Rising Suicides: A Silent Public Health Crisis

Besides the recurring suicide deaths that one comes cross in the news daily, it’s not unusual these days to hear of acquaintances, relatives and even close friends and family members attempting suicide or dying by suicide. The casualties also include a segment of people who were seemingly happy, settled in life, doing reasonably well professionally and personally who chose to take the drastic step. The rising cases of suicide among the youth and the students in the country is another concern. My heart breaks every time I read or hear about a youth on the verge of taking off in life, taking his or own life.

According to National Crime Records Bureau (NCRB) data, there has been a 25% increase in the number of suicides from 2017 to 2021. Also, suicide has emerged as one of the leading cause of death in the 15–29-year age group. Although India’s suicide rate of 14.04/lakh population in 2019 placed it at 49th rank globally, the grim reality of the increasing numbers of suicides being reported from India cannot be overlooked. These deaths indicate a silent public health crisis brewing in India that has hardly received any attention.

Ending one’s life by suicide is a personal decision and act, but greatly affected by external circumstances and decisions. There are some who are sensitive and are deeply affected by things around them triggering suicidal tendencies. People suffering from mental health issues like depression and schizophrenia are also prone to taking their own lives. Many successful people, including celebrities and achievers in sports, movies and performing arts, have also ended their lives by suicide.

Penury, financial upheavals, failed love affairs, extra-marital affairs, rejection, pressure of academics and competition, family problems, substance abuse – have all been identified as some of the main causes driving people to take their own lives. However, few among them have been assuaged or supported through their periods of anguish. In many of these suicide cases, the friends and family members have purportedly expressed shock and disbelief at the untimely demise.

Every suicide is a painful act and leaves a trail of questions than answers. Besides a few who seek medical counselling/treatment for their turmoil or have been supported by family members to do so, majority of the people do not even share with people close to them that they no longer find their lives worth living. Or perhaps they did not have anyone to share with in the first place. Were they aware about the mental health support available? Or there weren’t any available or sparsely available?

Mental health has never been considered as critical as physical health in India. Despite improvement in the availability and accessibility of hospitals, doctors and counsellors, mental health remains a grossly neglected area even when suicide cases are spiralling.

The situation seem to have been exacerbated by Covid-19 pandemic. Apart from the half a million people who died after getting infected by the virus, 3.17 lakh people died by suicide in the years 2020 and 2021. In fact, the year 2021 recorded the highest suicide rate (of 12 suicides per 1 lakh population) since the beginning of this century. The Covid  years also saw an increase in the rate of male suicides perhaps largely due to the economic repercussions following the pandemic with pay cuts, intermittent salaries and loss of jobs.

Out of the total male suicides, the maximum number of suicides were carried out by daily wage earners followed by self- employed persons. Moreover, from among the total suicides by people in the farming sector, 50% were agricultural labourers.

The spate of suicide by students enrolled in coaching institutes and premier colleges like the IITs is also alarming. As per NCRB, over 13,000 students died in 2021 in India at the rate of more than 35 every day, a rise of 4.5 per cent from 2020 with 864 out of 10,732 suicides being due to “failure in examination”.

Kota, the coaching hub of India has witnessed a distressing trend of rising suicides with 25 cases reported in this year alone. Besides the intense competition and the pressure to succeed in entrance exams, the financial strain on students from financially deprived sections amplifies the pressure compelling students take the drastic step. The environment of high competition, family and peer pressure creates a pressure-cooker like situation for many students who stay alone and fail to share their mental distress.

Relationship issues, lack of self-esteem, social isolation, substance abuse, social media and a dependency on a virtual world are also making the youth increasingly vulnerable and volatile. The high percentage of suicides consistently occurring in the young, productive population of the country recently definitely calls for serious action from parents, families, governments, educational institutions and the medical fraternity.

In India, financial problems among men and relationship-related stressors in women victims were among the main causes of suicides. The females who committed suicide were mostly homemakers who took their lives due to “Marriage-Related Issues,” especially “Dowry-Related Issues.” Unfortunately, data over the last 20 years show that a fifth of the population committing suicide in India have been housewives. Among women, housewives account for 50 per cent of suicide deaths in the country – which is a telling observation on the mental health condition of women in India.

According to an analysis by the International Institute for Population Sciences (IIPS), a third of suicide victims in India had family issues that acted as a trigger, highlighting the importance of personal relationships and familial support. Economic insecurity has emerged as a big trigger too, where for instance, there has been 200% rise in the suicide rate of daily wage earners from 2014 to 2021. Untreated mental illness too contributes majorly to suicidal deaths in the country with a large section of the individuals not receiving proper medical diagnostic evaluations, counselling support and treatment.

Although India launched its National Suicide Prevention Strategy (NSPS) in 2022 to reduce suicide mortality by 10% by 2030 compared with 2020, a more immediate, holistic and creative approach is required involving families, medical fraternity, educational institutes and enabling economic and social policies.

Training of general physicians in mental health and suicide prevention, increasing access to counselling and treatment support, massive awareness on the criticality of mental health and seeking support, destigmatising suicide, together would be certainly useful in preventing the untimely deaths.

We need to be more connected and proactive individually and collectively too at family and community levels to recognise, support and help seek treatment for those who are vulnerable.

Suicide is an untimely and avoidable death. And we need to recognise that suicides don’t happen in a vacuum. Sometimes it’s a cry of help which we fail to recognise or take it seriously. The high suicide rate in India is a substantial public health challenge that requires immediate action.