When anyone speaks about suicides in India, we immediately think of farmers. About 5,650 farmers had committed suicide in 2014. In the same year, more than 20,000 housewives committed suicide. Despite four times the number of tragedies, suicides by housewives have not caught the attention of policy makers. The sheer extent of the problem was described in the recent Lancet article titled Gender differentials and state variations in suicide deaths in India: the Global Burden of Disease Study 1990–2016.
As per the Lancet article there were 230,314 suicide deaths in India in 2016. This is 50% more than the number of people who died in road accidents in the country, in the same year. India’s contribution to global suicide deaths increased from 25.3% in 1990 to 36.6% in 2016 among women, and from 18.7% to 24.3% among men. Alarmingly, this phenomenon could nullify our demographic dividend. Suicide was the leading cause of death in India in 2016 for those aged 15–39 years; 71.2% of the suicide deaths among women and 57.7% among men were in this age group.
What is more alarming is that suicide is a problem on the rise. The suicide rates in 2016 are up a whopping 40% from the rates in 1990. Suicide is already the 9th leading cause of death in India.
The study also throws up some surprises. The biggest one is that the suicide rate among Indian women is higher than that among men. This is contrary to the worldwide trend of more men committing suicide than women. The number of suicides by women in India in 2016 was 2.1 times higher than the global average.
According to Peter Mayer of the University of Adelaide and author of Suicide and Society in India, “marriage confers protection from suicide to married women". Studies have found suicide rates for married people in the US and Australia, for example, are lower than for others in the same age group. India, clearly, is an outlier. A highly disturbing trend is that married women account for the highest proportion of suicide deaths among women in India.
It is also surprising that five southern states—Tamil Nadu, Karnataka, Andhra Pradesh, Telangana and Kerala—are some of the most vulnerable to this public heath crisis. West Bengal and Tripura are the other states on this list. Only three countries in the world have higher suicide rates among women than these six states. It is also to be noted that the more conservative and economically backward states of Bihar, Jharkhand, Uttar Pradesh and Orissa have the least number of suicides among women.
This is a serious public health issue that needs to be closely studied. But that is easier said than done. In the case of most other health issues, the cause of the problem is usually a virus or a micro-organism that can be easily diagnosed. The method for countering those micro-organisms is also well researched. The appropriate vaccines or medicines will be made available at scale to tackle the problem. But the problem of suicide is very different.
The causes of suicides could be biological like depression and mental illness. It might be sociological factors like unemployment, domestic violence, gender inequality etc. It might be economic factors like crop failure, high debt rates etc. Or it could be a combination of many of these factors. So the interventions to reduce the number of suicides also have to work at various levels. This means that suicide is not a problem that can be eradicated by taking a few medicines daily for a few months.
While tackling the problem, one should not ignore its behavioural aspects. Although suicide is an individual act, there are several indications that it is a socially contagious problem. Studies have reported that publication of books like Johann Wolfgang von Goethe’s novel, The Sorrows of Young Werther, or mere newspaper reports on the suicide of Marilyn Monroe tended to increase suicide rates. This shows that just the sensitive portrayal of the inner angst of an individual who committed suicide, in the media or even by word-of-mouth communication, could glamourise suicide or normalise it as a legitimate option when dealing with interpersonal predicaments—leading to more suicides. This contagion effect is called the Werther effect.
One of the effective strategies to counter the Werther effect is the Papageno effect. This protective effect has been the name in honour of the character in Mozart’s opera, The Magic Flute. When Papageno fears that he has lost his love, Papagena, he prepares to kill himself. But three boys save him at the last minute by reminding him of alternatives to dying.
Newspaper stories of how individuals coped with their suicidal tendencies reduce suicide rates. This was effectively tested in Austria back in 1987. Many other countries now support active collaboration with the media to prevent suicide contagion. These findings underline the fact that the media can make a very relevant contribution to suicide prevention by minimising sensationalist reporting, and maximising reporting on how to cope with suicidal tendencies and adverse circumstances.
This recent Lancet article should be a wake-up call for policy makers in India. India has always taken pride in the stability of its families. Women are the lynchpins of the emotional well-being of these families. Suicides, more so of married women, will have long-term consequences on the wellbeing of families and, more broadly, society. We cannot ignore this problem anymore.
Biju Dominic is the chief executive officer of Final Mile Consulting, a behaviour architecture firm.
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