There was nothing noticeably wrong with Arun Kumar, 21. Happy-go-lucky, or so he seemed, especially when he was with the ‘gang’. Arun would drink cheap liquor and smoke ‘tough’, a locally available drug, and frolic with the older boys in his Purasawalkam slum in Chennai.Until one day, when without warning, Arun very deliberately tied a hangman’s knot, climbed up to the loft of his hut, slipped the noose around his neck and jumped to his death. His mother and sisters were inconsolable. Arun was fatherless. His friends sobered up and found themselves jobs after a death that came too soon.“We didn’t know at all, right up to the end,” said Satish Kumar, 25, and a close friend of Arun. “He did mention once or twice that he had suicidal thoughts. In fact, his mother was very worried that he kept talking about committing suicide. But we always told her that we would take care of him. We never realised,” said Satish, shaking his head in disbelief.

Arun Kumar was a mere statistic in 2014, when he committed suicide. His story is part of the demographics released every year by the National Crime Records Bureau (NCRB).



In 2014, Chennai earned the notoriety of holding the top rank in suicides amongst metros for four years in a row. And Arun is typical of Chennai’s sorry tale. Fatherless and with a mother who managed to scrape together Rs 3,000 a month as a maid, Arun and his two sisters grew up in grinding poverty.

When the sisters got married and left home, it was only Arun and his mother. A wild kid who got into frequent fights, Arun dropped out of school without completing the VIIIth standard.His temper ensured that he did not stay for long in a job making car cushions. Arun was subsequently told, a few months before his death, that he had a clot in his brain. Unemployed, unwell, poor and disturbed about his illness, Arun Kumar became another notch in Chennai’s suicide register.With 2,214 suicides in 2014, Chennai alone contributes over 10% to Tamil Nadu’s suicide numbers. After 2010, Chennai’s suicides almost doubled from 1,325 to 2,438 in 2011, beating neighbouring Bengaluru to the top spot. The main cause for suicides in Chennai, according to the NCRB, is family problems.The second biggest cause is drug or alcohol addiction. Males outnumber females in committing suicide by over 2.5 times.The majority of victims (62.4%) are from the low-income group, earning less than Rs 1 lakh per annum. Sadly, the majority of suicides are by youngsters and older people — between the age group of 15 and 29 years and then again after the age of 60.Why are Chennai’s residents taking their own lives? The clue, say experts, lies in what Bengaluru suffered until about a few years ago. “Ten years ago, Bengaluru witnessed largescale migration from rural areas, and rapid changes in economic profile and lifestyle,” says Lakshmi Vijayakumar, a prominent psychiatrist and founder of Sneha, an NGO that runs a suicide helpline.“Bengaluru has settled down but Chennai is witnessing these same changes now. Migration from rural areas to the urban jungle is stressful for many.Suicides automatically go up when stress increases without any help at hand,” she adds. Sudden forced changes in lifestyle mean that vulnerable people fall into various traps — alcoholism, drug addiction, domestic violence, a debt cycle and, ultimately, suicide.Vijayakumar says that there could be a historical link to why more southerners commit suicide than their northern counterparts.“Historically, northerners have had to fight wars through the ages while southerners typically never had to,” she says. “Northerners tend to be more expressive and aggressive as a result, while south Indians introject their emotions — they turn in inwards and do not express them. This, again, causes depression, which results in suicides,” she says.High literacy rates — Tamil Nadu’s and Kerala’s pride — could well be a bane as far as suicides go.Experts opine that higher literacy causes higher expectations which, when dashed, lead to suicide. Throw caste conflict into the mix and the state of Tamil Nadu is a bubbling cauldron of stress, anger and depression, resulting in youngsters taking their own lives.Old parents left to fend for themselves in troubling times often take their own lives, unable to handle the stress of loneliness and fear of the future. Vijayakumar says that her NGO Sneha averages 20-30 calls a day. “About 70% of callers are acutely suicidal,” she adds.Tamil Nadu has been amongst the top two ranks in the list of states with highest suicide rates for the past four years. While Chennai’s problems are typically those of urbanisation, rural Tamil Nadu languishes as well.If Chennai’s victims commit suicide mainly by hanging or self-immolation, rural Tamil Nadu’s victims usually consume pesticides as a means to end their lives.In the districts, though, a plan has been put in place by the state government since 1997 to deal with the issue of mental health and suicide rates. The District Mental Health Plan, part of the Centre’s National Mental Health Programme of 1982, is being implemented in 25 districts out of 32.“The first step is to create awareness amongst the public that mental illness is by and large curable and that suicides can be prevented,” says C Ramasubramanian, state nodal officer of the District Mental Health Program in the state.“We have 50% of the population suffering from mental illnesses — both major and minor — but [have] only 5,000 psychiatrists and 2,500 psychologists in the whole country. Psychiatric social workers are even fewer. Our resources in dealing with mental illness are challenging,” he says.After awareness comes training — doctors at primary health centres in these 25 districts have been trained to identify and treat basic mental illness and suicidal tendencies.Apart from this effort, a mobile psychiatric team has been put in place in each district comprising of psychiatrists, psychologists and social workers.This Satellite Psychiatric Unit travels to different taluk hospitals in a vehicle every day. Ramasubramanian says that this ensures that patients in rural areas do not have to travel long distances to avail of psychiatric help.These efforts have borne fruit in a pilot project in Madurai, set up in 2010 by the then district collector, when a sudden outbreak of suicides took place in nearby Sellur village amongst the weaver community.Called ‘Pudhu Yugam’ (New World), this centre conducts awareness and counselling sessions in the district jointly with the Madurai Institute of Social Work.“Seventy cases have been successfully counselled so far to ensure that no further suicide attempt takes place by the patient,” said Ramasubramanian. “Since its inception in September 2010, 300 patients have approached the Pudhu Yugam centre for help.”The state government wants to extend this model to all other districts. A sum of Rs 12 lakh per district allocated under the 12th Five Year Plan by the Centre will be used to establish a suicide prevention centre a la Pudhu Yugam. A demand for another Rs 3.16 crore has been put up to the state government and awaits approval.“The fisheries department of the state has in fact begun the first counselling centre for government employees in DMS [Directorate of Medical & Rural Health Services] complex in Chennai,” added Ramasubramanian. “It has been named ‘Santham’ or peace. Training programmes are being conducted for government employees on stress management,” he said.Experts though say that other simple but effective strategies too need to be pursued by the state government to bring down suicide rates immediately, especially in the rural areas. In 2010, Lakshmi Vijayakumar, as part of a study for the World Health Organisation, conducted an experiment in two villages near Kattumannarkoil in Cuddalore district. The theory was that suicide is an impulsive act and once the most prevalent means to committing suicide is made inaccessible, the moment passes and suicides become fewer.“We spoke to the panchayat [of the two villages] and set up a bank-locker system for farmers to store pesticides,” explained Vijayakumar. “There were two keys to the locker — one in the farmer’s possession and another in the store manager’s possession. The farmer, who would earlier bury his pesticides in the field, would have to store it in the locker instead. This way, we decided to make access a little tougher,” she said.

A year and a half later, results showed a dramatic drop of 78% in suicide rates in these two villages.



“It costs only about Rs 7,000 per month to set up and run this system,” said Vijayakumar. This study was recently published in the prestigious Lancet medical journal as part of the ‘The Million Deaths Study’.

“In the urban areas, a concentrated programme must be introduced in schools between the Xth and XIIth standards,” she says. “We need to teach students how to seek help, how to resolve interpersonal problems and basic life skills.”Experts agree that young adults, who are the most vulnerable to suicide, must be trained on handling emotional issues, anger management and dealing with lifestyle changes.Doctors and nurses across the state need to be trained in identifying and dealing with depression and alcoholism. The stigma associated with depression must be destroyed, they agree.“As for the elderly, we need to find a means to take care of their physical health, improve their quality of life and reduce loneliness,” addsVijayakumar.Back home in the slums of Purasawalkam in Chennai, Arun Kumar’s friends say they miss him, almost a year on.“We did not even think of taking him to see a doctor or a psychiatrist,” rues his friend Satish Kumar. Perhaps, if the ‘gang’ had known enough to read the signs of depression, one young life could have been saved from a torturous end.(The writer is a freelance journalist based in Chennai)