Editorial: The storm inside

In the backdrop of World Suicide Prevention Month, which is observed in September, it might be pertinent to examine the alarming statistics emerging out of India. In our country, over 170,000 lives are lost annually due to suicide. More suicide rates are seen among men in states with higher levels of unemployment, while unemployment is an important risk factor among women too. Globally, suicide is the third-leading cause of death among those aged 15-29 years and is estimated to claim over 7.2 lakh lives every year, per the World Health Organization. About three-fourths of such episodes transpire in low- and middle-income countries.

Here in India, the reportage pertaining to student suicides has become a daily affair. According to the Tamil Nadu government, until March this year, as many as 26 students from the state have died by suicide, owing to their disappointment with NEET since the examination was introduced in 2017. Medical aspirants aside, those cutting their teeth in coaching centres, determined to make a mark in the IITs or the UPSC selections are also finding themselves swallowed whole by this phenomenon. Since January this year, as many as 14 students have died by suicide in the coaching hub of Kota, while 26 cases of suicide were reported in the city in 2023.

The National Crime Records Bureau (NCRB) 2022 report, tells us that Kota ranks 34th among cities in the country for suicide incidents and 18th in incidents of suicide due to fear of failing exams. Meanwhile, Rajasthan stands at 10th position in the country for students suicides. The growing number of episodes among students has prompted the medical fraternity to deliberate on preventive interventional mechanisms that can address this problem that threatens to derail the lives of lakhs of youth.

Authors of a new six-paper series published in The Lancet Public Health journal argue that national strategies aimed at preventing suicide should include measures to address social risk factors to prevent individuals from reaching ‘crisis point.’ The international team of authors, including those from the Public Health Foundation of India, New Delhi agreed that while clinical services are a must to tackle such problems, there is an acute need for a change in the narrative around suicide — i.e. to move away from presenting it as a purely mental health issue and acknowledge the impact of risk factors, such as poverty, domestic violence, addictions and isolation.

The scholars harkened back to the release of the National Suicide Prevention Strategy in November 2022. This strategy grounded most of its proposed solutions within the ambit of mental health, in spite of being privy to police reports which said that factors, including gender, employment, and stressful life events have important roles to play when it comes to opting for extreme measures. The strategy which aimed at lowering suicide deaths in the country by 10 per cent by 2030, hinged on setting up effective surveillance systems for suicide and integrating a mental well-being curriculum across educational institutions.

The authors of the new series described six aspects of a public health approach to preventing suicide, which included a model that looks closely at social determinants of suicide. The need of the hour is creating a more supportive environment that prioritises early intervention, reduces stigma, and saves lives. What’s more important is that the public health approach must consider national policies that can cushion the effects of economic downturns, including maintaining minimum wage levels.