Suicide second-leading cause of death among Indian youth
What is triggering this distressing trend in India? Illustrations: Uttam Ghosh
The day the Class X exam results were announced, Dhanalakshmi rushed back home from work in the afternoon.
She
had found out by checking online that her daughter, 16-year-old
Sridevi, had failed the exam and she was worried she might not be able
to handle the disappointment.
But when she reached their
two-room house in the crowded quarter of Jogupalaya in Bangalore, it was
to discover the body of her son, 19-year-old Shekhar, hanging from the
ceiling.
A week after the incident, Dhanalakshmi cannot bring herself to talk about it -- her sobs prevent her.
Her
sister, O Jayalakshmi, and daughter try to explain, perhaps to
themselves as well, why Shekhar took this drastic step while she gazes
at the photograph of her son, and the small lamp burning in front of it.
Shekhar, they said, had been very close to his sister and had
big plans for her. "He told me he would support me in whatever I wanted
to do," says Sridevi, speaking softly.
Two lanes away in the
same neighbourhood, where tiny houses jostle for space with each other,
another family is grieving the death of their 15-year-old, Dileep Kumar.
Kumar had failed five subjects in the board exam and, worried
that he had disappointed his father, a contractor and president of the
Ambedkar SC/ST Welfare Society in the area, consumed pesticide.
"Before
he died, he apologised to his father, and told him he had not wanted to
let him down," says Kumar's mother Veni, who has been working as a
nanny in Kuwait for the last 15 years. Her husband, who she says was
very close to their son, hardly speaks during our meeting.
Kumar's and Shekhar's are hardly isolated cases.
Last year, a study on suicide mortality in India published by
The Lancet
pointed out that suicides were the second leading cause of death among
15- to 29-year-olds (the number one cause being road accidents in males,
and maternal mortality for women).
And in March, the University of Washington's Institute for Health and Metrics Evaluation reported in the
British Medical Journal that suicide was the leading cause of death for women in India aged between 15 and 49 years.
India's
own National Crime Records Bureau reported that there were 135,585
suicides in 2011, the latest year for which the figures are availab#8804
that's more than the number of lives lost to HIV in the same year
(116,000, according to the National AIDS Control Organisation).
The
figure could also be under-reported because of the stigma attached to
suicides and the fact that attempted suicide is a criminal offence,
though the government has begun steps to delete this section from the
Indian Penal Code.
What drives them to commit suicide?
The reasons, experts say, are varied -- from loneliness and alcoholism, to depression and economic factors.
"But
our studies have shown that usually, it is a combination of one or more
of these factors," says H Chandrashekhar, head of the department of
psychiatry, Bangalore Medical College and Research Institute.
Anita
Gracias, a volunteer at suicide helpline Sahai, who answers calls with a
warm 'Good evening, Sahai, may I help you?', says most of the calls she
receives are from people who are lonely.
"People call and ask
me where they can go to make friends," says Gracias, who has been a
volunteer since 2002, adding that the age of callers has been reducing.
Her youngest caller is a 15-year-old.
"The number of suicide
attempts among the youth in India and in developed nations might be
similar, because this is the group that is at the highest risk the world
over due to a number of factors, such as youth being more impulsive.
But unlike in the West, the suicide mortality rate in India is much
higher because here, people have easy access to lethal methods and
access to emergency medical care is limited," says Vikram Patel,
professor of international mental health at the London School of Hygiene
and Tropical Medicine and one of the authors of the Lancet study.
The
number of suicides, across age groups has also been increasing, points
out G Gururaj, head of the department of epidemiology, National
Institute of Mental Health and Neuro Sciences.
"There has been a
three-fold increase over three decades -- from around 40,000 in the
1980s to over 135,000 now. And for every completed suicide, there will
be 10 to 15 attempts."
But most worrying, perhaps, is that
despite these numbers, policymakers have failed to recognise suicide as a
public health problem.
"India is one of the few countries that
continues to treat suicides as a purely sociological or economic or
political issue, when they are actually a national public health issue,"
says Patel.
Acknowledging this would mean putting in place a
national suicide prevention policy and programme, which would include a
number of interventions.
Both Gururaj and Patel emphasise that
because suicide is not restricted to any particular group in terms of
region, age, income or any factor, for that matter, there can be no
"one-size fits all" solution.
There are, however,
certain policies adopted by various countries that have proven to be
effective. Among these would be creating awareness which would help in
early recognition of the symptoms, and restricting access to lethal
means, such as pesticides.
"If you can delay the impulse to
commit suicide by making it difficult to buy a drug or pesticide, you
can change their minds," says Patel.
"If they don't get it at the first store, it's unlikely that they'll visit more."
Countries around the world have tried this, and succeeded.
Following
a rise in the number of paracetamol overdoses and deaths due to
paracetamol poisoning, England passed a law in 1998 restricting the
number of tablets that could be sold and reducing the packet size.
The
Centre for Suicide Research at Oxford found that suicide deaths from
paracetamol and aspirin fell by 22 per cent the year after the
legislation was passed, while overdoses fell by 20 per cent in the
second and third year.
Closer home, Sri Lanka, which once had
the highest suicide rates in the world, managed to reduce it by half in
two years by restricting access to pesticides, says Patel.
In
India, meanwhile, 15-year-old Kumar could kill himself by buying a
pesticide used against bed bugs from his neighbourhood grocery store for
Rs 35.
There is also insufficient research into suicides in India, says Gururaj.
"It's
a hidden phenomenon. Nobody wants to invest in research because there
is no profitable drug that's going to come out of it."
Other countries, says Patel, have managed to bring down their rates of suicide and there is no reason why we can't either.
"Unfortunately, we just discuss and debate the issue, instead of doing something about it."
Warning signs of suicide
- Sudden change in personality, increased pessimism
- Person becomes withdrawn
- Giving away of personal effects, valuables without reason
- History of depression, psychiatric illness
Steps to reduce number of suicides
- Creating awareness of suicidal behaviour, so that it can be recognised early
- Limiting access to lethal pesticides and drugs
- Early detection of mental health problems
- Establishment of crisis intervention centres and suicide helplines
