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Updated: September 8, 2012 20:33 IST

The final solution

SUDHA UMASHANKER
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Reach for a helping hand...Photo: Special Arrangement
Reach for a helping hand...Photo: Special Arrangement

September 10 is World Suicide Prevention Day. With the increasing suicide rate in India, especially among the youth, here’s a look at what can be done to save these lives.

Young people are taking their lives with alarming frequency in recent times. Unable to play the cards that life has dealt them, they imagine that putting an end to their lives is the only deliverance for them and their family. The causes run the gamut from incurable illnesses and extreme physical pain to rejection by a lover or desertion by a life partner, to huge debts and financial losses, to failure to clear exams.

Without the requisite life skills, every trial and tribulation seems daunting to the suicidally prone and reason enough to stop living. But what do the numbers indicate?

A health problem

Dr. U. Gauthamadas, Head of Neuro-Behavioural Medicine and Stress Management, Apollo First Med Hospitals says, “According to the National Crime Records Bureau (NCRB) the suicide rate in India has been increasing steadily and has reached 11.2 per 1,00,000 of population in 2011, registering a 78% increase over the rate in 1980 (6.3). For every suicide completed, nearly 8 to 10 attempt to end their lives. By this criterion, the rate of suicide attempted and completed shoots up alarmingly, to nearly 100 per 1,00,000. Despite the gravity of the problem in India, suicide is considered more of a medico-legal than health problem. The majority of reported cases are registered with the police. Hence information about the causes and risk factors is insufficient. A study by NIMHANS showed that nearly three fourths of suicides were in the productive age groups of 16 to 40 years, with half of them in the age group of 21-35. More men completed or attempted suicide — a ratio of 2:1 — with the exception being in the 16-25 year bracket, in which women outnumbered men.”

Dr Lakshmi Vijayakumar, Psychiatrist, Founder of Sneha (a help line for the suicidally inclined), and WHO Consultant, points out, “One cannot attribute the rise in the numbers of those committing suicide to India’s growing population. Many suicides are not reported, so there is always underreporting. Incidentally, according to the National Crime Records Bureau there were 1, 35,585 suicides in 2011. Various correlations have emerged from several studies. Suicide rates in the southern states are more than in the northern states, and rural rates are higher vis-à-vis urban rates. What is most distressing is that the majority of suicides is among people in the productive age according to the NCRB. In the age group 30-44 it is 34.2 per cent and in the age group 15-29 it is 35.4 per cent. So it is not only a personal loss. It is an economic and social loss.”

Delving deeper into the causes and triggers that drive people to take their lives, Dr Lakshmi Vijayakumar says, “In a majority of cases it is due to family issues. When the family, which is supposed to be an anchor, is itself a problem, one feels alienated. Other traditional support systems are also disappearing. If you take the educational system, it is a whole can of worms. The rapidity of change in society is too quick for some people to get acclimatised to. Besides individual expectations are sky high and there is the culture of instant gratification, whether it is about relationships or career or anything else. Economic disparities, migration, the inability to face rejections when denied something one craves for — these are enough to push people to the brink. Alcohol consumption has also gone up tremendously and under the influence of liquor more people have committed suicide. With more young people taking to alcohol, this is a double threat.”

The phenomenon of young people moving out of their cities in search of greener pastures and better-paying jobs is not without its share of woes.

According to Dr. Gauthamadas, “Many migrant workers and employees who have relocated have little social support in their adoptive cities. They are often single and lonely and, if married, have little family time. And when things go wrong at work or home, they have no one to turn to for help. Moreover the changing social fabric has resulted in a breakdown of social bonds between individuals and the community, partly from the loss of traditional values combined with a relatively small physical reference group to relate to (as opposed to virtual).”

Thankfully today, there are many help lines one can turn to for professional help in complete anonymity, besides counsellors and women’s groups for additional support. Yet why is suicide on the rise? Is there insufficient awareness or is it that people don’t want to be seen as needing help?

Explains Dr. Gauthamadas, “There is still little understanding and awareness about suicide in our country and suicide help lines. To listen and read about an act of suicide has become such a mundane event that it has led to a sense of apathy. People attribute suicide to individual failure. Victim blaming is common without understanding the social, familial, occupational and mental health factors involved. No one believes that it can happen to them or their near and dear. In India, suicide carries a huge social stigma and those who experience suicidal ideas hide them because of this and do not seek counsel.”

Watch for the signs

And there are always tell-tale signs. Dr. Lakshmi Vijayakumar says, “Most suicides are not a surprise. The majority of victims communicate that they are depressed, suicide prone, whatever. It is just that we don’t listen.”

Talking about other giveaways, Dr. Gauthamadas says, “Thoughts or talk of destiny calling, not being able to go on , having enough of life, wishing that one hadn’t been born, combined with feelings of guilt, worthlessness, shame, loneliness, helplessness, hopelessness are immediate red flags. In some others there could be a sudden behavioural change, apathy or withdrawal from social interaction, sudden desire to tidy up personal affairs, irritability, anger, sudden crying spells or passionate goodbyes as if they are never going to see you again.”

Seeking professional guidance or going to a therapist can help. Magdalene Jeyaratnam, Director, East West Centre for Counselling, says, “With the suicidally inclined, it is often a case of complete despair and hopelessness that nothing is working, there is no hope and no one can help. Going to a therapist helps because a suicide risk assessment can be done and steps initiated to connect them to family and people from whom they can draw strength, and avoid situations which are conducive to executing the plan (a person living alone for instance).”

There are people who are at high risk. Says Jeyaratnam, “Someone who has suddenly lost his/her job or whose marriage has come apart is driven to end his/her life. If a person whose marriage has broken down is contemplating suicide, we don’t just look at the marriage as one big issue but break it up into smaller components and examine what can be done to better the situation. If a spouse has left the wife we concede that, yes, it’s a terrible situation to be in and there is great loneliness but she can be helped to get in touch with her strengths.”

Speaking of a 40-year-old man, a former alcoholic whose addiction is behind him but who has landed in severe financial problems, she recalls, “The moneylenders were at his door and his wife’s jewellery was also pledged. There was a high level of hopelessness and the reality mirrored that. As counsellors we do not mock or belittle the individual but acknowledge their emotions and validate it. Suicide is an option. We do not discount that. But we give the person some hope and talk about other options. There is another group of people who suffer from depression, which is enough to consume them and who don’t need a reason to end their lives. Since there is a typical chemical imbalance and an attendant overall sense of helplessness, only medication can help them.”

But things can be done in our homes, educational institutions workplaces to provide support. Spelling out a plan of action, Dr. Gauthamadas says, “At a macro level awareness is the key with multi-sectoral involvement. Mental health professionals must work with institutions and media to speak to the community about the issue. Sri Lanka has been able to reduce its suicide rate by more than 25 per cent as a result of a concerted multi-sectoral public health approach. Suicide reporting must be shifted from the police to the health reporting mechanism.”

Adds Dr. Lakshmi Vijayakumar, “We must teach the individuals life skills and problem solving techniques, enable them to improve self worth, help them cultivate an attitude of tolerance and resolve interpersonal issues. At the societal level, alcohol availability must be reduced and access to pesticides reduced. At the family level we have to have better communication, better acceptance and respect of individual spaces. It is important to understand and accept that youngsters sometimes have to struggle in life. We need to provide them support but refrain from being intrusive.”

There is some hope on the horizon. Magdalene Jeyarathnam says, “More and more people are coming to counsellors. If they don’t seek professional help it is because they feel that what they are facing is a personal or financial issue, and the professional can’t help them through that. What we can do is help them see their problems in a new light and with a sense of hope.”

Case Histories

Geetika Sharma, 23, a former air hostess with MDLR airlines committed suicide on 5 August 2012. In her suicide note she accused politician Gopal Goyal Kanda, Home Minister of Haryana, of harassment.

Kuldeep Yadav, second year student of Civil Engineering, IIT-Madras, allegedly committed suicide by hanging himself from the fan with a nylon rope. The police suspect he took the extreme step after a failed love affair.

Manasa Merugua, 21, first year MTech student of IIT M, committed suicide in her hostel room. Police said family problems led her to take the extreme step.

Rajesh Kumar Jain, 39, a mining trader operating out of Hospet in Bellary district, allegedly hanged himself from the ceiling fan of his bedroom in Bangalore. While his brother said he was dejected, which could have been because his wife ended their 15-year-old marriage, it was also reported that he suffered huge financial losses in business of late.

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