Suicides & Suicidal Risk in India: What do the numbers say?
Sai Krishna Muthyanolla
June 18, 2020
The National Mental Health Survey of 2015-16 reported some alarming statistics. The survey estimated that 1% of the population reported high suicidal risk. What does that survey & other data say about suicides & suicidal risk in India?
Recently, the death of a Bollywood actor due to suicide has triggered a debate on mental health and suicide prevention in India. Reports show that cases of suicides by hanging have increased in certain pockets during the lockdown which has put people under immense stress. The UN had already warned of mental health crisis due to the pandemic.
Every 40 seconds, one person dies due to suicide
Suicides are a global phenomenon. According to the World Health Organization, every year, close to 8 Lakh people die due to suicide globally. At least one person dies due to suicide every 40 seconds. In 2016, suicide was the second leading cause of deaths among 15-29 age group, preceded by road injury.  Over 79% of the global suicides occurred in low- and middle-income countries while the high-income countries had a high suicide rate of 11.5 per lakh population. The latest data released by WHO indicates that India has the highest rate of suicides among the Southeast Asian countries, a rate of 16.3 per lakh population. It should be noted that for every suicide, there are many other who may have attempted to suicide. Unlike most common causes of death, suicides can be prevented through timely intervention.
Many studies have been taken up in India and abroad, to understand various aspects of suicides such as cause, demographic details such as age, gender, etc. Such analysis will help governments and stakeholders take the necessary steps to prevent suicides.
India accounted for more than 1/3rd suicides of women and almost 1/4th suicides of men worldwide
A Global Burden of Diseases study published on Lancet, on overall trends of diseases, injuries, and risk factors from 1990 to 2016 for every state of India revealed that suicide deaths in India increased by over 40% in the span of 26 years. In 2016, India accounted for 36.6% of the global suicide deaths among women and 24.3% among men. Though there has been an increase in proportion of suicide deaths in India among both genders, the same is more among women than men.
The age standardized suicide death rates among men per lakh population in India stood at 21.2 and that for women was 14.7 in 2016. While the rate among men was the same in 1990, the rate among women has dropped from 20 to 14.7. Despite the reduction, India has the third-highest female suicide rate (14.7) in the world after Lesotho (24.4) and Republic of Korea (15.4).
Suicide is the major cause of death among in the 15-29 age group
The study also highlights that suicides were the prime cause of death among Indian youth in the age group of 15 to 29 years and 15 to 39 years, while it was ranked second and third respectively at the global level. Meanwhile, India has the largest population of young people below 25 years of age, in the world.
It was also observed that the southern states of Andhra Pradesh, Karnataka, Tamil Nadu, and Telangana, consistently had a higher suicide death rate. Older studies cite that the disparity among numbers reported by states is because of better reporting systems. Furthermore, higher literacy, higher socio-economic status, and higher expectations could be the reasons behind higher suicide rates in the south.
One in 20 persons in India suffers from Mental Illness
Most suicides are a result of psychiatric diseases, depression, substance use disorders and psychosis. The National Institute of Mental Health & Neuro Sciences (NIMHANS) in collaboration with 15 other institutions conducted a National Mental Health Survey  (NMHS) in 2016 on behalf of the Central Government. The survey was conducted in 12 states among individuals of 18 years and above. A total of 34,802 individuals were interviewed. The survey revealed prevalence of mental health problems in the country. According to the survey, one in 20 persons in India suffer from depression. Around 15 crore individuals were also estimated to be suffering from a mental morbidity in India. Further, the study indicated that nearly 1% of India’s population reported high suicidal risk.
Those residing in urban metros had highest suicidal risk
As per the survey, the prevalence of suicidal risk across different socio- demographic categories is plotted in the following graph. Suicidal risk was highest among those residing in urban metros (1.7%). Widowed or separated persons also possessed high suicidal risk. Risk was more prevalent among those aged between 40 to 49 years and among females. The risk across different categories calls for multi-sectorial approach to address the public health problem.
For every suicide in India, more than 15 attempts happen
A study titled ‘A population-based analysis of suicidality and its correlates: Findings from the National Mental Health Survey of India 2015–16’ analyses suicidality data from the NMHS survey. Suicidality refers to thoughts, plans, and acts of suicide which have not resulted in death. Findings of the study revealed that in 2015, about 1% of the population had high suicidality which required urgent intervention. Further, for every death by suicide, there were more than 200 people with suicidality in India and more than 15 suicide attempts. The numbers however, varied across states and with socio demographic characteristics. In 2015, more than 4.4 crore adults in the country could have had suicidality.
Suicide data in NCRB report is much lower than WHO data due to under-reporting
The National Crime Records Bureau’s (NCRB) annual publication, Accidental Deaths and Suicides in India report in 2018 has recorded 1.34 Lakh suicides, which comes to a suicide rate of 10.2 per lakh population. The NCRB report which records and acts as reference for suicides in the country, has reported a suicide rate of 10.3 per lakh population in 2016, lower than the number reported by WHO. This is because the data reported in ADSI report is based on the FIR’s filed which states the apparent cause of death based on evidence collected and autopsy reports. NCRB reports may be under-reporting suicides and possibility of misclassification of suicide deaths cannot be ruled out. Yet, the data in the NCRB report is useful to derive adequate insights on suicides such as cause of death, gender, etc.
Stigma and taboo around mental health is a cause of concern
Farmer suicides and suicide among students are the most often discussed topics related to suicides in India. Opening up about mental health is still viewed with stigma in the society. The issue is complex and specific to one particular sector. People involved in various professions and sectors, be it agriculture, education, business, politics, film industry, law, justice etc., are prone to this.  The variation across gender, age, rural-urban set up, and other socio-economic conditions makes it clear that no single- approach will be enough to address the issue but coordination and collaboration across sectors is the need of the hour. For instance, in case of students, having suicide prevention interventions at schools will be useful.
Another way to address the issue is through reducing the access to means of suicide. Around 20% of suicides world-wide have reportedly taken place by intake of pesticide, self-poisoning, hanging, and use of firearms. Safeguarding the vulnerable groups such as those who face discrimination like trans persons, indigenous population, refugees, and migrants is also required.
National Mental Health Program was implemented in 1982 for assuring mental healthcare services across world
The National Mental Health Program is being implemented in India since 1982 with the objective to ensure availability and accessibility of minimum mental healthcare for all, especially, to the most vulnerable and underprivileged sections of the population. Through the program, the Central Government supports the implementation of District Mental Health program (DMHP) across 655 districts in the country. Through DMHP, basic mental health care is provided at the community level through counselling services, sensitization, education, etc. at different levels.
Mental Healthcare Act, 2017 decriminalizes suicide attempts
In 2017, the government passed the Mental Healthcare Act, 2017 aimed at providing mental healthcare and services for persons with mental illnesses. The Act empowers the government to set up a Central Mental Health Authority and similar state level authorities in states with which all mental health practitioners and institutions need to register themselves. The act protects the dignity of people with mental illnesses. It decriminalizes suicide- meaning, a person who attempts suicide will not be punishable under Indian Penal Code. They will be considered suffering from mental illness and adequate care will be provided to them.
Suicide Rate is an indicator in the SDGs
Suicide rate is an indicator under the Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages. The goal is to bring down premature mortality by one-third from non-communicable diseases through prevention & treatment and promote mental health and well-being. The goal is also to reduce suicide mortality rate.
No national helpline numbers for suicide prevention is available in India
In India, there is no national distress helpline as yet. However, there are many organizations that collaborate with the government and extend counselling services and suicide prevention helplines.
Medical Helpline number 104 is used in some states such as Assam, Karnataka, Tamil Nadu, Odisha, and Punjab for counselling services along with other services. The most efficient solution to address mental health problems and suicide prevention would be to have a central national helpline number that operates 24*7. A few numbers available online have been listed below.
11.00 am to 9.00 pm (Mon to Sat)
Featured Image: Suicidal Risk in India