BackOpinion | The crime of silence around the country’s suicide epidemic
Psychosocial intervention in the form of talk therapy can effectively reduce suicide risk
PremiumEvery 40 seconds, someone somewhere in the world takes his or her own life. Imagine if it was not someone somewhere in the world. Instead, it is a family member, a friend, a colleague, a neighbour, or a person we know, who is perhaps thinking of taking their life. The crisis would then look different.
According to the World Health Organization (WHO), for every 100,000 women, about 16 women take their own lives. By the data available, India’s suicide rate for women is the sixth highest in the world. About a decade ago, a bulk of young female deaths in the country were attributed to child-bearing and related causes. Today, suicide is the leading cause of death among young women. We lose about 25 men for every 100,000 men to suicide. Suicide is the second biggest cause of death, especially amongst younger men, exceeded only by death due to traffic accidents. The Lancet series, the last such extensive study on suicides in India, placed the death toll of suicide in 2010 at 187,000.
Behind these numbers lie stories of immense human distress and suffering that cause people to take the ultimate step of taking their own lives. Suicide is a complex phenomenon, and can be precipitated by a range of inter-related factors laced with a sense of hopelessness. The two mental ill health conditions most often associated with suicide are alcoholism and depression. Amongst the young, the commonest causes seem related to academic performance, and a “let down" in romance. Other factors stem from opportunity deficits and disadvantages determined by caste, economic and other forms of social inequity, political ideology, domestic violence, bullying, harassment and chronic diseases, among others.
Global studies also show that a great number of suicides occur in countries with a rapid pace of development, such as India and China. What is evident is that it has taken on epidemic proportions, especially in our country. Each case leaves behind a close network of other human beings whose lives will never be the same again. Yet, there is a deafening silence around suicide, beyond the very few that get discussed in the media.
Until recently, suicide was a criminal offence under the Indian Penal Code. This pushed a bulk of the reporting underground. Beyond the law lie deep-rooted cultural and social beliefs that consider suicide a taboo, and its discussion, a no-go area. Most organized religions do not allow for the same rites and rituals of death for those who has killed themselves. This is because certain religions and cultures consider the taking of one’s life a sin. The feeling of guilt this induces does not help the cause. Not only does it rob an individual’s space to “come out" and talk about it, it also strips the family, loved ones and friends of space to grieve after a loss.
While there are no quick and easy solutions to the deep-rooted societal problems that are linked to suicide, there are things that each one of us can do to prevent a friend, a co-worker, a family member, a neighbour, and an acquaintance from taking the step.
The first of these is to be more responsive to people in our immediate environment. This includes stopping by and checking on that friend who has been a little withdrawn lately, offering an ear to someone who needs to vent. Evidence around suicide indicates that the ultimate act of killing oneself is an impulsive one, and that the impulse tends to pass if the moment is handled well. This is the premise that suicide helplines work on.
Several studies have indicated that there are multiple risk factors associated with suicide, and these may vary with gender, age, physical and mental well-being, and individual experiences. Treatments and therapies, therefore, vary as well. Psychosocial interventions have been found to be beneficial for individuals who have attempted suicide. It has been observed that these interventions have dissuaded several individuals from making another attempt.
Psychotherapy or Talk Therapy is one such type of psychosocial intervention that can effectively reduce suicide risk. This can a) help people learn new ways of dealing with stressful experiences through training; b) help individuals recognize their own thought patterns and consider alternative actions when thoughts of suicide arise; c) reduce the rate of suicide among people with borderline personality disorder, a serious mental illness characterized by unstable moods, relationships, self-image, and behaviour.
Decision makers and policies must ensure reduced access to means that promote thoughts of suicide. In order to address the immense need for viable mental health care services, there is also a need to develop scalable and evidence-based models of care across the country through collaborations and partnerships. These models, once endorsed by the government, can be replicated across India. The Maharashtra government’s partnership with Tata Trusts on mental health initiatives in Nagpur is one such example.
Each and every individual can make a difference, and all it takes is one little step to reach out to someone who is in need. It is important to listen and connect and seek professional help whenever there is a need for it. One little gesture may, perhaps, save a family member, a friend, or someone we know. This one little gesture can help end this crime of silence that lurks in our midst.
Tasneem Raja is senior program officer for the health portfolio at Tata Trusts
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