One of the major challenges that Global Public Health faces is suicide. According to an estimation by the World Health Organisation (WHO), around 8,00,000 suicide deaths occur every year, globally. The annual global age-standardised suicide rate is 10.5 per 1,00,000 population. The estimation and accuracy of the rates of suicides is appurtenant on suicide registration systems. This is something that many countries lack, which in turn grossly affects precise documentation. These systems are more likely to be streamlined in High-income countries (HICS), reflecting 95% of suicides documented through good quality registration data from 39 countries. However, only 8% of suicide is estimated through good-quality registration data in lower and middle-income countries (LMICS).
There is a prodigious need to address the prevailing sociodemographic factors intertwined with the risk factors, to bring down the deaths by suicide in India. Several calls have been made with regard to this accentuating the need for a robust, evidence-based national suicide prevention strategy. Certain specific vulnerabilities attributed to suicide, if addressed through strong policies, can catalyst the prevention of many deaths. For instance, in Brazilian municipalities, a Brazilian conditional cash-transfer programme was introduced to mitigate poverty-induced suicides. Similarly, reviews indicate a higher suicide mitigation success across some countries that have exercised national bans on hazardous pesticides. The Indian government thus needs to develop strategies particularly targeted at India-specific suicide precursors. India makes up roughly one-sixth of the world’s population, with an individual population of more than 1.3 billion. It is extremely sardonic that India accounts for a majority (82%) of suicides among the countries in the South-East Asia Region, scoring the highest. This posits India as an important country with an expeditious need for suicide prevention. The gender differences in suicide documented in India are also vexing which proffers the immediate need for more examination into the epidemiology of suicide with particular focus on gender. The number of reviews with an exclusive focus on gender as a proximate of suicide in India is limited. More scoping as well as systematic reviews need to be piloted. One such scoping review has been conducted by Rane and Nadkarni which threw insight into factors such as suicide rates, the methods undertaken and the preponderance of certain specific demographic factors in India. To quote one of the most recent demises, on the evening of June 2, 2023, Sraddha Satheesh, a food technology student, died by suicide in Kottayam.
According to the Global Burden of Disease (GBD), Indian women had twice the suicide death rate in comparison to the global average for women in 2016. Since 2016, the pattern has only been continuing up to 2019 with the suicide death rate for Indian women being estimated at 12-7 in comparison to the global average of 6-1 per 1,00,000 women. The highest rates of suicide were observed in the age groups of 15-39 with 71.2% of Indian women within this age group. Published in May 2023, a study conducted by Professor Dandona et al, elaborated on the specific socio-demographic factors associated with women who die by suicide in India. This study took a detailed analysis of deaths by suicide among women in India for the years 2014-2020 from the National Crime Records Bureau (NCRB) which serves as the main source of data with regard to deaths by suicide in India. However, it is important to be mindful of some known issues such as under-reporting or inadequate reporting in the NCRB.
This study highlighted the socio-demographic factors of the Suicide Death Rates (SDR) of women in India. Women currently married accounted for 63.1% of deaths in developed states and 52.6% in less developed states. Women who are married indicated a higher rate of suicide than women who had never been married. In the years spanning from 2014-2020, 36.3% of women died by suicide exclusively due to family problems. Whilst hanging was found to be the leading cause, poisoning from the consumption of hazardous substances such as insecticides was found to be the second leading cause. Among the category of less developed states identified in this study, Rajasthan was one. It would be worthy to note the suicide epidemic that has been ongoing from 2018 up till May 2023 in Barmer, Rajasthan. There has been a worrisome trend in Barmer, with consecutive suicide deaths, sometimes as groups and sometimes as a cumulative replication spanning across the female and male populations. This is referred to as the Werther effect or copycat behaviour/ suicide emulation. This phenomenon is most relevant to the situation in Barmer which also brings to light the importance of the way media reports on suicide. For instance, this can be considered in terms of the Escape theory.
An individual suffering from a seemingly unsolvable issue might feel prompted to end their life when they read a news article that enlists a similar instance. Thus, media guidelines need to be streamlined to ensure responsible reporting of suicide with close attention to the words, phrases and illustrations used.
Whilst suicidal ideation might be long mulled, the act in itself is carried out in a capricious momentary impulse.
Regardless of which stage you are in, it is important to vocalise your feelings to your loved ones and get help from a mental health professional.
Nothing is more courageous than being vocal and getting help for suicidal thoughts. There is absolutely no stigma in taking help as one day, you might be seminal in helping another person who is struggling with the same.
Reach out for help
Voice that Cares is a Pan India free public helpline that supports individuals who are ideating suicide. Their number is 8448-8448-45. Similarly, there are many state-specific and community-specific helplines that can be found online.
(The author is a multidisciplinary professional who works in the UK.)
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