Adolescent Mental Health & Suicide Prevention: Insights from Kenya and South Africa

1. Adolescent Health &Teen suicide: Prevalence and Prevention By: Kaye Alianda 3rd year BPsych (SACAP, Johannesburg) M.A (UoN, Nairobi) B.Ed. (K.U, Nairobi)

2. Life is not worth Living

3. Place of hopelessness • people are unable to see alternatives to their problems or an end to their pain They have deep sense of depression Act impulsively (in the case of teens) • just want to make it all go away forever

4. The face of depression

5. Current situation in Kenya: Suicide cases on the rise • 2014 World Health Organisation (WHO) rankings for every 100,000 attempted suicide cases in Africa: • 3,000 occurred in Kenya, between 17 and 30 years of age. • Kenya comes 65th out of 192 countries according to the WHO on suicide prevalence. • More women than men in Kenya attempt suicide: most of these attempts do not succeed..

6. Current situation In S.A

7. Some of the Reasons • Depression mental illness drugs alcohol abuse, strained relationships • inadequate parenting, poverty, abuse, trauma, domestic violence, broken homes and chronic diseases. • Current slow growth of economy unemployment Frustrations about money and jobs can lead to depression, drug abuse and alcohol addiction. • When the young people feel inadequate and powerless they may be tempted to commit suicide.

8. Role of Technology

9. Technological trends • 3% of Youth in Kenya want a Smartphone as their next phone. • 2 out of 3 Youths in Kenya either own a mobile device or have access to one. • Social media dominates Internet consumption between the ages of 7 and 25, peaking at 87% ahead of downloading music, research and email. • TV and radio are the most consumed medias overall by Kenyan Youth but as they get older Internet consumption increases substantially. • Computer usage at home is dominated by Internet usage. • Internet usage increases from pre-teens, through the teens and is most popular with post-teens. • Youths access the Internet around 4 times a week on average and this increases with teens and post-teens. • Internet access is dominated via mobile devices in Kenya at over 90% on average across all age categories.

10. Some Social Media Platforms

11. Cyber bullying

12. Cyberbullying is linked to teen depression • 54% have witnessed online bullying • 33.8% of students aged 12-17 yrs were victims • 39% on Face book (89 to 97.5% of teens have an FB account) • 29% on YouTube • 22% on Twitter • 22% on Instagram • Snapchat

13. VideoGames YouTube, • 9th May 2017: Kenya bans ‘Blue Whale Challenge’ after Nairobi teen suicide: The ban comes after a 16 year-old-boy in Kamukunji committed suicide after successfully going through all the 50 stages of the killer game.

14. Common methods

15. Cases of firearms • 4th May 2017:Teenagershoots himself in quarrel with servant over a car. • The teenager grabbed his father's gun and shot himself in the head after a domestic worker barred him from using a family car. The police said Kariuki, a licensed gun owner, was away in London together with his wife at the time of the incident at their Mugumo Terrace home. • 18 Feb 2017: Auniversity student shoots himself in the chest twice using his father's gun.

16. Look and Listen…the sign are always there

17. Policies that help Prevent Suicide • Ensure safety from poisonous products, objects, firearms • Suicide watch • Encourage hospitalisation • Monitor social media use • Talk to the person/get help for them

18. Services in place in Kenya • Helpline 1: +254 20 3000378/2051323 • Universal Suicide Prevention Awareness Ribbon (IASP)Befrienders Kenya in partnership with the Mental Health – Department of Mental Health launched the Suicide Prevention Awareness Ribbon. This was during the World Suicide Prevention Day national event held on 9th September, 2016 organized by the Ministry of Health at the Mathari National Teaching and Referral Hospital in Nairobi. • Lifeline offers emotional wellness programs aimed at building resilience and coping skills in the youth. They offer counseling services for youth with suicide ideation.

19. More help for Suicide • SITAWA WAFULA: NomadicMentalHealthCrusader: SuicidalpreventioncasesFREE SMS service 22214 • Suicidehubandhotline in Kenya LinkedtoSitawaWafula

20. Current interventions in South Africa

21. Community Intervention Model • In New York, a YES workshop successful since the 90s in reducing suicide. • Objectives are for adults to learn how teenagers feel • Teach teenagers problem solving skills • Train the community on identifying teens at risk • Educate parents and teens on risk & protective factors. • Provide a website with resources for support

22. School based intervention model • Life orientation curriculum should include information on suicidal behavior. • Teachers should have some basic knowledge on identifying children at risk and where to refer them to. • Each school should have a dedicated counselor. • In Canadian school program, teachers are trained to be “Gate keepers” by identifying and intervening to refer children at risk to the necessary professional. All staff inc bus driver has basic suicide awareness education. • The school also has a suicide prevention tool kit available to all staff, parents and students.

23. Inter-sectoral collaboration • Department of Health • Department of Education • Police Services • Schools • The community • Parents • Adolescents

24. Suicide is preventable!

25. Pyscho-ed follow up material • 13 Reasons why: American drama-mystery web televisionseries that revolves around a high school student who commits suicide after suffering a series of demoralizing circumstances, brought on by select individuals at her school. Before her death, she records tapes detailing 13 reasons why she ended her life. • Books: Self esteem; negotiating teenagehood successfully; relationships • http://www.goodreads.com/list/show/11647. Books_On_Teen_Suicide_Prevention • Pintrest: Adolescent Suicide information

26. References • Cyber crime Support. (n.d.). Cyber bullying definition. Retrieved April 2, 2016 from http://cybercrime.org.za/cyberbullying/ • http://www.myhealth.co.ke/my-health/youth-suicide-cases-rise-kenya-according-ew-report/ • http://www.capitalfm.co.ke/news/2017/05/kenya-bans-blue-whale-challenge-after-nairobi-teen-suicide/ • http://www.eadestination.com/investigative-journalism/1167-teen-suicide • http://www.pewglobal.org/2015/04/15/cell-phones-in-africa-communication-lifeline/ • Healthy child. (2014): School-based Suicide Prevention: A Comprehensive Approach. Retrieved from http://www.gov.mb.ca/healthychild/ysp/ysp_bestpractices.pdf. • https://www.standardmedia.co.ke/article/2001238509/teenager-shoots-himself-in-quarrel-with-servant-over-car • Lindqvist, P., Johanson, L., & Karlsson, U. (2008). Bio Medical Central Psychiatry. In the aftermath of teenage suicide: A qualitative study of the psychosocial consequences for the surviving family members. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2375873/. McArt, E., Shulman, D., & Gajary, E. (n.d.). Developing an Educational Workshop on Teen Depression and Suicide: A Proactive Community Intervention Retrieved 19th April 2016 from https://www.questia.com/library/journal/1P3-46554210/developing-an-educational-workshop-on-teen-depression

27. References • The Constitution of the Republic of the Republic of Kenya. Government Printer. • https://www.befrienderskenya.org/abuse.htmlInternational Association for Suicide Prevention (IASP) • The South African Depression and Anxiety Group (SADAG) (n.d.). Retrieved March 24, 2016 from http://www.ngopulse.org/organisation/south-african- depression-and-anxiety-group.

28. Thank you for Listening