India’s Suicide Problem
By Atish Patel
- Agence France-Presse/Getty Images
- Shown, Jiah Khan.
The apparent
suicide of 25-year-old Bollywood actor Jiah Khan
last week was greeted with shock in India, a country where suicide is
the second-most common cause of death among people aged 15 to 29,
according to a
study in The Lancet.
Of the 114,800 males who took their own lives in India in 2010, 40%
were aged 15 to 29, while 56% of the 72,100 women were in that age
bracket, the study said. The report’s lead author, Vikram Patel, a
psychiatrist and joint director of the Centre for Global Mental Health,
says female suicides in India are often linked to relationships,
including domestic violence and forced marriage. For men, the major
reasons were related to work and financial difficulties, he told India
Real Time.
“It reflects the general role of men and women in India,” Mr. Patel said.
In India, people carry out suicide mainly by self-poisoning with
pesticide and hanging, which are more lethal than methods typically used
in the West like overdosing on non-prescribed drugs, Mr. Patel said.
Public health interventions such as restricting access to pesticides
might help prevent many suicide deaths in India, Mr. Patel wrote in The
Lancet report, which said there were about 187,000 suicides in India in
2010, the second highest in the world after China. The fact that these
two nations have the most suicides is in itself unsurprising given their
large populations.
India’s suicide rate is about 16 per 100,000 people a year, the study
said. The rate in the U.S. in 2010 was 12.4 per 100,000 people,
according to
Centers for Disease Control and Prevention, while in the U.K. in 2011 it was 11.8 per 100,000, the
Office for National Statistics said. Countries with higher rates include South Korea, Greenland and Eastern European nations like Lithuania, reports show.
Through rapid urbanization, India has witnessed a change in family
structure, with people moving out of joint families into nuclear
families. Although the effect of this change has not been studied in
detail, some experts believe this has impacted India’s suicide rate.
“Families now are fractured and the support systems in place earlier
are not working,” said Johnson Thomas from Aasra, a Mumbai-based
organization that runs a 24-hour suicide prevention helpline.
The confidential helpline, which has been operating for 15 years,
gets 35 calls a day, Mr. Thomas said. That adds up to about 12,775 a
year. The majority of calls are from men, who struggle more than women
to express their feelings, Mr. Thomas added.
“Indian society doesn’t allow men to be emotional… they don’t really have anyone to confide in,” he said.
In a
study
published in 2011, an international team of health researchers said
India had the worst rate of severe depression of 18 countries surveyed,
with 36% of respondents showing at least five symptoms, such as loss of
appetite and a sense of worthlessness, for a period of two weeks or
more.
That study also showed that women were twice as likely as men to suffer from depression.
There is a lack of specialist mental health experts and psychiatric
clinics in rural India, where more suicides occur. According to The
Lancet report, suicide rates in rural India are about twice as high as
in urban areas. The problem is exacerbated by the easy availability of
pesticides and a lack of emergency care, the report noted.
Clinics addressing mental health issues like depression have opened
in cities in recent years. But there is a stigma in getting psychiatric
treatment, doctors and experts say.
“People continue to have a closed mindset related to mental illness,”
said Sanjay Chugh, a New Delhi-based psychiatrist who runs his own
private clinic.
“Mental illness is still understood as a form of disease which will
be ‘fixed’ by faith healers, a divine intervention or through rituals or
prayers,” he added.
Also, suicide is a crime in India.
In a 2011 ruling, India’s Supreme Court asked Parliament to consider
quashing the law, but no action has been taken. Under the law, a suicide
survivor can be sentenced with a one year prison term or a fine, or
both.
In a 2007 report in the Indian Journal of Psychiatry, Lakshmi
Vijaykumar, who runs a suicide prevention network called Sneha in the
southern Indian city of Chennai, said that making suicide illegal has
proved counterproductive.
“Emergency care to those who have attempted suicide is denied as many
hospitals and practitioners hesitate to provide the needed treatment
fearful of legal hassles,” she wrote in the
report.
“The actual data on attempted suicides becomes difficult to ascertain
as many attempts are described to be accidental to avoid entanglement
with police and courts,” she added.
Last year, the government drafted a bill to decriminalize the act of
attempting suicide but it hasn’t yet been introduced for discussion in
Parliament.
“More than legalization of the act, what is needed is spreading
knowledge and making people more mindful and sensitive toward mental
health as a field, as it would automatically open doors for devising
means and methods to combat it,” Mr. Chugh said.
Worldwide, up to one million people die by suicide every year,
according to the World Health Organization. In the last 45 years,
suicide rates have increased by 60%, says the
WHO, and suicide is among the three leading causes of death among people aged 15 to 44.
A post-mortem report said the cause of Ms. Khan’s death was asphyxia due to hanging. It ruled out foul play.
Atish Patel is a London-born multimedia journalist based in Delhi. You can follow him on Twitter @atishpatel.
Follow India Real Time on Twitter @IndiaRealTime.
