EARLIER this year a neighbour dropped by the Chundawats’ house in the northern suburbs of Delhi, wondering why his friend Lalit had not opened his nearby shop. When he let himself in the reason became clear. Everyone inside—11 people from three generations—was dead. Two brothers, their wives, a sister and their children dangled from the ceiling in a hallway, suspended by ropes, blindfolded, hands tied. The family matriarch, 77-year-old Narayani Devi, lay strangled nearby. Only Tommy, a dog, survived.

Police say the deaths were a mass suicide, most likely prompted by occult beliefs. Yet, strange though the incident appeared, the Chundawats’ death was only one of numerous collective suicides across India this summer. In July in the state of Jharkhand alone, two families killed themselves, driven by the more prosaic motive of despair over debt.

Suicide is often seen as a rich-world problem, but is all too common in India. New research, published this week in the Lancet, a medical journal, reveals that India suffers from perhaps 230,000 a year, nearly double previous estimates. With 18% of the world’s population, it is responsible for nearly a quarter of suicides among men worldwide, and almost four out of ten among women. Suicide is the leading cause of death for all Indians between the ages of 15 and 39, and for Indian women between the ages of 15 and 49.

The paper’s lead author, Rakhi Dandona of the Public Health Foundation of India, says that previous estimates for suicides relied solely on police reports. These tended to undercount, not least because until last year Indian law considered suicide, as well as “abetment” of it, a crime. Her team instead extrapolated results for the past 25 years from a range of nationwide medical records, including nearly half a million autopsy reports.

India’s suicide rate, like the global one, is falling. But whereas the rate among women worldwide has fallen by half since 1990, and in China by an astonishing 70%, in India it has dropped by just 25%. And just as South Korea and Russia have relatively high suicide rates, but most Muslim-majority countries relatively low ones, there is stark geographical variation among Indian states (see chart). A woman in the southern state of Tamil Nadu, for example, is ten times more likely to commit suicide than one in jungle-bound Mizoram in the north-east. Men in the poorest state, Bihar, kill themselves at a quarter of the rate of those in bustling Karnataka, the heart of India’s technology industry.