World Suicide Prevention Day 2021: 20 attempted suicides for each death by suicide

Taboos take their toll, silently

Society

September 10, 2021

/ By / New Delhi

World Suicide Prevention Day 2021: 20 attempted suicides for each death by suicide

According to the World Health Organisation, over 700,000 deaths by suicide occurred in 2019 across the world (MIG photos)

As we mark World Suicide Prevention Day, experts helping those with suicidal tendencies say the various taboos and pressures of Indian society, right from schooling to marriage and employment and familial obligations push more and more Indians, especially the youth, to take the extreme step and end their lives. Awareness about help is rising, but not fast enough as the number of suicides and attempted suicides keep on rising each year.

The numbers are frightening enough, even though they remain the tip of the iceberg. One in every five suicides in the world takes place in India. According to the World Health Organisation, over 700,000 deaths by suicide occurred in 2019 across the world. Data provided by the National Crimes Register Bureau (NCRB) of the Indian government says that in the same year, in India, over 139,500 persons died by suicide, making the country the single largest source of such deaths in the world.

But both these numbers may be a severe understatement and more so in the case of India. Experts working in the field of helping people with suicidal tendencies say that for every reported suicide, there are many more that go unreported, mainly due to the stigma and taboo attached to suicide in India, as well as in many other countries. This makes families and the next of the kin try to report the death as one by natural causes or accidental, rather than admit to a suicide.

“The numbers given by NCRB about suicides in India are just reported figures. There are so many more unreported figures because people don’t want to accept that one of their kin has committed suicide. They don’t report it and it is just considered as some natural death. The relatives don’t want to come out with a suicide case in their families. It is still a taboo. There is still a stigma around this word,” says Sriranjani Joshi, executive council member and treasurer of Befrienders India, a voluntary organisation active in suicide prevention.

Befrienders India, part of the UK-based Befrienders Worldwide, has been working for the last 26 years on the issues of suicide prevention as well as providing emotional support to depressed, distressed and suicidal persons over telephone helplines.

“Our volunteers are professionally trained based on the international guidelines set by them. We currently have 13 functional centres and a few probationary centres. It is a totally volunteer-based organisation. Some centres have 50-60 volunteers whereas some others have 20 volunteers. The volunteers are selected after several rounds of rigorous interviews and then they are trained through a well-researched training module,” Joshi tells Media India Group.

Moreover, another very significant number that is not present in the NCRB data is the far greater number of attempted suicides in India as against those that result in a death. Befrienders India puts the number of attempted suicides 20 times as high as the number of deaths by suicides, meaning in India at least 2.8 million people tried to take their own lives just in 2019. And as anecdotal evidence would suggest even this number a fraction of all those with suicidal tendencies, but have not yet tried to take the ultimate step.

Youth, males most vulnerable

While there are many kinds of people who can have suicidal tendencies and can hail from different kinds of socio-economic and ethnic backgrounds, in India two major categories stand out in terms of people who opt for death by suicide. Experts say that in India, the young, between the ages of 18-26 years, are more prone to ending their own lives, making Indian youth amongst the most vulnerable in the world.

According to NCRB, of the 139,000 suicides in 2019, 93061 or 67 pc were by young adults, which increased by 4 pc over 2018, while overall, number of suicides rose by 3.4 pc. Another important element is that a large number of students, too, end up killing themselves, unable to handle the peer or parental pressure to do better in schools as an increasingly hypercompetitive Indian education system keeps on pushing students beyond limits. The number of students ending their lives has been rising fairly rapidly every single year. In 2018, a total of 10,159 students died by suicide, while the number was 9,905 in 2017 and 9,478 in 2016.

Another stark data is the sheer number of males who take the ultimate step. Of the reported suicides, men significantly outnumber the women. For instance, in 2019, over 97,000 or over 70 pc were males, while just over 41,000 or close to 30 pc were by women.

While the list of causes that provoke suicides is an unending one, some of the most common causes for suicides in India, according to experts, were professional problems, abuse, violence, familial problems, financial loss, sense of isolation and mental disorders. Farmers burdened by debt and uncertainty over harvests, are also prone to suicides. At least 10,281 persons involved in the farm sector ended their lives in 2019.

Societal taboos propel suicides

Experts like Joshi of Befrienders India blame the societal taboos for the high number of suicides and for the issue to remain a stigma, something to be covered up after a death, rather than take preventive action by recognising the problem and immediately reaching out to the vulnerable with the right kind of help and approach. This may be one of the reasons why so many more men die by suicide rather than seek help.

“It is one of social norms as we always hear that boys don’t cry. Men are cooped up. They don’t have anywhere to go. They don’t usually cry or vent their feelings out. It is taken as an unmanly thing and a sign of weakness. So, they want to vent out and confide somewhere,” says Joshi, adding that the number of male callers is also proportionately higher than the female callers. “Boys reaching out for help more in number is both because they cannot express themselves freely or because of the societal pressure,” she says.

In 2018, a total of 10,159 students died by suicide (Photo:Christopher Catbagan/unsplash)

The taboos and stigmas prevent voluntary organisations like Befrienders India or clincal psychologists from playing the right kind of proactive role that they can, with proper assistance from institutions like schools. Joshi says that whenever her organisation tries to approach schools or even companies and other institutions to organise a suicide-awareness programme, they are told to mount a session on stress management instead, without using the dreaded word, suicide.

“That’s still a taboo. So that is why for the past three years we have been trying to have a campaign called Go Yellow. Yellow is the colour for suicide prevention. Sensitisation is important as we are telling people to speak out,” says Joshi.

Dipti Neeraj Karandikar has been working as a clinical psychologist in Ahmednagar, a mainly agricultural town in western Maharashtra, for the past 15 years. She says that lack of awareness about mental health related issues is one of the biggest hurdles in India in helping those with suicidal tendencies. “In Maharashtra, schools are dealing with issues like, should English language be a compulsory subject from Class I or not. So, how do you expect them to focus on emotional and sensitive issues concerning the children? But for me every child should know about their emotions and psychology and therefore the subject of psychology must be included in syllabus for them to understand their problems and issues. Currently they are totally unaware of their emotions and problems,” Karandikar tells Media India Group.

It is not just the schools or businesses that need more sensitisation about the problem, but just about everyone, especially the family and friends who can and sometimes play a crucial role in helping people with suicidal tendencies.

Currently, however, the landscape for helping those with suicidal tendencies in India is mostly managed by NGOs as the government has not yet taken a proactive role in suicide prevention. Though in many countries, national suicide prevention helplines have been active for decades, in India that is yet to happen, and Joshi says the government should already have set one up. “The government is yet to come with a suicide prevention helpline. We need a toll-free helpline run by the government, just like it did for child helpline. In the same way, a toll-free national helpline for suicide prevention is the need of the hour,” she says.

Fortunately, the society as well as the government seem to have taken note of the right approach as an increasing number of people have begun to speak about the need for a better mental health awareness, say experts, which is also borne out by the fact that organisations like Befrienders India have begun to receive many more calls from young males than women, and many more than before.

The volunteers have kept pace with technology and new modes of communication in order to reach out to the vulnerable ones and also allow the ones with suicidal tendencies to seek help, anonymously or at least not face to face. Befrienders India says besides the phone, it also uses emails and social networking platforms like WhatsApp in order to make it easier for the people to reach out for help wherever they may be and whenever they may need to speak out. Joshi says this seems to be bearing fruit in terms of rising awareness and increasing demand for help.

“In India now there is more awareness as we see youngsters approaching for help and we receive more calls now. And since youngsters are into technology, so we have started email befriending also, because they are more comfortable over an email rather than picking up a phone and speaking. There are some centres that also provide WhatsApp Befriending. We try to keep upgrading our modules,” says Joshi.

Pandemic pushes people towards suicides

Over the past 18 months or so, since the outbreak of the Covid-19 pandemic, there have been several reports about the severe increase in mental health problems caused by the total isolation as well as the unprecedented financial trauma generated by the pandemic as nearly half a billion people lost their jobs and most of them are yet to find another.

Several of these reports also highlight the spurt or the likely spurt in the number of attempted suicides as well as deaths by suicide across the world. The situation is no different in India, which has suffered one of the worst tolls of the pandemic, with a stringent, prolonged and poorly planned lockdown as well loss of over 220 million jobs and a deadly second wave earlier this year which led to hundreds of thousands of unreported deaths all over the country.

Organisations as well as doctors working in the field across India have reported a sharp spike in the number of people reaching out for help during the pandemic. In Ahmednagar, Karandikar says that over the years, of the number of patients that she treated, she had spotted at least 3-4 everyday with suicidal tendencies. This number, she says, has jumped significantly during the pandemic.

“From the last one and a half year, due to the Covid-19 pandemic we observed that there has been a sudden increase in suicidal thoughts and suicidal tendencies on an average per day. Instead of the earlier 3-4, now we are seeing at least 7-8 persons everyday who are having suicidal thoughts, out of which 2-3 people would even have attempted suicide,” Karandikar tells Media India Group.

As it was during the pre-pandemic period, the number of men who are vulnerable remains far higher than the women. Karandikar attributes this to the fact that in most households, it is the adult male who is the sole bread winner and hence the unprecedented job losses in India, most of which are far from returning, put an unbearable pressure on the men. “The incidents of suicide are vastly higher among male, because we can say that India is a male dominated culture, as male have more responsibility like work, family responsibilities and so on,” adds Karandikar.

Joshi of Befrienders India says her own organisation, too, has been getting many more calls since the pandemic arrived. “Calls have been on rise during Covid-19 as people have been cooped up inside their house. We have had so many calls where people have just picked up the phone for so long and held the phone as they could not speak out and seek help since they were at home and did not have the privacy. They don’t have the space to speak out. Earlier they could speak out from college, schools or offices, but now they are trapped inside the house, always surrounded by someone,” says Joshi.

She adds that the calls started coming more in numbers a couple of months after the lockdown was announced. “Slowly when people started losing jobs and started feeling lonely, it was then they started getting apprehensive. Senior citizens also used to call us and say that what if I fall sick, who is going to take care of us? Being very vulnerable to the virus, they were even more confined indoors and could not meet their peers and had nobody to speak to. Many elderly persons whose children lived abroad, they were scared that if something happened to them, their children would not be able to come and meet them. They had lot of apprehensions. But it was a difficult period for young children also,” says Joshi.

While the society as a whole and organisations like employers or schools as well as the government need to do much more to help those vulnerable to suicides, experts believe there is no support like the one that can be extended by the family and friends to help prevent suicides.

“Family and friends make a lot of difference. When people know that they have someone around them who will listen to them, it makes a lot of difference then. It gives them a support system to stand up again and start walking,” says Joshi.

Only when every family member and close friend becomes aware of how to spot a vulnerable one, screaming silently for help and then provide the needed support, can India remove the blemish of rampant suicides.

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