World Mental Health Day, on 10 October, is an opportunity to unite across the African Region and globally, for better well-being.
This year, the focus is on suicide prevention because globally, every 40 seconds, a life is lost to suicide.
In the African Region data are scarce and stigma is significant around suicide, but we know this is an important public health problem. Where data is available such as Côte d’Ivoire, Equatorial Guinea, and Lesotho, rates have been shown to be higher than 20 suicides per 100 000 people each year. This is higher than in most European countries, China or the United States of America.
Globally, almost four out of five suicides occur in low- and middle-income countries. In these countries rates of suicide are similar among men and women.
In the African Region, WHO works with countries to integrate mental health services at the primary care and community levels, through the WHO Package of Essential Noncommunicable Disease (PEN) interventions and with WHO Mental Health Gap Action Programme (mhGAP) training, so far conducted in Liberia, Nigeria, South Sudan and Uganda. We also work with communities to address psychosocial needs in the aftermath of health emergencies.
Yet we know that mental health is a chronically under-resourced area. For example, in Ethiopia, it is estimated that 20 million people have mental health issues, but only 10% have access to treatment and less than 1% receive specialized care.
However, with community-based action we can change this. Through the inaugural WHO Africa Innovation Challenge in 2018, I met Ephrem Bekele Woldeyesus, a social entrepreneur in Ethiopia. Ephrem started a weekly radio show on wellness, including mental health, to drive social change. He uses revenue from the radio show to subsidize mental health services for community members and is expanding into school-based mental and social health programmes.
Home-grown, grassroots innovative solutions, like Ephrem’s, can lead to change in the lives of thousands of people. Another example, is the Friendship Bench, which started in Zimbabwe and has been replicated in other African countries as well as New York City. The programme brings together older women, trained as lay health workers, to support people in need with problem solving therapy.
So, today, I would like to urge everyone to consider what you can do to improve mental health in your community and reduce suicide cases. For example:
- governments can facilitate multisectoral collaboration, including limiting access to pesticides, firearms and certain medications and strengthening policies to reduce the harmful use of alcohol;
- the health sector can train non-specialized workers to assess and manage suicidal behaviour, to identify, treat and care for people with mental and substance use disorders, chronic pain and acute emotional distress, and improve follow-up care for people who have attempted suicide;
- the education sector can implement school-based interventions to offer mental health support for adolescents;
- researchers can conduct qualitative studies to identify culturally relevant risk factors and how they apply in different contexts;
- the media can report responsibly in line with WHO guidance; and
- communities can contribute to reducing stigma and discrimination and providing supportive networks.
Together, we can reduce the number of suicide cases, tackle the stigma of mental illness and support each other for better well-being in our communities.
Mr Ephrem Bekele Woldeyesus’s integrated mental wellness programme
Preventing suicide: A resource for Media Professionals (WHO, 2008)
Friendship Bench Zimbabwe