Breaking the Stigma: Shedding Light on Ethiopia's Silent Killer - Suicide

The 26-year-old journalist Sara Ahmed found herself caught in a relentless cycle of sadness and despair. 

Her battle with depression began with an overwhelming sense of sadness and a profound feeling of emptiness. As the days turned into weeks, she found herself sinking deeper into the depths of despair. 

Her struggles were compounded by three attempts to take her own life, as she felt trapped in a world that no longer held any meaning for her.

As the symptoms of depression and suicidal thoughts took hold, Sara's days were spent aimlessly scrolling through her phone, seeking solace in a digital landscape that only deepened her feelings of isolation. 

Lost in a sea of perplexing emotions, Sara grappled with an inner turmoil she struggled to comprehend. It wasn't until she stumbled upon a Telegram channel that the fog began to lift. 

As she immersed herself in the enlightening content shared on the platform, Sara's eyes were opened to a profound revelation: she was experiencing the depths of depression.

This newfound understanding became a catalyst for change in Sara's life. She bravely confided in her father and sought medical attention, eager to take control of her mental health.

However, despite her efforts to raise awareness about her illness, Sara found that her family and friends struggled to understand the gravity of her situation.

As she shared her experience with those around her, Sara was met with dismissive responses, even from those who considered themselves well-informed. To her dismay, some suggested that a simple cup of coffee would be enough to cure her depression.

It was during this challenging time that Sara attempted her third suicide, a desperate act born out of the depths of her despair.

“When that happened,” said Sara, I was immediately taken to the hospital and managed to survive.”

The incident became a pivotal moment for Sara, a catalyst that ignited a fire within her. Determined to make a difference, she resolved to leverage the power of her social media platforms to raise awareness about mental health issues and suicidal attempts, especially through Facebook. 

She embarked on a mission to share her own journey and provide support and resources to those in need. 

“I  came to realize later that suicide is a problem that affects many people,” she said. 

Data from the World Health Organization (WHO) backs Sara’s view. Globally one million people die by suicide every year and this amounts to 1 in 40 people, according to WHO. 

Suicide’s impact starts with a family but its impact is extended to the society and country as it has become the leading cause of death among the youth (between 15 to 29 years old) taking the lives of the country’s productive segment of the population. 

An academic study conducted in 2022 at Dilla University shows that there is a high prevalence of suicidal ideation and attempted suicide in Ethiopia. The prevalence is high in women due to sexual violence and early marriage among other causes, according to the study.

People tend to seek professional help when they encounter problems related to suicidal thoughts. Studies show that 50% to 75% of suicidal ideation, which refers to thoughts, fantasies, and wishes about ending one’s own life, and attempts are reported to primary healthcare facilities. 

While Sara was fortunate enough to survive after seeking medical help, the tragic reality remains that in recent days, youth in Ethiopia are losing their lives before receiving the vital medical assistance they desperately need when confronted with suicidal ideation. 

In recent times, Ethiopian social media platforms have been inundated with a heart-wrenching tale of a young girl who tragically took her own life. Her distressing Facebook posts hinted at her deep struggles, providing glimpses into the dark place she was in. 

Adding to the sorrow, a private message she had sent to a friend came to light following her untimely passing, further highlighting the immense pain she carried within. 

This incident serves as a poignant reminder of the pervasive mental health challenges that contribute to the alarming rates of suicide among young people in the country.

Miraj Juhar, a psychologist and a mental and psycho-social support leader at CARE, an international NGO working to help women and children in poverty, says mental illnesses and substance use disorders are associated with an increased risk of suicide.

In Ethiopia, one in four citizens suffers from a mental disorder, according to Miraj. 

“As a solution to prevent suicide, public education and awareness campaigns are being implemented continuously at the community level to prevent suicide,” said Miraj.

The Ministry of Health has also developed the national mental health strategic plan 2020-2025 with the main of contributing to the prevention of suicide in Ethiopia, according to the Ministry. 

“The Ministry has given priority to suicide prevention in its work on mental health issues,” said Jemal Teshome, mental health officer at the Ministry of Health. 

As a milestone, the government has included suicide prevention programs in the recently updated Essential Health Services Package of Ethiopia, a document that lists the medical package of services that the government provides at health centers. 

Mental health services have also gained recognition as essential donor requirements. Both local and international NGOs integrated Mental Health and Psycho-Social Service (MHPSS) interventions into their development and emergency projects. 

Despite the positive strides, there are still gaps to be addressed regarding mental health awareness and suicide prevention, according to Eleni Misganaw, president of Mental Health Users Association, which was established in 2018 to ensure mental health conditions are engaged meaningfully in the country’s health care system. 

“Other countries, including neighboring country Kenya, have a comprehensive suicide prevention program,” says Eleni. “That is what we are advocating for.” 

The Association is working on advocacy to make sure that enough attention and funds will be allocated to treating mental illnesses. Its members are using social media to raise awareness about mental health. 

It also has a platform where peers share their stories and members call each other and talk about their problems including suicidal thoughts. 

Azeb Asaminew (MD), assistant professor of Psychiatry at Addis Ababa University, recognizes the efforts by such associations to play a vital role in preventing suicide or reducing the impact of suicide on families along with medical doctors. 

Every clinician must be aware of assessing suicide risk, and is important for patients to talk about their struggles with suicide before the medical doctors make assumptions about it, according to Azeb.

“Some injuries are non-lethal and others can be life-endangering,” she said. “The site of the injury determines how dangerous it is.”

These ongoing efforts to prevent suicide in Ethiopia face various challenges. One of the challenges is the low number of mental health professionals in the country. 

Studies show that there are about 150 psychiatrists in the country serving about 115 million people. In rural areas, it is the responsibility of Psychiatric nurses to treat patients. There is also a low number of psychologists and social workers, which require the policymakers’ attention.  

The second challenge is that mental health issues are considered as taboo in Ethiopia so people don’t talk about it openly and seek medical help. 

“There are still people who spend their days locked away at home not getting enough care and food,” said Eleni. 

The third challenge in the country is people's preference to go to traditional or spiritual interventions fully avoiding going to a health facility. 

This is where the role of social media comes into the scene. Eleni’s association and Sara use their social media platforms to create awareness about mental health and fight stigma against people struggling with mental health. 

“More often people are encouraged to talk about their own problems when someone opens up in a post or a video as seen in the comment section,’ said Eleni.

Yonas Lakew (MD), a Psychiatrist based overseas, is actively working to promote awareness regarding different mental health issues through Facebook, YouTube, and TikTok. 

He also gives medical advice and tells stories about famous people who have been affected by different mental illnesses.

Yonas believes that the awareness creation campaign is not enough to see changes in the country. Thus, he launched a campaign advocating for a hospital that provides mental health care to be built in every region.

Experts in the field advise that, in addition to medications for specific mental health conditions psychotherapy is an effective treatment option for suicidal ideation and attempts.

DBT (dialectical behavioral therapy) and CBT (cognitive behavioral therapy), which are types of evidence-based psychotherapies, are widely used psychotherapeutic interventions that can show promising results in preventing suicide.

Other countries including Ethiopia use hotlines in which people who have had struggles can call and get advice, as a suicide prevention mechanism. 

The current hotline used in the country is 952, where people can call for any health-related tips. It has six health professionals, who have been training by WHO, giving the service through the hotline. Among them, two are psychologists who give advice related to mental health conditions including to those who have had suicidal ideation. 

Mental health has gained momentum globally. In September the annual World Suicide Prevention Day is celebrated paving the way for health professionals to bring attention to suicide and its major effects on people's lives worldwide. Hashtags like ‘mental health matters’ and ‘it is okay to not be okay’ have been trending in recent years.

Professionals encourage talking openly about mental health issues and seeking help, and social media can be a powerful tool to create awareness. 

Testimonies like Sara, who had three suicide attempts, are opening the eyes of the public. The light has been shed on a problem that has often been swept under the rug. People are starting to talk about the issue but signaling that there is still more to be done.