A public health approach to suicide prevention means better data collection, multi-sectoral collaboration, gatekeeper training and evidence-based interventions
These headlines in India over just three days last week make for depressing reading. ’18-year-old Instagram influencer kills self in Thiruvananthapuram, cyber bullying alleged’. ‘Youth commits (sic) suicide after being sexually assaulted by 4 men in UP’s Gorakhpur’. ‘Youth preparing for IIT-JEE dies by suicide in Rajasthan’s Kota’.
For every youth suicide reported in the media, there are several that go undocumented. Suicide is not just a pressing public health issue. It is a stark reflection of broader societal challenges, especially in developing nations such as India.
Around 79 percent of global suicide deaths happen in the developing world, with a staggering 90 percent of those among adolescents.
Suicide ranks as the fourth leading cause of death for 15 to 29-year-olds globally. In India for the same age group, suicide is the leading contributor to deaths among women and second leading contributor among men.
Particularly concerning is the spike in suicides among children under 18, which rose by 18.5 percent in 2020 alone, as calculated from the Accidental Deaths and Suicides in India (ADSI) reports for 2019 and 2020.
35 suicides each day
In 2021, more than 13,000 students died by suicide, which is more than 35 suicides per day. Between 2017 and 2021, student suicides increased 32 percent, as calculated from the ADSI reports from those years.
The most heartbreaking aspect is that 40 percent of male suicides and 56 percent of female suicides occur between the ages 15-29, painting a grim picture of the struggles faced by young people in contemporary India.
India’s demographic dividend offers a promising avenue for accelerated economic growth and development.
With a substantial youth population, India stands on the cusp of a significant opportunity to harness the potential of this demographic advantage and translate it into higher economic output, greater innovation, and enhanced competitiveness on the global stage.
However, to fully leverage this advantage, India must foster an environment conducive to young people and not lose them to the preventable phenomenon of suicide.
Suicide among young people in India is not just a statistical concern; it is a deeply human tragedy with far-reaching implications. Beyond the stark reality of numbers lies a tapestry of stories, each reflecting the intricate interplay of personal struggles, societal pressures and systemic shortcomings.
To be able to design and deploy a strategic response to this crisis it is critical to unpack these drivers of suicide in young people and understand the underlying contextual mechanisms.
What drives young people to suicide
One critical aspect often overlooked is the mental health landscape among young people.
Mental health issues like depression, anxiety and substance abuse among young people often go undetected or untreated, exacerbating feelings of hopelessness and despair.
This is further complicated by the digital age which has ushered in new challenges, from cyberbullying to social media-induced stress and unrealistic expectations.
Young people are navigating an increasingly complex virtual and analogue world, where comparisons are constant, and self-worth is often tied to external validation.
Finally, the stigma associated with seeking mental health support further isolates young individuals, pushing them to the margins of society’s consciousness.
Beyond individual struggles, societal factors and structures play a significant role in shaping young people’s mental well-being. One example is the education system, which aims to empower and uplift, but can become a breeding ground for stress.
The relentless pursuit of academic excellence, coupled with the fear of failure and societal expectations, creates a pressure cooker environment for many students.
Between 2012 and 2021 there was a 57 percent increase in suicide among students, compared to the previous decade (2002-2011); and a substantial proportion of student suicides are attributed to “failure in examination“.
Another key societal factor is gender norms and expectations, which can impose rigid standards that limit self-expression and personal growth. Girls in India face unique challenges, from early marriages to restricted opportunities, while boys grapple with notions of toxic masculinity and emotional suppression.
Family dynamics also come into play, with strained relationships, domestic conflicts, and lack of communication channels contributing to feelings of alienation and despair. Family issues, including conflicts and domestic violence, are major contributors and have been cited as a cause in approximately a third of suicides among young people in India.
Finally, economic hardships, especially in marginalised communities, further compound the stressors young people face, limiting their access to essential resources and support networks.
Effective interventions
Effective suicide prevention strategies must, therefore, adopt a multifaceted approach that addresses these myriad factors.
Early intervention through mental health screenings and accessible counselling services is crucial in identifying at-risk individuals and providing timely support.
Community-based initiatives that foster peer support, resilience-building skills, and open dialogues about mental health can create safe spaces for young people to express themselves and seek help without fear of judgement.
Education plays a pivotal role not just in academic achievement but also in promoting mental well-being. Incorporating mental health education into school curricula, training educators and parents on recognizing warning signs, and promoting positive coping mechanisms can empower young individuals to navigate life’s challenges with resilience and self-awareness.
Policy-level interventions are equally vital, from strengthening mental health infrastructure to implementing evidence-based suicide prevention programs. Advocacy efforts aimed at destigmatising mental health issues, promoting help-seeking behaviours, and ensuring equitable access to mental health services can drive systemic change and save lives.
While there is growing evidence on how to effectively respond to this crisis, a few changes need to happen for optimal deployment of these strategies.
For example, the data gaps related to suicide are glaring and the limited data from the National Crime Records Bureau (NCRB) restricts in-depth analysis and hampers effective policymaking.
A shift towards a public health approach to suicide prevention is imperative, necessitating improved data collection, gatekeeper training and evidence-based interventions tailored to diverse demographics.
Media, both print and digital (formal and informal) have a key role to play in supporting suicide prevention efforts. In the digital age, where information is abundant but nuanced understanding is lacking, misinformation and societal myths about suicide can perpetuate harmful beliefs and behaviours.
Sensationalised media coverage, for instance, can glamorise or oversimplify the complexities of suicide, leading to copycat behaviours or misunderstandings about prevention strategies.
Addressing suicide is not just about the numbers-it’s about saving lives and fostering a society that values its young people.
It is an urgent call to action for policymakers, healthcare professionals, educators and communities to work collaboratively towards a future where suicide is no longer a leading cause of preventable deaths among young people in India.
Ultimately, addressing suicide among young people requires a collective effort – one that transcends disciplines, sectors, and societal norms. It is about fostering a culture of empathy, understanding, and proactive support, where every young person feels valued, heard and empowered to seek help when needed.
If this article has raised issues for you, or if you’re concerned about someone you know, visit https://findahelpline.com/i/iasp.
Prof. Abhijit Nadkarni is NIHR Professor of Global Research at the London School of Hygiene and Tropical Medicine, UK. He is also Co-Director of the Centre for Global Mental Health at LSHTM and King’s College London. He is co-author of ‘Life Interrupted: Understanding India’s Suicide Crisis’ (2022).
Originally published under Creative Commons by 360info.
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