A ‘secret’ public health crisis
The focus of this year’s World Mental Health Day, which falls on October 10, is prevention of suicide. This is a pressing issue for India, which contributes disproportionately to suicide deaths worldwide. A global burden of disease study published in the Lancet, which focused on suicide deaths in India from 1990 to 2016, found suicide was the leading cause of death of people in the age group of 15-39 in India. The proportion of women dying by suicide was also disproportionately high, compared to other countries. Suicide is India’s “secret” public health crisis, secret because little attention or resources are allotted to deal with the issue in a meaningful way.
Not all deaths by suicide are a product of poor mental health. People attempt suicide for a variety of reasons, pushed to an extreme step by intersecting factors that put the individual in a state of crisis. Simply dismissing suicide as a result of depression is to miss the forest for the trees. Economic, social, and personal issues come together to cause distress in an individual. Having the means and opportunity without access to support can allow a person to follow through on ideation. Suicide researchers have long suggested that the access to the means by which persons attempt suicide be restricted—pesticides, household poisons, etc. Similarly, support mechanisms need to be strengthened. Even now in India, there are but a handful of reliable suicide helplines manned by well-trained individuals. More such facilities need to be set up and information about them disseminated.
In the new Mental Health Act, India practically decriminalised suicide, stipulating that an attempt to end their life must be presumed to made under severe stress. However, support needs to be made available to such individuals. Counselling must be destigmatised and made accessible at schools and colleges. Mental health is a component of public health and suicide is a public health issue. As much resources as are made available to successfully tackle deaths by road accidents and viral infections must be expended to tackle suicide.