Suicide Prevention & Protecting Mental Health in Post Pandemic India

Suicide Prevention in Post Pandemic India

As per the data shared worldwide, more than 700,000 people take their own lives every year while each suicide is tragic and has a lasting effect on friends, family, and communities. An estimated 20 persons attempt suicide for every suicide that occurs.

The COVID-19 pandemic raised concerns about mental health and suicide, which have persisted into the post-pandemic period. These concerns are especially relevant in times of armed conflict and high inflation-induced economic insecurity. Suicide rates during the early months of the epidemic were either lower than expected or stayed reasonably consistent in many nations for which we have reliable data, mainly high-income countries.

For instance, suicide rates have gone up, especially among women and young people, in India and Japan. High-quality data from lower middle-class and low-income nations is still hard to come by, though, given that 77% of suicides worldwide occur in such nations. This might lack the infrastructure and resources to offer adequate mental health care and suicide prevention services, safety nets for the economy, or social support, highlighting a concerning disparity.

So Who Are at The Highest Risk?

Especially the youths are at high risk. Suicide ranked as the fourth most common cause of death for young people aged 15 to 29 in 2019. The World Health Organisation (WHO) 2022 World Mental Health Report states that women and young people have been most affected by the pandemic's social and economic effects. Due to extended school and university closures, young people experienced a disruption of routines and social relationships, which resulted in a loss of learning, socialisation, and experiences essential for healthy development.

Hence, isolation and disruption increases the loneliness and anxiety. These are two emotions that are established risk factors for suicidal ideation and death by suicide. Furthermore, having to stay at home might have raised the likelihood of experiencing family stress or abuse, all of which are established risk factors for mental health issues and suicide. We need to stay alert as the pandemic's longer-term effects on the economy, society, and mental health will become apparent by talking about ways of mental health care and creating awareness about suicide prevention.

Now, Let’s Understand The Contributing Factors of Death by Suicide in India

The factors that are contributing death by suicide in India are as follows -

  1. Family problems, prolonged illness in family and caregivers burden.
  2. Illness, mental health concerns and/or any type of disability.
  3. Drug abuse/alcohol addiction
  4. Marriage related issues, relationship concerns etc.
  5. Bankruptcy or indebtedness
  6. Failure in examination, unemployment and acute concerns related to career.
  7. Fall in social reputation, shame

The Current Situation of Suicide in Indian Scenario

According to the National Crime Record Bureau (NCRB), 164 033 suicides were reported in India during 2021.

  1. Being the second most populous country in the world, the suicide death rate (SDR) in India is higher than the global average, especially in women.
  2. The age-standardised suicide rate of 11·1 per 100 000 for Indian women is more than double that of the global age-standardised suicide rate of 5·4 per 100 000 for women.
  3. The ratio of completed suicide to attempted suicide in India is about 1:7 in the elderly, which is double the ratio of 1:15 in lower age groups. This is reflective of a poorer ability of the elderly to recover from the bodily insult and shame associated with attempting the act of suicide.
  4. Adolescents and young adults Youth is a period of heightened risk of suicide and suicide is a leading cause of death among young people in India. The average suicide rate for girls was 148 per 100,000, and for boys, 58 per 100,000.
  5. In a study which evaluated the cause of death among those aged 10-19 years, in a rural population of 108,000 in southern part of India, suicide accounted for about a quarter of all deaths in males and between 50% and 75% of all deaths in females aged 10-19 years.
  6. Youth in the age group 15-29 years accounted for the largest proportion (34.5%) of suicides followed by those in the age group 30-44 years (34.2%).

So it is very clear from these statistical information that the rate of Post-Pandemic suicides are at an alarming stage. We must win this battle by hook or crook.

Let’s Discuss, What We Should Do to Reduce The Post-Pandemic Suicide Rates

Suicide can be prevented in many ways on a personal, social, and governmental level. We all have a part to play in 'creating hope through action,' as per the triennial theme of World Suicide Prevention Day. In its LIVE LIFE handbook for suicide prevention, WHO suggests implementing four major evidence-based interventions as a starting point. These are -

  1. Restricting access to weapons and highly dangerous pesticides, which are means of suicide.
  2. Teaching the media how to responsibly report on suicide.
  3. Developing the social and emotional skills of adolescents.
  4. Early detection, evaluation, management, and monitoring of individuals impacted by suicidal thoughts and behaviours.

In 2019, suicide was the fourth leading cause of death among young people from 15 to 29 years of age.

The World Health Organisation actively assists nations in creating comprehensive national plans for preventing suicide. A multisectoral public health strategy to suicide prevention requires national leadership and coordination, but local communities can support these efforts by taking into account their own needs, goals, and circumstances. Variations in suicide rates among nations, for instance, based on geographic location or demographic sub-populations, indicate that local bottom-up procedures and top-down suicide prevention strategies need to work together. Identification and execution of suicide prevention initiatives can steer pertinent community activities towards the general public, particular groups, and/or individuals.

We can all support one another personally as friends, spouses, parents, co-workers, bosses, and neighbours who are going through a difficult time and require mental health care. It is important to note that talking about or mentioning about ‘suicide’, does not 'plant the seed' or motivate someone to act on their sentiments when you ask them whether they are considering suicide. Rather, it frequently eases worry and makes others feel understood. It's critical to listen receptively and extend your assistance as an essential part of mental health care intervention. Other ways could be to go with them for their appointment and encourage them to seek assistance from a social worker, therapist, or mental health care provider.

We cannot overlook suicide. People can reduce suicide and suicide attempts globally by increasing awareness and putting well-informed treatments into practice. Individuals, communities, and nations can build hope through action.

Few Simple Ways to Protect Mental Health and Prevent Suicide in Your Known Circle

  • Ask someone you are concerned about if they're thinking about suicide. Studies show that asking someone if they are having thoughts of suicide does not increase the likelihood of a completed suicide nor does it increase suicidal thoughts.
  • Be there for them. You can call or plan an in-person meeting.
  • Keep them safe. Reduce access to lethal means for those at risk.
  • Help them connect with ongoing support. Call at 24X7 MENTAL HEALTH CRISIS HELPLINE NUMBER: 1800-120-820050.
  • Follow up. Give them a call or visit. Send a text or an email to let them know that you are present and available.

The Strategic Ways to Assess and Prevent Suicide

Effective suicide prevention is comprehensive: it requires a combination of efforts that work together to address different aspects of the problem.

Nine ways are mentioned in the model below, which together provide a thorough strategy for mental health care promotion and suicide prevention. Every strategy has a broad objective that can be achieved by a variety of potential actions (i.e., policies, practices, programmes, and services). This comprehensive approach model was modified from a model based on the U.S. Air Force Suicide Prevention Programme created by SPRC and the Jed Foundation.

  1. Identify and Assist Persons at Risk
  2. Many people who are in need don't look for assistance or support on their own. Finding those who are most vulnerable to suicide might help you reach them and get them connected to resources for mental health care and other relevant assistance. This technique includes, for example, educating warning signals, conducting suicide screenings, and providing gatekeeper training.

  3. Increase Help-Seeking for
  4. People can lower their risk of suicide by learning how to identify when they need support and mental health care. Self-help resources and outreach initiatives are two examples of strategies to reduce someone's obstacles to getting assistance, such as ignorance of available resources or doubts about the efficacy of assistance. Additional interventions for suicide prevention need to focus on the social and structural environment by creating peer norms that encourage asking for help when needed or by improving the accessibility and cultural fit of services.

  5. Ensure Access to Effective Mental Health Care and Suicide Prevention
  6. Ensuring that people who are at risk of suicide have prompt access to evidence-based therapies, suicide prevention programmes, and integrated care networks is a crucial component of suicide prevention. Recovery and rehabilitation can be greatly aided by suicide prevention strategies like safety planning and evidence-based therapy administered by qualified professionals. Another crucial tactic for guaranteeing access to efficient mental health care and suicide prevention treatment is lowering the financial stress, cultural, and practical barriers to care. This ensures accessibility and affordability of mental health care and suicide prevention support.

  7. Support Safe Care Transitions and Create Organizational Linkages
  8. You can reduce a person’s suicide risk by ensuring that they have an uninterrupted transition of care and by facilitating the exchange of information among the various individuals and organizations that contribute to their care. Individuals at risk for suicide and their support networks (e.g., families) must also be part of the communication process. Tools and practices that support continuity of care include formal referral protocols, interagency agreements, cross-training, follow-up contacts, rapid referrals, along with patient and family education.

  9. Respond Effectively to Individuals in Crisis
  10. People in your community, organisation, or school who are in serious emotional distress could require a variety of services. In addition to hotlines and helplines, walk-in crisis clinics, mobile crisis teams, hospital-based psychiatric emergency services, and peer-support programmes are all part of a comprehensive continuum of care that ensures the person moves from illness to wellness. Crisis services offer assessment, stabilisation, and referrals to further care in order to directly address the risk of suicide.

  11. Provide for Immediate and Long-Term Postvention for Suicide Prevention
  12. A postvention plan is a set of protocols to help an organization or community respond effectively and compassionately to a suicide death. Immediate responses focus on supporting those affected by the suicide death and reducing risk to other vulnerable individuals. Postvention efforts should also include intermediate and long-term supports for people bereaved by suicide.

  13. Reduce Access to Means of Suicide
  14. Restricting access to and use of lethal self-harm instruments by those experiencing a suicidal crisis is a crucial step in lowering the likelihood of suicide mortality. Changing medicine packaging, providing gun safety locks, teaching families on how to securely store weapons and pharmaceuticals, and placing vertical barriers on bridges are a few examples of steps that can be taken to lessen access to fatal means.

  15. Enhance Life Skills and Resilience
  16. By teaching people life skills like critical thinking, coping, and stress management, you may prepare them to deal with challenges like physical illness, divorce, financial difficulties, and ageing in an appropriate manner. Resilience is the ability to bounce back from adversity and adapt to change, and it reduces the risk of suicide. Although resilience and life skills share certain parallels, resilience include additional qualities such as optimism, a positive self-concept, and the ability to cling to hope. A few tools for improving resilience and life skills are self-help books, smartphone apps like Mpower - Holistic Mental Health app, and skill development programmes conducted by Mpower.

  17. Promote Social Connectedness and Support
  18. Even in the face of risk factors, people can be shielded against suicide by supportive relationships and a sense of community. Through social programmes tailored to certain demographics (such LGBTQIA+ adolescents or elderly individuals), as well as through various initiatives that lessen loneliness, encourage a feeling of community, and cultivate emotionally supportive relationships, can foster and improve connectedness.

If you need help for yourself or someone else, contact the our toll-free

24X7 MENTAL HEALTH CRISIS HELPLINE NUMBER: 1800-120-820050.

Referances:

https://www.statista.com/statistics/616974/suicides-by-cause-india/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554961/
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00053-1/fulltext
https://en.wikipedia.org/wiki/Suicide_in_India
https://www.sciencedirect.com/science/article/pii/S2666560323000312
https://www.thelancet.com/journals/lansea/article/PIIS2772-3682(23)00125-7/fulltext
https://ap.data.gov.in/keywords/suicide

image credit : freepik

Author
Chitra Pareek
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