Times View

NEW DELHI: Four of India’s southern states — Tamil Nadu, Andhra Pradesh, Karnakata and Kerala — that together constitute 22% of the country’s population recorded 42% of suicide deaths in men and 40% of self-inflicted fatalities in women in 2010.Maharashtra and West Bengal together accounted for an additional 15% of suicide deaths.Delhi recorded the lowest suicide rate in the country. In absolute numbers, the most suicide deaths in individuals, aged 15 years or older, were in AP (28,000), Tamil Nadu (24,000) and Maharashtra (19,000).The first national study of deaths in India , published in the British Medical journal The Lancet on Friday, says that suicide has become the second-leading cause of death among the young in India.Of the total deaths by suicide in individuals aged 15 years or older, about 40% suicide deaths in men and about 56% in women occurred in individuals aged 15–29 years.Suicide deaths occurred at younger ages in women (average age 25 years) than in men (average age 34 years). Educated persons were at greater risk of completing a suicide.The risk of completing a suicide was 43% higher in men, who finished secondary or higher education, in comparison to those who had not completed primary education. Among women, the risk increased to 90%.Lead author of the study Professor Vikram Patel of the London School of Hygiene and Tropical Medicine told TOI that the 1.87 lakh people committed suicide in India in 2010.About half of suicide deaths (49% among men, and 44% among women) were due to poisoning, mainly ingesting of pesticides. Hanging was the second most common cause for men and women, while burns accounted for about one-sixth of suicides by women.Professor Patel felt that with the decline in maternal death rates, suicide could soon become the leading cause of death among young women in India.The study says the National Crime Records Bureau underestimates suicide deaths in men by at least 25% and women (36%).He told TOI, “Overall, more Indian men commit suicide than women, but the male to female ratio for suicides is smaller in India than in many Western countries, in particular among youth. Studies have suggested that social factors such as violence and depression are key determinants of suicide in women.”Prof Patel pointed out to lack of national strategy for suicide prevention in India.He said, “Suicides can be prevented through interventions like banning the most toxic pesticides and teaching rural communities on safe storage of pesticides. India should also start mental health promotion for young people through schools and colleges and introduce crisis counseling services and services for treatment of depression and alcohol addiction.”Prof Patel added that although much of the current concern about suicides has focused on agricultural workers, over three in four suicide deaths in India occur in other occupational groups (including those who are unemployed and homemakers).“Compared to most other countries, suicide rates are especially high in young adults and, in particular, young women for whom suicide rates in India are four to six times higher than in developed countries. The suicide rates vary 10-fold between states with the highest rates in the southern states of India,” he added.Suicide deaths among men were almost 11-times higher in Maharashtra as compared to Delhi. When it came to women, it was four times higher in Maharashtra than Delhi.The study says the age standardized suicide death rate per 100,000 people at all ages was 18.6 for boys and men and 12.7 for girls and women.The suicide death rate in men aged 15 years or older varied little across age groups in comparison with that of women, which peaked in 15-29 years and decreased thereafter. At ages 15–29 years, suicide was the second leading cause of death in both sexes.Most suicide deaths occurred in rural areas — the age standardized death rates were about two times higher in rural than in urban areas.In the absence of other causes of death, men aged 15 years or older have a lifetime risk of suicide of 2% or higher in AP, Karnataka, Kerala, and Tamil Nadu.“The large variations we observed between states clearly point to the role of as yet poorly understood social factors in influencing the risk of suicide in India. We recorded a reduced risk of suicide versus other causes of death in women who were widowed, divorced or separated, compared with married women and men,” Prof Patel said.The study says, suicide claims twice as many lives in India as HIV-AIDS and almost as many as maternal deaths in young women. Suicide kills nearly as many Indian men aged 15-29 as transportation accidents. Studies have shown that the most common contributors to suicide are a combination of social problems, such as interpersonal and family problems and financial difficulties, and pre-existing mental illness.A very large proportion of suicides in India can be attributed to the manner in which families and society at large deal with all forms of mental illness. Where something as common as depression is rarely recognised and when recognised is even more rarely treated because there is a stigma attached to ailments of the mind, there clearly is a problem. What can be easily treated with some medication and counselling more often than not goes untreated till it develops a more serious form. Both government and civil society need to act to change this. Above all awareness must be built that the mind is as liable to be affected as other bodily organs and there is nothing to be ashamed of in acknowledging this.