A recent article in the Lancet has once again turned the spotlight on suicide. Psychiatrists have been talking about ways to reduce suicides, but rue the fact that governments, state and central, have shown little interest.
A blueprint to stem suicides, the National Suicide Prevention Strategy, was launched in November 2022. The aim was to establish effective surveillance mechanisms for suicide within three years and establish psychiatric outpatient departments to provide suicide prevention services through the District Mental Health Programmes in all districts within the next five years.
It called for integrating a mental well-being curriculum into all educational institutions within eight years. It also sought to develop guidelines for responsible media reporting of suicides and restrict access to the means for suicide.
Top killer
In India, more than 1 lakh lives are lost annually to suicide, and it is the top killer in the 15-29 years category.
From 2019 to 2022, the suicide rate increased from 10.2 to 11.3 per 1,00,000.
The NSSP envisages a specific strategy for every state and district. “We have explained the strategy, who should implement it, and the cascading effect. The ministry of health, education, and agriculture in each state must have a task force. We have provided short-term, medium-term, and long-term goals. But two years later, nothing has happened,” said Lakshmi Vijayakumar, who has been running a suicide prevention programme, Sneha, for four decades.
The health department should take the lead, but other departments like fertilisers, chemicals, information and broadcasting should also be adequately represented in the task force, she said. The education department should be part of the task force to promote emotional wellbeing.
‘Lack of political will’
Soumitra Pathare, Director for the Centre for Mental Health Law and Policy, one of the framers blames the lack of political will, both at the centre and the state.
“There is a sense of fatality when we start talking about suicide prevention. ‘We cannot completely eliminate suicides’, is what we hear. Instead of saying prevention we must say reduction. Even a 20% drop in suicides would save 40,000 lives annually,” he remarked.
He also blamed the lack of will in the media to make conscientious efforts to educate themselves on reporting suicides. By talking about suicides we would be acknowledging the problem and try to find solutions, he reasoned.
Dr. Pathare and Dr. Lakshmi pointed out that it is likely the only health condition which claims 1.27 lakh lives but there is no government programme to prevent it.
Dr. Pathare cited Tamil Nadu as an example where suicides had drastically reduced thanks to the introduction of supplementary examinations for school students. Yet the government has done nothing to implement the NSPS yet. “The present approach is piecemeal. We need a district wise programme that can bring about consistent results,” Dr. Pathare said.
Dr. Lakshmi calls for several editions of competitive exams so that youngsters gain confidence that they can appear whenever they want.
Policy changes work
“The National Education Policy is good, but it has not been implemented. The vocational guidance programme and multiple exits, grade system, and the flexibility to make course changes are all good. But it has not been implemented,” she said.
“I would like to emphasise that policy changes do make a difference and these policies are there and need to be implemented. Once implemented, we see results. And the example is Tamil Nadu. “Tie up NEP and NSPS, and by implementing the strategies deaths can be reduced,” she said.
Dheeraj Singh, an alumnus of the Indian Institute of Technology Kanpur, who currently mentors students from IITs said: “Suicides can be prevented with timely supportive action. Citizens must learn the skills of identifying someone with suicidal thoughts, ask them openly about their thoughts, talk to them without fear and refer them to a caregiver who can complete a safety plan and provide suicide prevention counselling. These simple steps, if taken with care for the affected person, can save many lives at risk especially those of young adults and senior citizens.”
Dheeraj Singh, an alumnus of the Indian Institute of Technology Kanpur who currently mentors students from IITs, said: “Suicides can be prevented with timely supportive action. Citizens must learn the skills of identifying someone with suicidal thoughts, asking them openly about their thoughts, talking to them without fear, and referring them to a caregiver who can complete a safety plan and provide suicide prevention counselling. These simple steps, if taken with care for the affected person, can save many lives at risk, especially those of young adults and senior citizens.”
On the mentoring of IIT students, among whom the suicide rates were high, he said the idea was to provide emotional support to students struggling with stress, anxiety, and hopelessness and those unable to access available support systems. “We have managed to save several precious lives through this intervention, and survivors are doing well now with the help of psychiatrists and psychologists,” he said.
(Assistance for overcoming suicidal thoughts is available on the State’s health helpline 104, Tele-MANAS 14416. and Sneha’s suicide prevention helpline 044-24640050)
