Context: Recently, the Ministry of Health and Family Welfare announced a National Suicide Prevention Strategy, the first of its kind in the country to achieve a reduction in suicide mortality by 10% by 2030.

National Suicide Prevention Strategy

• The strategy is in line with the WHO’s South East-Asia Region Strategy for suicide prevention.

• Aim: The strategy broadly seeks to establish:

• Effective surveillance mechanisms for suicide within the next three years.

• To establish psychiatric outpatient departments that will provide suicide prevention services through the District Mental Health Programme in all districts within the next five years, and

• To integrate a mental well-being curriculum in all educational institutions within the next eight years.

• It envisages developing guidelines for responsible media reporting of suicides, and restricting access to means of suicide with time-bound action plans and multi-sectoral collaborations.

• The stress is on developing community resilience and societal support for suicide prevention.

Significance of the strategy

• The most important thing is that the government has acknowledged that suicide is a problem.

• We now have a well-conceived plan involving multi-sectoral collaborations, because the only way a strategy would work would be to involve various sectors.

• The strategy should now be passed on to the States for them to develop locally relevant action plans; and then cascade to the district, primary health and community levels.

The South East-Asia Region Strategy

It aims to:

• Strengthen advocacy, effective leadership, and governance for the prevention of suicides.

• To provide comprehensive, integrated, and responsive mental health and social care services in community-based settings to address suicides.

• To implement strategies for the promotion of mental, social, and physical health and well-being aimed at preventing suicides

• To strengthen information systems, evidence, and research on suicide

Suicide rates in India

• According to the National Crime Records Bureau (NCRB) report 2021, the Suicide rate in India is increasing alarmingly.

• Delhi has recorded the highest number of (2,840) suicides.

Reasons for Suicide

• 33.2%: Family Problems (other than marriage-related problems)

• 4.8%: Marriage Related Problems

• 18.6%: Illness

• Daily wage earners accounted for 42,004 (25.6 percent) of the total victims. One in four of the recorded 1, 64,033 suicide victims during 2021 was a daily wage earner.

• They were followed by self-employed people, unemployed people, and those involved in the farming sector were the top categories of people who died by suicide in 2021.

• The report certainly points out suicides as a critical public health issue in India and qualifies for a closer epidemiological assessment.

How is Suicide a Social Problem?

• The problem with only viewing suicide as an individual problem is that we neglect the importance of social forces contributing to suicide.

• Suicide is a serious social problem whose incidence varies between genders, age groups, geographical distribution, and the influence of the socio-political structure of society.

• More youth committing: For the youth of the country (15-29 years), among whom 1/3rd of all suicides take place.

• Performance pressure: Data suggests that one student dies by suicide every 55 minutes, and 1,129 suicides among children below 18 years of age in 2020 were due to failure in examinations.

• Farm distress: This is followed by farmer’s suicide and the gendered variance observed these days.

• Gendered variances: More women are committing suicides these days.

• The risk of suicide in a population increases when the social context fails to provide a healthy sense of purpose and belonging, contributing to an individual’s sense of contribution and connection.

• Furthermore, suicide should be viewed as a multidimensional public and mental health issue, having complex interactions with the economic, social, cultural, psychological, and biological realms of individual and collective existence.

Key challenges

• Under-reporting of such cases due to fear of social stigma and sometimes to rescue from judicial procedures.

• Fear of legal action:  Section 309 of the Indian Penal Code (IPC) makes suicide a punishable offense. The fear of punitive action and added hassle of having to deal with police and courts often results in a refusal to seek help.

• Social stigma: The social stigma associated with suicide results in the NCRB grossly under-reporting the true numbers of suicide. 

Related Initiatives

• Mental Healthcare Act, 2017: It aims to provide mental healthcare services for persons with mental illness.

• KIRAN: The Ministry of Social Justice and Empowerment has launched a 24/7 toll-free helpline to provide support to people facing anxiety, stress, depression, suicidal thoughts, and other mental health concerns.

• Manodarpan Initiative: It is an initiative of the Ministry of Education under Atmanirbhar Bharat Abhiyan. It is aimed to provide psychosocial support to students, family members, and teachers for their mental health and well-being during the times of Covid-19.

Additional Facts

• Maharashtra topped the country in terms of the number of suicides reported in 2021 followed by Tamil Nadu and Madhya Pradesh.

• Madhya Pradesh is going to be the first State in the country to draft a suicide prevention strategy and the government has formed a task force for it.

Strategies to Prevent Suicide

Strengthen economic supports:-

• Strengthen household financial security

• Housing stabilization policies

Strengthen access to and delivery of suicide care:-

• Coverage of mental health conditions in health insurance policies

• Reduce provider shortages in underserved areas

• Safer suicide care through system change

Create protective environments:-

• Reduce access to lethal means among persons at risk for suicide

• Organizational policies and culture

• Community-based policies to reduce excessive alcohol use

Promote connectedness:-

• Peer norm programs

• Community engagement activities

Teach coping and problem-solving skills:-

• Social-emotional learning programs

• Parenting skill and family relationship programs

Identify and support people at risk:-

• Gatekeeper training

• Crisis intervention

• Treatment for people at risk of suicide

• Treatment to prevent re-attempts

Lessen harms and prevent future risk:-

• Postvention

• Safe reporting and messaging about suicide

Road Ahead

• Holistic approach: Promoting national and sectoral research into the reasons for suicide mortality and its rise, and making culturally and economically appropriate suggestions to help mitigate the problem is critical.

• Counselling by mass-media: During times of distress, media must promote health-seeking behaviour, correct information and counter the possible myths related to suicide.

• Evidence-based interventions: Keep in mind the needs of the most vulnerable and marginalized populations, like women and young individuals, providing the required support systems can reduce the number of lives lost and build a healthier response system.