Mental health in India: the need for a national suicide prevention strategy targeting young people

According to National Bureau of Criminal Records (NCRB)India recorded more than 1.53 lakh suicides, or about 418 daily suicides in 2020. This equates to a suicide death rate (per lakh population) of 11.3 in 2020, compared to 10.4 in 2019 This is the highest number of suicides in the country. in a decade and is the tallest in the world. Among those who committed suicide, students saw the largest increase of 21.2% in 2020, compared to a 7 to 8% increase in recent years. For every suicide death in India, more than 200 people have suicidal thoughts and behaviors, and more than 15 suicide attempts. Bearing in mind that these figures are only for reported suicides and there is no exact data on the number of suicide attempts, the burden of suicides in India may be much more serious. The numbers may further be compromised by the endemic stigma attached to mental health and the legal complications of suicide reports that lead to massive under-reporting of suicides.

The drastic increase in suicides in 2020 also indicates the negative impact of the pandemic on mental health. Unemployment, inability to access opportunities, social isolation, among other factors, have led to increased stress and anxiety. The situation is compounded by the discrimination associated with mental illness that negatively affects help-seeking behavior, and the lack of information about who to contact for help.

In terms of gender variance, the suicide rate among Indian girls and women continues to be double the global rate despite a Reduction of 40.7% from 1990 to 2019 in India. These deaths are often due to marriage-related issues like dowry harassment, early marriage, forced marriage, arranged marriage, domestic violence and widowhoodthus underscoring the urgent need to expand gender-sensitive mental health services.

For the country’s young people (15-29 years old), among whom 1/3 of all suicides take place, data suggests that one student commits suicide every 55 minutes, and 1,129 suicides among children under 18 in 2020 were due to exam failure. Suicides are also responsible for most deaths in the Age group 15 to 39 compared to other causes. The increased pressure and anxiety related to passing exams and the fear of failure among students can translate into an increase in suicides. The highest political offices in the country should deliberate on the introduction of context-specific interventions and set priorities for multi-level action for suicide prevention in various sectors. India also needs to mainstream suicide prevention at all levels of public health in the form of a national suicide prevention policy at the macro level. In addition to peer support through parents, families and communities at the individual level need to provide empathetic, non-judgmental listening.

According to the Central Board of Secondary Examination, nearly 1.59 lakh students failed Class Xth and 1.34 lakh students failed Class XIIth examinations in 2020. As Board Examinations approach, it is necessary to put systems in place to universally conduct additional exams that allow students to sit for exams. Having functional helplines before, during and after exams can also reduce student anxiety. Additionally, engaging in conversations about mental health issues in schools and colleges to guide students in managing mental health issues and creating safe spaces for them to share their issues can also reduce stress and improve their ability to perform well.

Another challenge is that most suicide prevention research is undertaken in high-income countries, which may have limited applicability in a developing country like India. It is essential to promote national and sectoral research on the reasons for suicide mortality and its increase, and to make culturally and economically appropriate suggestions to help alleviate the problem. Greater emphasis also needs to be placed on collecting suicide numbers in real time to understand the severity of the crisis and ensure timely and planned interventions.

Additionally, media reports can play an important role in shaping people’s understanding of suicide. In times of distress, the media should promote health-promoting behaviors, correct information and counter possible myths related to suicide. Inappropriate reporting that sensationalizes suicide details, shares the identity of the person who committed suicide and their methods, can lead to greater stigma around suicides and Mental Health. It can be potentially harmful to vulnerable populations and cause a 1-2% variance in suicides. Reporting guidelines issued by the World Health Organization and those of the Press Council of India should be followed to ensure responsible reporting standards and proper journalistic conduct.

Although entirely preventable, India is losing more and more people to suicide. The gravity of the crisis, aggravated by the Covid-19 pandemic must be addressed by creating a holistic environment for mental health. Undertaking evidence-based interventions that take into account the needs of the most vulnerable and marginalized populations, such as women and young people, providing the necessary support systems can reduce the number of lives lost and establish a more effective response system. healthy.

(Dr Virander Singh Chauhan, Emeritus Visiting Professor, Institutions of Eminence, University of Delhi and Founder ETI; Dr. Lakshmi Vijayakumar, Founder SNEHA)

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