Suicide cases in Zimbabwe, mental health crisis laid bare.

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By Sibonile S Siziba

THE high rates of suicide in Zimbabwe should be an impetus to re-evaluate, repurpose and if possible, reorganise the mental health service delivery system in the country.

Many cases of suicide have been reported in Zimbabwe and mental health experts say the problem is on the rise.

Zimbabwe has a 14.1 suicide rate per 100 000 population and is 5th on the continent`s countries with the highest suicide rate, according to the World Health Organisation`s 2023 World Health Statistics report.

Lesotho has the highest suicide mortality rate, at 72.4, followed by Eswatini with a rate of 29.4, South Africa in third with 23.5, Botswana in fourth at 16.1 while Zimbabwe takes the 5th place with a rate of 14.1 per 100 000 population. A report released by the National Peace and Reconciliation Commission (NPRC) in May this year showed that in Mashonaland Central alone, 53 suicide cases were reported in 2022, an increase from 35 that were recorded in the same province the previous year.

These statistics are a glaring indicator that suicides are a serious phenomenon and should push the country to invest more in mental health service delivery.

When refocusing the public mental health service delivery system, it is imperative that we consider the emerging and growing phenomena such as the COVID 19 pandemic as well as the rampant drug and substance abuse.

A counselling psychologist and founder of a mental health focused organisation, Someone Always Listens to You (SALT Africa), Tafadzwa Mugazambi-Meki notes that mental health in Zimbabwe should not just be about the psychosis elements such as ‘schizophrenia’ and ‘bi-polar’, but other factors that encompass mental health such as depression and suicides.

Tafadzwa Mugazambi-Meki

The drug and substance abuse scourge in the country is also directly linked to suicides. Studies have shown that more than half of the youths in Zimbabwe could be taking harmful drugs and substances and this increases the risk of suicides.

Socio-economic challenges such as endemic poverty are linked to increased rates of stress, trauma and mental health challenges, which all increase the risk for substance use, according to a 2018 United Nations Office on Drugs and Crime (UNODC) report. Substance use in Africa is on the rise, with projections estimating a 40 percent increase in people who use substances between 2018 and 2030, the report highlights.

These everyday realities now compound the mental health problem in Zimbabwe, and the starting point in dealing with this complex situation is investment. This investment primarily is about the fiscal resources being channeled towards the country`s public health delivery system, and further, having specific and adequate funding for mental health services.

Whilst Zimbabwe has made significant strides in increasing budgetary support towards health, the sector remains underfunded to meet the critical needs. In 2023, Treasury allocated ZW$473,8 billion, translating to 11 per cent of the total budget, which is below the Abuja Declaration of 15 per cent.

While the budget only allocates financial resources, the actual disbursement of the funds remains a huge area of concern. Some public health institutions have reported only receiving 20 percent of the funds allocated to them through the national budget.

This means the provision of critical health services, such as mental health, remains depressed. According to research published in a 2020 International Journal of Social Sciences, Sub-Saharan Africa has the largest gap globally in the treatment of mental, neurological and substance use disorders.

Zimbabwe`s investment into mental health service delivery should start from increasing the budgetary allocation towards health and ensure there is an actual disbursement of the allocated funds.

The investment into public mental health service delivery should also see the increase in the provision of rehabilitation centres. Zimbabwe has a few major public referral facilities that offer mental health and psychiatry services, and these include Ingutsheni Hospital in Bulawayo, Ngomahuru Hospital in Masvingo, Sally Mugabe Hospital Psychiatric Unit and Parirenyatwa Hospital Annexe in Harare (MHoCC).

Ingutsheni Hospital

As problems of depression, anxiety and drug and substance abuse rise and compound the mental health problem in Zimbabwe, more affordable rehabilitation centres are required to cater for the growing mental health needs.

Whilst private health service providers have come on board to offer mental health services, the cost factor is a stumbling block towards universal access by all citizens.

Founder of Start to Stop, an organisation with interests in mental behaviour, Zwelibanzi Ndlovu, in one interview with the media, is quoted stating that the high cost of drug rehabilitation inhibits people requiring the services from doing so.

As many cannot afford the existing centres that offer good quality services, they resort to the public and under resourced facilities where they are crowded and often the service is poor. Thus, in dealing with the growing mental health concern in Zimbabwe, there is a need for more affordable and well-resourced public health facilities.

Health experts suggest that for suicides to take place there would be underlying mental health issues that go unaddressed and only come to the surface when one commits suicide.

This presents one other area where investment is needed in fighting the growing public mental health disorders and suicides, which is that of raising awareness and changing attitudes. Mental health issues thrive sometimes because they are mostly ignored by society.

Speaking at a community dialogue engagement in Bulawayo in July this year, Zimbabwe Republic Police Deputy Provincial Spokesperson Assistant Inspector Nomalanga Msebele revealed how people with suicidal intentions often show them but these are ignored by those around them.

Assistant Inspector Msebele is quoted by a local newspaper saying that people who commit suicide show intentions but most relatives and friends ignore the traits at the time. They even mention it in passing and no one takes it up or inquire further.

Police have also revealed that most of the causes of suicide, according to suicide notes they find on the scene, are domestic disputes, debt and life challenges.

Zimbabwe`s economic crisis, characterised by unemployment, high inflation and exchange rates is a trigger for life problems such as debt, domestic disputes. Many families are struggling to afford having basic requirements such as putting food on the table, buying clothes and pay school fees for children.

With such economic pressures often come mental stress, anxiety and depression and in extreme cases suicides. It is imperative that when dealing with the mental health problem in Zimbabwe, authorities invest in facilities that offer psycho-social support.

Sibonile Siziba is a Masters in Counselling Psychology student at the Great Zimbabwe University.

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