, hence, there is a different among vulnerable populations. The country is yet to
gender ratio across the South-Asian countries.6 18 20 26 develop, implement and evaluate a comprehensive and
Comparing the demographic profile with the methods sustainable multisectoral suicide prevention plan, for the
of suicide, it was observed that the hanging and poisoning populace as a whole and for vulnerable persons in partic-
methods of suicide were more prevalent across most of ular, as recommended by WHO.29
the variables. Hanging, in particular, was found to be
predominant among males, married and separated Limitations
people, people living in rural, semi- urban and urban Suicide in Nigeria remains an understudied social issue.
areas, people across the social classes, other occupations To the authors’ best knowledge, this study represents the
apart from students and people living in every other first comprehensive review of top and leading Nigerian
region apart from North Central. In addition, completed news portals, for a 10-year period, on their style of suicide
suicide cases from most of the unknown risk factors, reporting. For this study, 10 online news portals within
and the known factors including financial constraint, the period of 2010 and 2019 were scrutinised; hence,
depression and others were by hanging, and the majority the study findings may be perceived as uncritical to the
of completed suicides by hanging were done at home. true picture of suicidal variables and their reporting by
These further validate the increasing global trend of use
news portals, but they will trigger further research and
of hanging for suicide.21 26 Mars and colleagues27 found
contribute to the body of knowledge about suicide in
that hanging was the predominant method in Ethi-
Nigeria. Data were collected and scrutinised from online
opia, Ghana, Senegal, South Africa and Uganda. Other
news portals; hence, the source of data is not strictly scien-
methods, including poisoning and firearms, were found
tific. To understand how risk factors may be connected
to be predominant in Cameroon, Egypt, Malawi and
to suicidal behaviour, qualitative studies are needed to
Tanzania. However, poisoning was reportedly predomi-
understand the complexity of suicidal behaviour and the
nant among such variables as being female, unmarried,
sociocultural context in which these happen. Cautious
students and people in North Central. A high percentage
interpretation is needed to generalise the results, and
of completed suicide by poisoning cases was caused by
further larger-scale studies would help to fill up the huge
marital and relationship discord and familial disharmony.
information gap on suicide research in Nigeria.
With respect to the risk factors, aside from about 28%
of the cases whose risk factors were either unknown or
not mentioned, financial constraints (20.1%), marital/ Implications
relationship discord (10.4%) and familial disharmony This study focused on some patterns and factors respon-
(9.5%) made the top three risk factors in succession. For sible for suicide in Nigeria. The findings from the data
marital status, the study revealed that married people are revealed that socioeconomic factors are a major justifica-
more likely to die by suicide than unmarried, divorced tion for suicide while married folks, artisans and students,
or separated people. Establishing a link between some and especially males had the highest number of suicides
suicide variables and marital status, it can be deduced in the data collected between January 2010 and December
that many married people have such financial chal- 2019. Aside from the government’s intervention, schools
lenges that could lead them to die by suicide especially need to be involved in mental health to reduce the suicide
by hanging and in their homes. Similar risk factors have rate among students.
been reported in a similar socioeconomic contexts such
as in Bangladesh where marital discord, familial dishar- Correction notice This article has been corrected since it first published. The
provenance and peer review statement has been included.
mony and sexual harassment are reported as prominent
Twitter S M Yasir Arafat @SMYArafat
risk factors.18 21 26 There have also been reports of other
risk factors for suicide and suicide attempts in Africa Contributors TPO, SMYA and SKK conceptualised the research. TPO, OSF, MA and
FMA worked on data collection. TPO, SMYA and SKK analysed data. TPO, TBA, MA
including physical health problems, psychiatric disorder and FMA wrote the initial manuscript. SMYA and SKK perused and revised the initial
or symptoms, drug and alcohol use/abuse, interpersonal draft. Final draft was approved by all the authors.
and social difficulties, and socioeconomic problems.27 Funding The authors have not declared a specific grant for this research from any
It was revealed from our studies that Nigerian news funding agency in the public, commercial or not-for-profit sectors.
portals do not sensitise their readers and the entire public Competing interests None declared.
to the risk factors and preventive strategies of suicide.
Patient consent for publication Not required.
Suicide is a preventable phenomenon. For instance, the
Provenance and peer review Not commissioned; externally peer reviewed.
Korean government has developed a National Mental
Health plan, Suicide Prevention Centre and prevention Data availability statement Data are available on reasonable request.
education projects for the young, and also introduced Open access This is an open access article distributed in accordance with the
media guidance to reduce inappropriate reporting Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-commercially,
and to promote awareness of the protective role of the and license their derivative works on different terms, provided the original work is
media.28 Despite the preventive tendency for suicide, properly cited, appropriate credit is given, any changes made indicated, and the use
governments and policy-makers have remained apathetic is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
6 Oyetunji TP, et al. General Psychiatry 2021;34:e100347. doi:10.1136/gpsych-2020-100347General Psychiatry
Gen Psych: first published as 10.1136/gpsych-2020-100347 on 13 January 2021. Downloaded from http://gpsych.bmj.com/ on December 31, 2021 by guest. Protected by copyright.
ORCID iDs 14 Nwosu SO, Odesanmi WO. Pattern of suicides in Ile-Ife, Nigeria.
Tosin Philip Oyetunji http://o rcid.org/0000-0001-8341-7036 West Afr J Med 2001;20:259–62.
S M Yasir Arafat http://orcid.org/0000-0003-0521-5708 15 Gureje O, Kola L, Uwakwe R, et al. The profile and risks of suicidal
behaviours in the Nigerian survey of mental health and well-being.
Sujita Kumar Kar http://o rcid.org/0 000-0003-1107-3021
Psychol Med 2007;37:821–30.
16 Uwakwe R, Gureje O. The relationship of comorbidity of mental
and substance use disorders with suicidal behaviors in the Nigerian
survey of mental health and wellbeing. Soc Psychiatry Psychiatr
REFERENCES Epidemiol 2011;46:173–80.
1 Jacob KS. Suicide prevention in low- and middle-income countries: 17 Omigbodun OO, Adejumo OA, Babalola OO. Suicide attempt by
part perceptions, partial solutions. Br J Psychiatry 2017;211:264–5. hanging in preadolescent children: a case series. West Afr J Med
2 World Health Organization. Suicide, 2019a. Available: https://www. 2008;27:259–62.
who.int/news-room/fact-sheets/detail/suicide [Accessed 7 Apr 2020]. 18 Arafat SMY, Mali B, Akter H. Demography and risk factors of
3 World Health Organization. Suicide in the world: global health suicidal behavior in Bangladesh: a retrospective online news content
estimates. Geneva: World Health Organization, 2019b: 1–33. analysis. Asian J Psychiatr 2018;36:96–9.
4 World Health Organization. World health statistics 2018. World Health 19 Niederkrotenthaler T, Voracek M, Herberth A, et al. Role of media
Organization, 2018. Available: http://apps.who.int/iris/bitstream/ reports in completed and prevented suicide: Werther V. Papageno
handle/10665/255336/9789241565486-eng.pdf;jsessionid=7A6C effects. Br J Psychiatry 2010;197:234–43.
46D234B30AA610C4C3D250677E64?sequence=1 [Accessed 2020- 20 Aktaş SG, Kantar YM. A study of suicide mortality in turkey
07-04]. (2002‒2011). Journal of EU Research in Business 2016.
5 World Health Organisation. Depression and other common 21 Shah MMA, Ahmed S, Arafat SMY. Demography and risk factors
mental disorders: global health estimates. Geneva: World of suicide in Bangladesh: a six-month paper content analysis.
Health Organization, 2017. https://www.who.int/mental_health/ Psychiatry J 2017;2017:1–5.
management/depression/prevalence_global_health_estimates/en/ 22 Baker SP, Hu G, Wilcox HC, et al. Increase in suicide by hanging/
6 World Health Organization. Preventing suicide: a global imperative, suffocation in the U.S., 2000–2010. Am J Prev Med 2013;44:146–9.
2014. Available: https://www.who.int/publications/i/item/preventing- 23 Mustafa Demir. Who commits suicide most? Suicide by gender
suicide-a-global-imperative [Accessed 16 Jul 2020]. and age. State University of New York at Plattsburgh, USA, 2018.
7 Alabi O, Alabi A, Ayinde O, et al. Suicide and suicidal behavior in Available: https://medcraveonline.com/FRCIJ/FRCIJ-06-00250.pdf
Nigeria: a review. Psychiatry Journal 2014;37:1–6. 24 Naghavi M, Global Burden of Disease Self-Harm Collaborators.
8 Gureje O, Alem A. Hidden science? A glimpse at some work in Global, regional, and national burden of suicide mortality 1990 to
Africa. World Psychiatry 2004;3:178–81. 2016: systematic analysis for the global burden of disease study
9 Panyayong B, Tantirangsee N, Bogoian RRD, et al. Psychiatric 2016. BMJ 2019;364:l94.
disorders associated with intimate partner violence and sexual 25 Murphy GE. Why women are less likely than men to commit suicide.
violence in Thai women: a result from the Thai national mental health Compr Psychiatry 1998;39:165–75.
survey. Gen Psychiatr 2018;31:e000008. 26 Yasir Arafat SM, Arafat SMY. Current challenges of suicide and
10 Ohayi SR. “Doctor, please don’t say he died by suicide”: exploring future directions of management in Bangladesh: a systematic review.
the burden of suicide survivorship in a developing country. Egypt J Global Psychiatry 2019;2:09–20.
Forensic Sci 2019;9:3–9. 27 Mars B, Burrows S, Hjelmeland H, et al. Suicidal behaviour across
11 Islam MN, Islam MN. Pattern of unnatural death in a city mortuary: a the African continent: a review of the literature. BMC Public Health
10-year retrospective study. Leg Med 2003;5 Suppl 1:S354–6. 2014;14:1–14.
12 Onotai LO, Ibekwe U. The pattern of cut throat injuries in the 28 Liu J. Need to establish a new adolescent suicide prevention
University of Port-Harcourt Teaching Hospital, Portharcourt. Niger J programme in South Korea. Gen Psychiatr 2020;33:e100200.
Med 2010;19:264–6. 29 Ogundipe S. Nigeria: Suicide – Nigeria Lacks National Prevention
13 Legbo JN, Ntia IO, Opara WEK, et al. Severe burn trauma from Strategy. Vanguard News, 2019. Available: https://www.vanguardngr.
deliberate self-harm: the Sokoto experience. Niger Postgrad Med J com/2019/12/suicide-nigeria-lacks-national-prevention-strategy/
2008;15:164–7. [Accessed 17 Jul 2020].
Tosin Philip Oyetunji is a researcher in the College of Medicine, Faculty of Public Health, University of
Ibadan, Nigeria. He has worked for over six years in operational research for the implementation programs for
institutions, national agencies, and Non-Governmental Organisations (NGOs); alongside a strong desire to
be involved in health research. His main research interests include social behavior, mental health, population
health and epidemiology.
Oyetunji TP, et al. General Psychiatry 2021;34:e100347. doi:10.1136/gpsych-2020-100347 7You can also read
