CHAPTER ONE
INTRODUCTION
Background to the Study
Suicidal behaviour is any deliberate
action with potentially life-threatening consequences, such as taking a drug
overdose, deliberately crashing a car. Suicidal attempt often occur in response
to a situation that the person views overwhelming (Hudgens, 2003), such as
social isolation, death of a loved one, emotional trauma, serious physical
illness, aging, unemployment, or financial problems, guilty feelings or
dependence on alcohol or other drugs.
Suicidal behaviour has been reported
in technically advanced countries of the world as a leading cause of
psychiatric emergencies among children and adolescents (Robert, 2008), and one
of the strongest predicators of psychiatric admission for adolescents, he
concluded. In the United States, for example, suicidal ideation and attempts
among adolescents have been reported as being increasingly recognized as
important public health problem (Stone, 2001). Epidemiological studies suggest
that lifetime prevalence of suicidal attempts among high school students range
from 3.5 to 9.0 per cent (Andrews & Lewinsohn, 2002). The Centre for
Disease Control (2006) reported that suicide was the third leading cause of
death among the males ages 13 to 29 years in 2004, accounting for 14.6 per cent
in that age group in USA.
Sex abuse is another form of indirect
self-destructive behaviour that students may indulge in. Sex abuse is any
unlawful, forceful, sexual intercourse such as fornication, adultery or rape.
Cult members sometimes engage in raping spree of female students in the
universities. The survivors run the risk of becoming pregnant or contracting
HIV (Heise, 2001; Mocellin, 2002). If the raped victim becomes pregnant, they
run the risk of committing abortion and dying in the process, or dying during
delivery. If they contract human immune-deficiency virus, it will gradually
lead to full blown AIDS which may lead to death. The rapist may also contract
HIV which may cause AIDS and eventually death. Sex abuse by cult members has
been reported in various universities worldwide, including Nigeria (Amandikwa,
1999; Animba, 1999; Olukoya, 2002; & Ighodaro, 2002). People who have
traumatic childhood experiences including sex abuse are more likely to attempt
suicide, perhaps, because they are at higher risk of becoming depressed
(Robert, 2008).
Reckless driving by some university
students who sometimes carry their parents’ cars for a jamboree is a form of
suicidal behaviour. They may engage in excessive speed and dangerous overtaking
after drinking which may sometimes lead to premature and reckless deaths
through road accidents.
Studies have been carried out on
cumulative prevalence of suicidal attempt of youths in technically advanced
countries of the world (Reynolds & Mazza, 2000; Roberts, 2002; Shaffer
& Hicks, 2004). The results of these studies showed that the suicide rate
varied by age groups. Of all age groups, they reported, the elderly have the
highest suicide rates, particularly white men over the age of 75. This high rate
of suicide among the elderly people was adduced by the researchers to be due to
the debilitating effects of physical illness, loss of social roles and
relationships, and untreated depression. Moscicki (2003) and National Centre
for Health Statistics (2004) carried out studies on the cumulative prevalence
of suicidal attempt of youths in United States of America. The results of the
studies revealed that suicide was the third leading cause of death for persons
aged 15 to 24. The reason for this they adduced, was associated with a greater
prevalence of mental illness in young people, increased use of drugs in this
population, and the availability of firearms in the homes. Suicidal attempthave
also been cumulatively reported to be a strong predictor of psychiatric hospital
admissions in United States (Safer, 2007). The consequences and precursors of
suicidal attempt tend to point to the youths (the age bracket of the student
population in Nigeria). In Nigeria, there is paucity of data on the suicidal attempt
of youths, especially the undergraduates of universities, and this may affect
the prevalence of suicidal attempt. The prevalence of suicidal attempt varied
depending on the terminology used and tended to be higher in studies employing
anonymous questionnaires than in studies employing non-anonymous methods
(questionnaires or interviews), although most of these differences were not
statistically significant (Evans et al., 2005). Warheit, Zimmerman, Khoury,
Vega, and Gil (1996); Roberts, Chen and Roberts (2001); Demetriades, Murray,
Sinz, Myles, Chand, Sathyaragiswaran, Noguchi, Bongrad, Vryer, and Gaspard,
(1998); Garofalo, Wolf, Wissow, Woods, and Goodman (1999), reported higher
prevalence of suicidal ideation and attempts among Hispanic females than males.
Grunbaum, Basen-Engquist and Pandey (2008), however reported no significant
gender differential in the suicidal behaviour of their own study. World Health
Organization, (2002) found out that attempted suicide was most common in 15-24
year old young females, and should be prevented.
Ideally, students should be made to
study under conducive environment without undue stress. Conducive environment
constitutes of a condition devoid of economic, financial, social, and
psychological problems. This, however appears not to be so with students in
Nigerian universities. According to Eneh (1998), many Nigerian university
students face some excruciating economic difficulties such as inability to pay
their school fees, purchase essential textbooks for their courses, feed and
clothe themselves or cope with academic work, and obtain good medical care
while on campus. These unaccomplished needs among others may culminate in
suicidal attempt (Eneh, 1998).
Specifically,
the study sought to find out:
1
the prevalence of completed suicide among undergraduates of
universities in South Eastern States of Nigeria;
2
the prevalence of suicidal attempts among the undergraduates
of universities in South
Eastern
States of Nigeria;
3
the prevalence of suicidal ideation among the undergraduates
of universities in South Eastern States of Nigeria;
4
the health effect of suicide attempt among the undergraduates
of universities in South
5
Eastern States of Nigeria
6
preventive measures against the prevalence of suicidal attempt
based on students characteristics (sex and year of study).
The
following research questions have been posed to guide the study.
1
What is the prevalence of completed suicide among
undergraduates of universities in
South Eastern States of Nigeria?
2
What is the prevalence of suicidal attempts among
undergraduates of universities in
South
Eastern States of Nigeria?
3
What is the prevalence of suicidal ideation among
undergraduates?
4
What is the health effect of suicide attempt among
undergraduates?
5
What preventive measures are adopted against suicidal attempt
among the
undergraduates
of universities in South Eastern States of Nigeria?
Hypotheses
The following null hypothesis was formulated
for the present study.
HO1:
suicidal attempt among the undergraduates has no significant influence
on the health status of (p < .05).
The benefits that shall accrue from this study
are many. The results of the findings from the data analysed on the prevalence
of completed suicide and suicidal attempts it is hoped, would enable the health
educators to suggest intervention and prevention strategies appropriate for
undergraduates at risk for suicidal attempt. It would help sociologists and
other educators to provide intervention programmes to prevent premature deaths
due to suicides across the lifespan in Nigeria. It is expected also that the
results of the findings from the study will help to reduce the harmful
after-effects associated with suicidal attempt and traumatic impacts of suicide
on family members and significant others, as well as reduce the social stigma
attached to family members of people who commit or attempt suicide. This might
be achieved if the isolation and stigmatization of family members of suicide
victims are prevented or minimized. The finding will also help to ginger up the
various universities in Nigeria to establish suicide prevention strategy
centers with telephone ‘hotline’ services. These centers should be managed by
professionally trained suicidologists or medical practitioners versed in
identification and treatment of risk factors associated with suicidal attempt.
The
results of the findings from the analysis of data on the prevalence of suicidal
ideation will help the psychiatrists and suicidologists to identify early enough students with signs of depression, schizophrenia and
other mood problems and to treat them before they start attempting suicide. It
will also help guidance counsellors to plan out programmes of activities to
enable the students reduce incidences and prevalence of suicidal ideation
through a co-ordinated and planned programme of guidance counselling in the
universities. A well-coordinated and planned programme of guidance counselling
for students in our universities, it is expected, would decrease risk and/or
increase protective factors against such suicidal ideation behaviour.
The study was limited to federal, state, and
private universities in the South Eastern States of Nigeria. South Eastern
States of Nigeria comprises Abia, Anambra, Ebonyi, Enugu and Imo states. The federal, state, and private universities
in these states include five states, four federal and one private university.
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