Suicide is a serious and emerging public health concern in India. According to the World Health Organisation (WHO), the suicide mortality rate per 1,00,000 population in 2016 was 16.5 in India, while the global average was 10.5 per 1,00,000. The National Crime Records Bureau (NCRB) reported that in 2019 there were 381 suicidal deaths on a daily basis, totalling 1.36 deaths due to suicide in that year.
One of the pressing issues adding to the rising number of suicide cases in the country is the lack of attention towards mental health issues. The stigma surrounding anxiety, depression, and other issues prevents people from seeking help or opening up. When the situation goes out of hand, they may consider suicide as an option. Unless awareness and conversations around mental health surge, the situation will be hard to change.
The National Mental Health Survey of India 2015-2016 report, common mental disorders (CMDs), including anxiety disorders, depression, and substance use disorders are a huge burden affecting nearly 10% of the population. For all Indians with mental health problems, the treatment gap is staggering. Anxiety and depression affects 38 million and 56 million people respectively in the country. These figures translate to around 150 million Indians who are in need of mental healthcare but, unfortunately just ten percent of those in need of mental healthcare in India can avail it.
Also, the WHO reports that in the country there are less than 4,000 mental health professionals, i.e., 1 mental health professional for 4,00,000 people. Due to fear of being judged, medical students seldom opt for psychiatry. Also, often the families of suicide victims do not want post-mortems because of the fear of body mutilation of the deceased, the time-consuming nature of the process as well as the stigma attached. They prefer to stay away from police investigations. As a result, death by suicide is often reported as being due to an accident or illness. The low report rate of suicide is a big hindrance to research.
Despite the implementation of the Mental Healthcare Act 2017 by the government, India lacks suicide prevention strategies to combat the concern of the rising number of suicides every year. First of all, governance and leadership for suicide prevention need to be strengthened in our country. The government needs to focus on the development and implementation of national policies or strategies for suicide prevention.
Apart from appropriate budget allocations, such measures would also require legal, institutional, and service arrangements to be adjusted appropriately.
The health ministry should shift the focus of care towards comprehensive, community-based health and social care services to help people who are at risk of suicide. Such services should be integrated with primary and hospital care to ensure continuity of care between different providers. Greater collaboration is required between informal healthcare providers, school teachers, and religious leaders among other community members.
Also, research capacity and academic collaboration needs improvement to focus on various aspects of suicide and suicide prevention. Sex and age-disaggregated data requires to be collected and measured, while the direct and indirect costs of suicide and attempted suicide should be collected. Apart from all these strategies, campaigns to reduce stigma, guidelines for the mass media, and increasing public awareness are some of the essential steps that can be taken to address the issue of the rising incidence of suicides from mental health disorders.
It is quite clear that more needs to be done in India to promote mental well-being. The government must take note of the current scenario surrounding mental illness in the country and consider what essential steps need to be taken in the near future — with consideration of suicide prevention and awareness imperative.
(The author is a mental health expert.)
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