Understanding suicides – An Indian point of view

Dr Samir Parikh

Be it within the Indian context or not, it is an undeniable fact that the prevalence of suicides is a significant area of concern globally. However, if we are to take a glance at the statistics in India specifically, according to the World Health Organisation, the age standardised suicide rate in India was 16.4 per 100,000 for women which was the sixth highest in the world, and 25.8 for women, ranking to be 22^nd globally, in 2012. Furthermore, the youth in itself has long since been recognised to be a crucial period, with suicide being a leading cause of death among young people in India.
In fact, in spite of the growing efforts towards creating awareness and education, it is a fact that mental health is still largely shrouded by myths and misconceptions, with a large cross-section of the population still having doubts and hesitation in talking about their mental illnesses, let alone reaching out for help. Especially for suicides, it is extremely common for individuals to be shushed and dismissed when expressing their feelings of helplessness and despair, in the fear that talking about suicides might inadvertently increase the risk of an actual suicidal attempt.
However, what is necessary to understand is that simply talking about suicides CANNOT put an individual at a risk of committing suicide. On the contrary, it is these myths which further breed hesitancy and reluctance towards seeking professional help. Fear of being stigmatised may actually prevent the earlier identification and reporting of mental illnesses. And as a last straw, a lot of the signs of mental illnesses tend to be shrugged off or dismissed in the name of lifestyle, or character weaknesses, and therefore end up not being recognised for what they are, i.e. as a medical illness requiring adequate and timely professional interventions.

In a country like India, it is the stigma which becomes one of the primary obstacles in the way of identification and prevention of mental illnesses, being all the more true for cases of suicide, where it is common for the individual to be blamed for such a suicidality. In fact, it is worries and fears of being judged, not being heard, or being blamed which discourages individuals from actually reaching out for help.
It has been recognised that suicide is the eighth highest killer in the world, with 90% of those who commit suicide having had an undiagnosed, untreated or partially treated psychiatric condition. In fact, given the changes in the societal and family structures in the recent years, the social support available is markedly reducing, and reduced social interaction, especially since the invasion of the social media, has largely impacted the nature of resilience and strength an individual requires to draw upon in order to sustain their psychological well-being.
However, what is the most pivotal point to keep in mind here, is to shift the focus from not just the increasing prevalence of suicide rates, but instead focussing on the need for creating sensitised awareness and exposure, especially in the Indian scenario. The need of the hour is to encourage such help seeking behaviour and encourage a preventive approach to mental health. Such a prevention could be possible involving an education about the warning signs to ensure identification of at-risk individuals, encouraging compassionate conversations about mental health to help target the stigma associated with it, as a consequence encouraging help seeking behaviour.
Further, these efforts need to be made collectively, with parents, teachers, peers, media, role models and celebrities, as well as all stakeholders, to collaborate and ensure an open and sensitive environment, and to work towards creating a robust national suicide prevention policy, to help sustain these societal efforts.

Dr Parikh is Director and HOD, Department of Mental Health and Behavioural Sciences, Fortis Healthcare