Nyeri County in central Kenya has the highest suicide incidence in the East African nation with men said to be the more likely to take their lives. While mental health is pinpointed as the root cause, the other triggers vary from economic pressures to social pressure that includes peer influence.

As the numbers soar by the day, Nyeri County Commissioner, Ronald Mwiwawi, has called for intervention by stakeholders to reverse the worrying suicide trends in the county. Mwiwawi says in the past 10 years or so there has been an alarming increase in suicide incidence with men said to be the most affected.

Mwiwawi fears that unless drastic steps are taken to address runaway suicide rates in the county, the problem might soon metamorphose to catastrophic levels. He also disclosed that the majority of those who were taking their lives were mostly men who are the most critical pillars in the family and society.

“For the three years I have been here, suicide cases have been very high. Suicide has become a worrying issue. I have now asked people with mental health issues to walk into my office and have a chat with me so I can understand why we (men) are taking our lives. Let us talk to one another so we can address the rising incidence of suicide,” he advised.

 He made the remarks while launching the Social Health Authority registration exercise at the Nyeri Town Health Centre.

Some 726,000 people globally commit suicide every year, according to World Health Organization official statistics. Many more people make suicide attempts but every suicide is a tragedy that affects families, communities and even the whole world. Last year alone, suicide was cited as the third leading cause of death among people aged between 15-19 years worldwide.

The WHO estimates also show three quarters of global suicides cases in 2021 occurred among middle- and low-income countries.

“There is scanty information about suicides in Low- and Middle-Income Countries, including Kenya. A key contributor to this is the fragmented nature of reporting systems for suicide mortality.”

In Kenya, the ministry of health accounts in latest report: “In Kenya, data on intentional self-harm is difficult to distinguish from cases of accident or homicide. Even when recorded only partial data is available, is often missed. This warrants the urgent need for establishing systematic reporting practices for suicide. Statistics from WHO estimates Kenya crude suicide rate at 6.1 per 100,000 population with age standardised suicide rate 11.0 per 100,000 population, which translates to about 4 suicide deaths per day.”

During last year’s 61st Jamhuri (Republican) Day celebrations at the Nyeri Kamukunji Grounds, Mwiwawi, directed deputy commissioners, chiefs and their assistants to organise frequent public barazas to address  the high suicide incidence in the county.

He said he was horrified by the sheer number of people who were taking their lives in the county, describing the upsurge as alarming. The administrator said it was unacceptable for people to take their lives at such an alarming rate while those in authority do nothing about the issue.

Bishop Erastus Njoroge, who chairs the Kenya National Congress of Pentecostal Churches (KNCPC) described how he came face to face with a 50-year-old man who wanted to take his life. He rushed to the man’s house and fortunately managed to calm him down, besides confiscating the rope and poison he intended to use to end his life.

“Many people are desperate and have no one to turn to for help. People are going through so many challenges and have no one to talk to. I have dealt with so many attempted suicide cases, with the recent one being of a man in his 50s. I told him I visited because I wanted him to live. Taken aback at my words he asked me whether there were still people who still had concern and love for others. After answering in the affirmative, he broke down before me and promised never to take that road again,” explained Njoroge.

Njoroge says in addition to advocacy, counselling is needed to address the challenge of suicide cases in the society. He similarly explains that spiritual nourishment plays an integral role in managing mental health disorders.

“The young people need a lot of counselling and as spiritual leaders, we are available to offer help. If it were possible for every youth to be connected to a church it would be easy to conduct programmes and events tailored to address their needs. Such programmes provide opportunities for mentorship to the youth including on how to deal with relationships,” advises the cleric.

According to the ministry of health report, “Mental illnesses are often associated with suicidal behaviour and the prevalence of common mental illnesses in Kenya which include depression and anxiety disorders is about 10.3 per cent. Additionally, 42 per cent of those attending general medical facilities in Kenya have symptoms of severe depression. Suicidal thoughts associated with depression lifetime prevalence is estimated at 7.9 per cent, and for other mental illness is estimated at 5-8 per cent.”

Njoki Mariano, a mother of six and living in the slums of Majengo in Nyeri town recounted how depression claimed the life of her grandson six years ago, when he was only 15 years old. Mariano cites the experience as one of the most heart-breaking in her entire life.

“No tragedy bewilders a family more than suicide. The demise of my grandchild came to me as absolute shock. There was no prior expectation as everyone had woken up and embarked with the normal routines. It was only later in the day I received a call from my brother informing me that my grandson had been found hanging on a branch of a tree,” narrates Mariano.

Although her initial reaction was one of denial, the reality got the worst of her when she finally saw the lifeless body of her beloved grandson lying on the cold slabs of the morgue, as another statistic of the cruel hand of suicide.

Jane Wangechi a resident of Skuta Estate says she lost a cousin aged 38 years also through suicide. Wangechi says they only came to learn that her cousin had been struggling with financial challenges through a suicide note. Following the unfortunate incident, Wangechi now urges people not to shy away from disclosing their struggles with those they feel comfortable with instead of bottling up their struggles.

“I lost my cousin after he hanged himself in his bathroom due to financial struggles. It was so painful because we were friends and I never knew he was struggling with suicidal thoughts. We all face challenges in life but it is good to speak up when it gets really tough rather than sliding down the road to perdition,” she explains.

Fabio Ogachi, a mental health specialist and psychology lecturer at Kenyatta University, says the reason suicide cases seem high among men compared to women is because the latter have a stronger coping mechanism because they readily open up about their challenges.

On the other hand, the scholar says society tends to equate the male gender with masculinity and machismo, a misleading tag presents a man as invincible. People only realise the frailty of man after someone decides to take away his life rather than open up to the society and be stigmatised.

“The rate of suicide is high among men than women. There are many cases that go unreported because of stigma associated with suicide. It is not acceptable for men to be vulnerable so you find out that they don’t have an outlet for expressing their psychological pain. Suicide then becomes an escape route because they feel misunderstood, unwanted. If you look at women, they tend to express themselves when faced with challenges and emotionally they are able to have an outlet. If a man does the same, he is regarded as weakling,” states the university don.

Fabio nevertheless says that there are some notable red flags that can help pick out someone undergoing mental health challenges, a sure precursor in most suicide cases. In such instances, it is always prudent for those around such individuals to take prompt remedial steps to ensure the victim does not slide beyond help.

Remedial measures include but are not limited to counselling therapies, medical intervention and also practical magnanimity, whichever is applicable in a specific case.

“There is a typical change in behaviour as a result of depression where individuals start to isolate themselves from others. Some tend to withdraw from the social associations like work, family or hobbies they loved before. An individual can indulge in drugs and substance use excessively. Another sign can be through statements or comments a person makes wishing death on themselves.” he continues.

Dr Fabio encourages men to seek both community and professional help whenever they feel an issue is beyond their personal capacity. He underscores the significance of a social support system as a critical cog in the fight against suicide cases in the country.

“I encourage men to seek professional help either by visiting a counsellor or psychologist as they offer space where they can be heard and won’t be judged. Some issues need professional help while others can be resolved at the community level. I also encourage men to create their own forums as it’s easy for men to talk about their challenges with other men compared to the general public,” he advises.

“It is important for everybody to have a social support because lack of it leads to suicidal thoughts. People who are isolated and live in an environment that they feel judged and can’t freely express themselves tend to commit suicide compared to people who have social support system,” he further informs.

According to WHO, globally, there are over 700,000 suicide deaths annually which translates to one suicide every 40 seconds. For every suicide, 20 people make a suicide attempt and many more have serious thoughts of suicide. Most suicides occur in low and middle-income countries where there are huge gaps in health systems and resources with limitation in early identification, treatment and support of people in need.

Suicide is the fourth leading cause of death among 15-29-year-olds. In low- and middle[1]income countries the male-to-female suicide ratio is 1.5 men to woman. Suicide rates are highest in persons aged 70 years or over for both men and women in almost all regions of the world.

For each suicide, approximately 135 people suffer intense grief or are otherwise affected, translating to 108 million people per year who are profoundly impacted by suicidal behaviour.

The ingestion of pesticide, hanging and firearms are among the most common methods of suicide globally, but many other methods are used with the choice of method often varying according to population group.

• A Tell / KNA report / By Samuel Maina and John Bacha