Malini Nair,TNN | Sep 15, 2014, 07.03 AM IST
The first WHO report on worldwide suicide figures released last week ranks India on top. India has other worrisome trends -high rate of female and youth suicides. Psychiatrist Shekhar Saxena, author of the report and director of the department of mental health and substance abuse at WHO, tells Malini Nair that the Indian government has to step in and tackle the suicide surge.
What is the most alarming figure from India in the first WHO suicide report?
It has to be the high rate of suicide in the 15-29 age group. Traditionally , older and middle aged people are more prone to suicide and that is still the case in most developed nations but if 35% of your suicides come from the younger age brackets like in India that is both unusual and serious. Why should they feel so helpless at the peak of their life? Loss of life at this age is also damaging for the nation as a whole.
What do you think is the reason for this trend?
There are a number of factors at work. Like Japan and Korea, here too the young are under extreme stress to score well in schools and get into good colleges. Then there is keen competition in the job sector. These are relatively recent developments. If this is accompanied by economic stagnation and rapid social changes it could lead to suicidal tendencies.
Cultures like Japan and Korea also respect the idea of suicide, is it not?
Yes, some cultures see traditionally see suicides as an honourable escape from failure and shame. And that does explain high suicide rates in these countries. But in India, suicide is not glorified, it is stigmatized and on top of that, it is a criminal act. So people cannot even open up and talk to someone about it and seek help. Our studies have found that suicidal thoughts aren't permanent. Talking openly can give an individual other options or the time to rethink his/her decision.
The number of women committing suicides is also quite high unlike the west. Why is this so?
Yes, the gender margin is much narrower than in the West. But even then men in India are 1.5 times more likely to commit suicide than women. Actually, more women attempt suicide, than actually commit it. The figures indicate a high level of stress in society, like in some other Asian countries. China too shows high rates of suicides by women. The problems could be domestic, social as well as economic. Women also have less access to health and social services. There is high incidence of violence against women and children and this often leads to depression which is a high risk factor in suicides.
In the case of dowry-related suicides, isn't there a very thin line between suicide and murder?
Yes, but we have very little information on these kind of suicides. But we are aware that there is underreporting of suicides out of India. And despite that the figures are so high.
In India, mental health and suicide helplines are seen as the preserve of the NGO sector. But your report talks of the need for government intervention. What exactly can the government do?
The government needs to make multi-sectoral prevention strategies. If women can have better access to health and there are legal reforms, it could reduce suicide risks. If the young are stressed about education and job opportunities, government intervention can certainly help by bringing policy changes. The health and social care systems have to be strengthened. An alcohol policy could help because there is a clear link between dependence on alcohol and suicide.
This report talks of pesticide intake as the most oft-used means for committing suicide.
Pesticides are the commonest means of committing suicide in India, particularly rural India and especially in the south. This is mostly related to, poverty, debt. Reduced access to pesticides could help avoid many deaths because the tendency to commit suicide doesn't last forever. In some villages, community storage of pesticides - keeping it in locked with limited access - helped reduce suicides.
