Teen Noir

A disturbing trend threatens to hobble India’s young generation as health professionals and rights activists rise to meet the challenge by Ayesha Singh.
Teen Noir

His death came without warning. Hanging from the ceiling fan of his second-floor apartment in Bengaluru, 19-year-old Sahej Marwah left behind distraught parents and loved ones fraught with pain. He was now an added number to the list of 1.3 million adolescents in the world who died last year from preventable or treatable causes. In India, that number is 86,224 for 10 - 14-year olds and 155,154 for those aged 15-19 years, according to Global Burden of Disease 2015 estimates. Suicide is the leading cause. Marwah’s parents believe their son was being bullied by his roommates, with whom he often argued over religious matters. This time, the boys succeeded in silencing Marwah forever. 

“Many more voices will be silenced if we don’t make children’s interest our priority. We’ve been hearing the rhetoric that ‘children are greatest victims in our society’ since India’s Independence, but little has changed in our social environment that compels teens to be better than the best. This trend is dangerous,” says child rights activist and Nobel Peace Prize Laureate Kailash Satyarthi.


 In India, 21 percent of the population—that is, over 243 million—constitute adolescents. In 2013 alone, 3,594 of them aged between 10-14 committed suicide. The same year, another 23,748 in the age group 15-19 took their lives, according to the Lancet Commission on Adolescent Health and Wellbeing.
Sandhyarani Behera from Odisha can’t forgive herself even after four years of the death of her older daughter Sarojini. Unable to resist her mother’s frequent rebukes for not clearing the annual Plus II examination, the 17-year-old girl committed suicide by consuming poison. “I want to say sorry, but to whom?” says Behera. Neither she nor her husband had thought that behind their daughter’s falling grades and declining health conditions lay depression. They were more interested in improving her performance. “I would have counselled her instead of levelling accusations for her poor performance,” she repents.

But the falling grades and declining health conditions are symptoms of a larger issue—depression. In Odisha, academics-related suicide is the leading cause of deaths. The National Crime Records Bureau (NCRB) stated that the suicide rate in Odisha was 9.9 of one lakh people in 2014.

While self-harm is the front-runner in adolescent mortality matters, road accidents came a close second. More than 75,000 youths became victims of road accidents in 2014. According to traffic police, over 1,875 road-related cases were filed against minors in Bengaluru in 2015. Of the 5,004 road accidents in Karnataka in 2014, as many as 4,482 were caused due to reckless driving. Police believe that in many cases, parents were acted irresponsibly by giving vehicles to underage drivers. “Reckless driving should be a criminal charge as it claims lives of those involved in the act and other innocent people,” says a senior Karnataka Police officer. Incidents of motorcycle stunts are on the rise too. On September 1 this year, an 18-year-old youth was arrested for the death of a teenager girl during a motorcycle stunt in Bengaluru.

courtesy: Paul Jeffrey
courtesy: Paul Jeffrey


Similarly, Varkeychen Alex, a BTech graduate from Pala in Kerala’s Kottayam District, lost two colleges in an accident when their motorcycle collided with a truck. “They were returning after a test-riding a new superbike owned by one of them,” says Alex.

Sebin Sebastian, an advocate from Kochi, lost two friends when the motorcycle they were riding crashed into a lorry. One was a college union president of Government Law College, Ernakulam, and the other was an LLB student. They died on the spot.

An Indian Council of Medical Research report states that 12 per cent of children between four and 16 years of age suffer from psychiatric disorders. Fear of stigma is part of the illness. Jodhpur-based 19-year-old Ankita Mahla, a Class XI student, injected herself with poison three years ago. In one of her last conversations with her friend Shoili Das, she had confessed that she had been feeling persistently low. “We went to a therapist together because Mahla feared being judged by family members and friends about seeing a doctor for a mental issue,” says Das. The session seemed to go well, and she had booked another one for the next day. Before daybreak, she had taken her life. “Maybe it was depression, maybe it was something else, but her irrational fears about being labelled ‘mad’ kept her away from her family and took her straight into the death trap,” says Das.

In view of the unmet mental healthcare needs of children and adolescents of India, Clinical Psychologist at ePsyClinic.com, Aakriti Malik, and Dr Roopesh B N at NIMHANS, Bengaluru, carried out a research (currently unpublished) to understand awareness about child psychiatric conditions in parents and children and their expectations from mental health professionals. In a purposive sample of 40 parents, children and adolescents aged 10-16 years, it was found that more than half of the parents were unaware of their child’s psychiatric conditions. “The major barriers for parents were related to time, distance, lack of information about treatment options and financial constraints. Interestingly, the study found that majority children reported not being aware of their difficulties,” says Malik.

The number of adolescents attempting and committing suicide is increasing. This should be seen in the light of unemployment, relationship difficulties and significantly high family-based abuse and violence. “Even more important is the fact that there is a 90 percent treatment gap. It means 90 per cent adolescents who need help do not have access to it,” says Dr Achal Bhagat, Senior Consultant Psychiatrist and Psychotherapist, Indraprastha Apollo Hospitals and Saarthak Mental Health Services, Delhi.

Lack of awareness and disclosure of mental health problems lead to exclusion from peers and from the educational system. Bhagat believes that educational systems do not facilitate access to mental health service. In fact, they have become a barrier. “Parents may also ignore mental health issues. The problem is compounded by the increase use of substance use,” he says.

Nikhil Santhosh, a 16-year-old student, jumped to his death from the ninth floor of Mantri Tranquil Apartments in Bengaluru. Police said he took the extreme step after his mother scolded him for securing poor marks in internal examinations. He left a one-line note stating, “I don’t deserve to be your child.” Minutes before his death, his mother had said the same thing to him, “You don’t deserve to be our child.”

Even as the rate of suicide (number of suicides per one lakh population) in Odisha compared to southern states, Puducherry and Sikkim is low, the rates are alarming, especially around board exam results. A majority of adolescents in the state grow up in villages, which have a high Dalit population that comprises around 22 per cent Scheduled Tribes and 17 per cent Scheduled Castes, whose literacy rate is very low. Professor Rita Ray of National Law University, Cuttack, says, “Adolescents are vulnerable to many issues. The atmosphere for quality education is not liberal, which makes parents and children susceptible to study-related pressures.”

Cases of youngsters drowning at tourist places in Kerala is also spiralling. On the other hand, the state rarely sees any adolescent die of a particular disease. “This issue is nobody’s priority, but it demands special attention as it is preventable. Adolescents should be made vigilant about the danger of water,” says Dr N K Sanil Kumar, a urologist and a health activist from Kochi.

While certain reasons for adolescent deaths across the world may be universal—such as road accidents and suicides—some are particular to India. Poverty is one such reason. Vanita (name changed) took her son from JIIPER in Puducherry to Dindigul Government Hospital, and finally to Madurai Government Hospital. “I began spending all my days in the hospital, not because of my son’s health condition but because we were homeless. Our landlord kicked us out fearing my son had caught a contagious disease,” says Vanita. In the middle of it all, she lost her job.

“It was finally diagnosed that he had tuberculosis, but because of little access to money, we spent sleepless nights in hospitals,” she recalls.

“In their right to survival, children and adolescents from urban slums and villages still face scarcity of safe drinking water and sanitation. Demolitions of urban slums to beautify cities and migration from villages to cities for employment displace marginalised adolescents and their families and denies their right to survival in new locations,” says Sangeeta Macwan, Manager-Community Programmes, Sahaj Shishu Milap, an organisation working with adolescents and children. Abuse at home and workplace denies their right to protection.

Right to participation in social matters is not fulfilled, especially when decisions in their education and consent for early marriages are not taken from adolescents. “When adolescents are neither treated as children nor as adults, it hampers their development to a great extent,” says Macwan. In the presence of gender discrimination, the right to development among girls and boys from marginalised classes of society gets hampered. “Over the years, adolescent girls have died because of delayed health treatment and have committed suicide because of severe violence and burns as a result of domestic violence,” says Himalini from Thoughtshop Foundation, a social organisation working with problems plaguing adolescents and other issues.

Their rights to survival, protection, development and participation are violated. Neglected and with reduced opportunities for development, these girls experience low self-worth. They are considered a burden and become prone to child marriage and trafficking. “What follows is that they’re are soon burdened with household chores, early pregnancy, child rearing and become victims of domestic violence. Some even end up displaying criminal behaviour. Thus, the cycle of violence continues,” says Himalini.

Since a good part of her work involves working with marginalised communities who live in remote rural locations without medical treatment, Himalini says that delay in treating snake bites and consumption of local poison also cause deaths. In urban areas, adolescents who live along railway tracks are at a higher risk of losing their lives due to accidents.

There is an urgent need to structure fragmented adolescent health programmes and define a comprehensive programme addressing all the needs of adolescents under one framework. Working with teenagers requires focus since they are neither children nor adults. “Creating safe spaces for adolescent girls and young women, building self-worth, providing them with life skills, sex education and enabling them to explore life goals beyond marriage are necessary,” says Himalini.

Complications linked to early pregnancy and child marriage also need to be addressed urgently as these cause numerous deaths between the age group of 15 to 19. “Working with parents, in-laws and healthcare providers on their role in maternal health is important. But what will help most is preventing early pregnancy, especially contraception (pre-marriage counselling),” says Macwan.

The pressure on adolescents needs to be relaxed. Until a major shift in mindsets and attitudes is seen, status quo will be re-enforced. “Teens of this world and the youth are living in extremely suppressive conditions and don’t have avenues to express their idealism,” says Satyarthi. “Forty percent of the entire population is below the age of 18. To initiate a social environment where they are pushed to become tools of growth is necessary.”

To raise a collective voice against discrimination, violence, slavery, trafficking and other issues that plague the young, Satyarthi recently brought together some of the brightest minds to discuss, deliberate and offer resolutions on the subject. His Laureates and Leaders Children Summit on December 10-11 at Rashtrapati Bhawan was a step in assessing the situation at a micro level. “Let’s take a small step today by listening to the young of this country. Then another step in understanding them closely. And finally, mobilising them to rise above all limitations and become the most empowered members of the community,” he says.

In a century where our lives are moving faster than they ever did, we need to pause and think about the children who have little access to help, mental or physical. Lives can be saved with a little compassion, concern and empathy. Children, as it is said, are the future of a nation.

With Hemant Kumar Rout, Babu K Peter, Kiran Parashar and Johanna Deeksha

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