Limiting the availability of means to commit suicides, it is argued, has a positive effect on curbing suicides. Here, from a taluk in Cuddalore district in Tamil Nadu, is finally proof of concept.
Kattumannarkoil is located about five hours away from Chennai, and agriculture is the primary occupation. While the majority of the villages cultivate paddy and teak, some residents are involved in floriculture, where pesticides are used twice a day. “This was among the main reasons we chose the villages for the study. The idea was to see if setting up central storage facilities for the pesticide would be viable, and whether they would actually lead to reduction in the number of cases of suicide,” says Lakshmi Vijayakumar, founder, Sneha, suicide prevention helpline, and team lead. The preliminary results of the study, published in BMC Public Health Journal in September, showed that both these aims were fulfilled. Not only were the central storage facilities viable, but they had also the effect of bringing down the number of suicides, Dr. Vijayakumar et al argue. These facilities stored the pesticides under lock and key, while normally they would be stored in the fields or at home, and were left lying around casually.
Limiting access to lethal means and methods of self harm, or ‘means restriction’ has increasingly been found to be a useful suicide prevention strategy, many studies have revealed. The team also zeroed in on pesticides because of the significance of the substance in causing suicides. The WHO considers ingestion of pesticides as the single most important means of suicide, accounting for nearly a third of all suicides globally.
In a 2012 article in the Lancet, Patel et al showed the true extent of pesticide-related suicides in India. They reported that 49 per cent of men and 44 per cent of women died primarily from consuming pesticides. This amounted to a total of 92,000 cases of pesticide suicides, and 90 per cent of that occurred in rural areas. “The government figures are much less. The National Crime Records Bureau says only 21,084 suicides were due to pesticide ingestion,” Dr. Vijayakumar says.
However, given the vast use of pesticides in rural areas in a country that is largely agrarian, the implication is that there is easy access to means for suicide in India. This must be removed. Which is what the project intended to do. And achieved to an extent, if you go by the results of the study: when the survey began, there were 26 recorded cases of suicides and attempted suicides from pesticide ingestion in the villages that the central storage facilities were provided. This went down to just five when the team followed it up. The results also showed that storage of pesticides at home dropped from 44 per cent initially to 7 per cent at follow up.
“It is possible for things to go wrong with a central storage facility: it may not be accessible to all and the supervisors may not be present at all times. But in our study, we found that households which used the facility said it was useful, safe and conveniently located,” Dr. Vijayakumar explains. The authors conclude that the central storage facility as a medium term strategy is likely a “feasible step for reducing pesticides in developing countries.”