Monday, January 27, 2014 8:37:42 GMT
INDIA
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 astudy 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.
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