The psycho-social problems are those problems that represent the influence of psychological factors and the surrounding social environment on individuals’ physical and mental wellness and their ability to function. This approach is used in a broad range of helping professions in health and social care settings as well as by medical and social science researchers (Woodworth 2015). Psychosocial problems include: addiction, domestic abuse, poverty, family discord, divorce, etc. All of these impair psychological functioning and interpersonal relationships. When these problems are left without effective intervention, the situation might be an impetus for misery within a society.
Having discussed extensively on the factors that cause and or aggravate the issue of suicide, all of the previous explanations about suicide will be less meaningful and useful if we do not make effective recommendations to cleanse the society of this pandemic mental disease. This article addresses interventions and therapeutic measures that help to mitigate the root factors including psychosocial problems, symptoms and behavioral problems.
We must however note that prevention is always better than cure. Obviously, resistance always surfaces when mental dysfunctions are to be treated. This consequently makes it difficult to alleviate the dysfunctions. It is therefore important to identify and consider the risk factors in order to provide precautions and intervention to thwart escalation.Victims of this problem and people who are generally predisposed to suicide must gain insight into their psychological deficits through strong advocacy and awareness. Also, they must be willing to receive treatment, this is often a controversy and challenge faced by the mental health care professionals.
To prevent and mitigate psychosocial problems and suicide rate in Nigeria, the following should be considered and implemented:
Problem solving therapy
Many Nigerians have one way or the day experience or deal with psychosocial problems. Individuals who are unable to bear it may consider ending their lives; in other words commiting suicides. This sounds extreme but then the agony and distress that prompts suicidal ideation or attempt cannot be overstated. People have suicidal intent/ideation or who experience mental and or emotional distress often benefit from acquiring problem solving skills. One way through which this can be achieved is the development of strategies to cope more effectively with the problems they face. Obviously, people experience pains or distress when they encounter strain that are perceived to be beyond their control. They feel helpless and sometimes hopeless, and this triggers depression which sometimes become so severe or could lead to other severe mental disorders.
In the Nigeria context, this therapy can either be formal or Informal. Formal can involve visiting a professional psychologist where quality services are provided to technically imbibe in the person coping skills such as emotional intelligence, self awareness, cognitive restructuring etc. All of these help to deal with every day stressful situations and to fortify one’s personal strengths to elevate the psychological and affected physiological functioning. Here, analytical assessment is required at initial stage of therapy to understand the nature of the problem.
The informal way could involve organising programs at work place or school which serves to enlighten individuals on ways to manage their emotions and improve their interpersonal skills. With these knowledge and skills, individuals have resilience and strength to deal with and solve particular overwhelming life issues they get to experience. For example, a person who has experienced abusive relationships or domestic violence might have developed behavioral problems, depression, personality disorders, mood disorder, or other psychological dysfunctions associated with such traumatic experiences. Acquiring problem solving skills makes life a lot easier, it improves our wellbeing necessary to effectively achieve our life goals. We must note that to be able to solve a problem, our attitudes which include our beliefs about the problems must be altered. In other words, we need to be open minded and be willing to learn and change for the better which gradually transforms to the best versons of ourselves. As Beck (1995) said, for every psychological difficulty there is an underlying faulty belief system that must be restructured. For instance, instead of being gloomy about bad grades or the lost grant opportunity, all you need do is acknowledge those painful feelings and start preparing for the upcoming exam or the next year grant opportunity. Many issues that are catatrophized which consequently trigger emotional distress, only need us to take proactive steps to resolve the perceived problems and avoid repeating same past errors or misconduct.
Evaluations of the effectiveness of problem solving approach have generally been empirically proven. Indeed, in a meta-analysis of psychosocial interventions following suicide attempts, Van der Sande et al. (1997) found problem-focused and cognitive behavioural interventions to be the only interventions to prove effective in this groups.
The foremost suicide-prevention telephone hotlines was developed in the western world; United States. Listening ears were promptly and adequately provided to callers who were in intense mental distress. These individuals are then directed to appropriate persons or facilities where they can receive effective intervention. The Although these hotlines provide a valuablej service to people in crisis, research, empirically hotlines help only those that put a call through, which requires a lot of courage and resilience. Empirically proven also is that young women call more frequently more than men do, meanwhile report has shown that men have a greater risk of suicide. We could then say that men reach the point of commiting suicide because they refused to seek for help, probably for the fear of appearing weak which is unexpected of them by the society.
Nigeria needs to adopt this strategy by setting up and publicizing effective services that provide intervention when there is a case of emergency.
Schools should have suicide-prevention programs that train students, teachers, and school staff to recognize warning signs and be cognizant of where to refer students at risk of suicide.
Restrictions and bans
Another prevention method involves the restriction of access to means of carrying out suicidal act. There should be ways to curb people from jumping into oceans, such as placing security agencies around sea/bridge areas, in fact this might be a source of employment for some individuals. Also, restriction, people illegally possess firearms should be severely punished, this might restrict people’s access to owning guns and the likes. Countries who have placed these restrictions reported some effectiveness in reducing suicides. It is conspicuous that such methods bring about a delay during which suicidal intents and ideations may change or people might get to rescue the victim. For instance, in Nigeria access to snipers and the likes need to be mitigated. Although this sort of restriction has its advantage but without addressing the root problems as to why people commit suicides (which have been addressed in previous articles) people can still devise means to carry out the suicidal act. People need to be enlightened on the use of social media and the possible painful consequences of the whole process (act of killing oneself, especially attempts that are not successful leave the victims in more physical and psychological pains) Such vicarious learning would discourage people from committing suicide.
Advocacy and personal development training programs
Because depression and personality disorder precede most suicides, early detection of these symptoms and providing intervention through medication and psychotherapy are vital ways of preventing suicide. Generally, efforts of suicide prevention aim to identify people with the highest risk of suicide and to intervene before these individuals become suicidal. It is important to strongly create awareness and sensitize people about mental health and the deficiency of mental health and also encourage them to go for therapy. Group therapy can be organized for people who are exposed to the perceived risk factors. Just as medical outreaches entail, psychological outreaches need to be organized where set of people are assessed and recommended for appropriate interventions.
In fact, with enough financial backup, individuals may be compensated for receiving psychological assessment and or therapy, this is a form of token economy. When this is carried out effectively and persistently, the value for psychological services are becoming elevated. Sooner, there will be increment in the consumption of the services; this consequently attracts investment (both internationally and locally) in the field, simultaneously the field of mental health expands intellectually, financially and generally. With adequate awareness and insight; mental impairment will be healed at rudimentary stage before it escalates. This sort of advocacy may require huge capital , energy and most importantly cooperation of all mental health professionals/advocates, but in the end, the success will be worth all the initial stress and diligence. Unity and zeal are highly required for the success of this sort of advocacy and intervention.
Coping skills need to be taught to students and youths during the course of these programs. Parents and caregivers need to be sensitized on human psychological functioning to guide them on effective ways to nurture their children to develop abilities and skills necessary to cope with life stressors, regulate and improve their functioning (and overall wellbeing), build healthy relationships and to become the best versions of themselves that make significant impact on people around them. Such sensitization should be incorporated in the ante-natal and post natal programs. Parents need to learn the healthy behavioral modification strategies to successfully raise a successful child who functions optimally. Most Nigerian-Parents are so frustrated that they raise frustrated children. It has been observed that parents have children for wrong reasons, in fact these parents get married for wrong reasons (This is a discussion for a later time)
Mental Health Advocates and Professionals need to be supported by providing adequate resources needed to motivate them to function actively and effectively; and effect significant social changes beneficial to the wellbeing of Nigerians. Strong support will enable the advocates and professionals reach larger crowd and to provide quality services that will facilitate improvement in people’s overall wellbeing and relationships with others. All Nigerians need to positively transform their lives and communities are resilience and emotional intelligence. These will be acquired only through change in their psychological constructs; a function of cognitive restructuring and reorientation.
Investment in mental health institute
Research institute needs to be invested in to encourage investigations about problems and phenomena to provide understanding and solutions to problem as well as to foster psycho-social functioning and development. We are social beings who are constantly influenced by our immediate networks, once a larger percentage of these networks are unhealthy then there is high possibility of faulty system thinking to begin to reflect which consequently incite mental deficits and related problems in the society. When people are psychologically fit, many of the problems (crimes, poverty, poor government, corrupt leaders) in Nigeria will automatically be mitigated because behaviours become adaptive, lifestyles are healthy, actions are productive, and relationships are constructive too.
Mental health state is associated with behaviour at all stages of life. Evdences indicate that the social factors associated with mental ill-health are also associated with alcohol and drug use, crime, and dropout from school. The absence of the determinants of health, and the presence of noxious factors, also appear to have a major role in other risk behaviours such as unsafe sexual behaviour, road trauma, and physical inactivity (WHO,2004). Furthermore, there are complex interactions between these determinants, behaviours and mental health (WHO, 2004).
Effective policy making
It is also vital that mental health professionals are involved in policy making and important decision making on the affairs of the country. This will provide effective means to make people more productive which will facilitate sustainable development of the country. Key components that determine the functioning of a society are human behaviours (influenced by mental processes) and group dynamics that define relationships. Kleinman (1999) describes the dimensions of mental and social health problems in “broken communities” in shantytowns and slums and among vulnerable and marginal migrant populations: civil violence, domestic violence, suicide, substance abuse, depression, and post traumatic disorder cluster and coalesce. He suggests for a research agenda and innovative policies and programmes “that can prevent the simply gigantic burden that mental illness has on the health of societies resulting from the variety of forms of social violence in our era” (Kleinman 1999, p. 979).
Therefore, experts of these subject matters must actively participate in the decision making of the national affairs. Policies that support their services must be created. Such policies include: presence of mental health professionals in all institutions/organizations that constitute human operations, especially hospitals, schools, industries, agencies (especially health and security agencies), prisons, other government sectors and offices (in fact leaders need to be assessed before they are allowed to contest for a position). Relevant Assessment and Intervention tools must be present at these areas to enable optimal functioning, effective operation and quality services.
Effective Partnership is highly required. Psychologists and other relevant professionals including medical doctors, security personnel, political leaders, CEOs, need to collaborate to make the necessary plans that will be fruitful and beneficial to all.
Nigeria seems to address her issues superficially, we have accommodated unhealthy ways of life that such abnormality has become our normality. We pay less attention to problems at their rudimentary state until they aggravate, for instance, homeless people and people who have encountered traumatic experiences are ignored until their pains have intensified to the point that they become toxic to themselves and the society; such as criminals, terrorists etc. Until the root problems are thwarted considering the recommendation in this article and other related suggestions, there will be no significant sustainable development in the dear country – Nigeria or any country that fails to make mental health/welfare of the people their priority.
Suicide in Nigeria is majorly caused by the interplay of impaired conditioning and socialization, cognitive distortion, deficient executive control system, lack of coping skills (ignorance), brain defects and genetic dispositions triggered by stressful life events such as trauma (maladaptive family system, abuses, socio-economic problems), in other words psychosocial problems.
Nigeria has a problematic interpersonal system which predisposes a large number of people to mental disorder. The socio-cultural influences and learning processes are ambiguous, obsolete and faulty. Many parents and caregivers are apparently victims of PTSD themselves or a large number of them are clueless about the effective way to nurture a child, because they have no idea how the mind works and that children internalize every experience that come their way. Learning process and our interaction with others play critical role in forming our relatively stable thought, emotional and behavioral pattern that determine our attitudes, lifestyles; personality, decisions we make and the consecutive experiences that manifest in our lives. Youths need to develop and learn coping skills that will enable them to adapt to the environment, different circumstances and people. Young Nigerians need to be brought up in ways that strongly focus on improving their cognition, value system and understand that problems wil oftenl inevitably surface and it is their responsibility as humans to continually seek healthy and effective means to resolve them and adapt successfully to the environment as posited by the evolutionary theory.
The belief system that emphasizes conventions and collective livelihood needs to be ameliorated, the individual nature of every child must be acknowledged, focused on and developed. Nigerians must be brought up to take responsibility and clearly understand that consequences exist for every thought pattern and action that they exhibit. It is in their best interest; to promote their wellbeing and productivity if they act in ways that facilitate their personal development and which are beneficial most importantly to them and the society or people around.
The Government needs to invest more in health sector focusing on both mental and physical health. Policies must be created and implemented to support mental health professionals for them to render their services purely valuable and functional for the common good of all. Mental Health Professionals need to be more vibrant in creating awareness and enlightening youths and especially parents on effective ways to raise a successful child (leader). Medical practitioners and mental health professionals need to collaborate in order to improve the overall health of people while simultaneously elevating their own careers. This will effect significant socio-economic development in the country. The recommendation needs to be considered and implemented to improve the quality of lives (and functioning) of the people.
Please note; No matter the budget created to revive the economy without considering the above recommendations (emphasizing adequate investment in both mental and physical health), we will keep mopping the floor whilst the tap is gushing straight to the floor. Promoting mental health is an integral part of public health (WHO, 2004)
Judith, S., & Beck, A. (1995) Cognitive therapy: Basics and beyond. Guilford Press
Kleinman A (1999). Social violence: research questions on local experiences and responses. Archives of General Psychiatry, 56:978–979.
WHO (2004). Prevention and promotion in mental health. Mental health: Evidence and research. Geneva
Woodward, Kath (2015), Psychosocial Studies: An Introduction, New York, NY: Routledge, pp. 3–4, 7–8