On the edge
India boasts of its youthful energy but this promising scenario is juxtaposed with the rise in deaths of these youngsters due to suicides. Every third person in an Indian city today is a youth, indicates the findings of the State of the Urban Youth, India 2012: Employment, Livelihoods, Skills, a report published by IRIS Knowledge Foundation in collaboration with UN-HABITAT.
The report mentions, “By 2020, India is set to become the world’s youngest country with 64 per cent of its population in the working age group.” Also a UN report has said, “With 356 million people falling in the age group of 10-24, India has the world’s largest youth population despite having a smaller population than China.” These indicators make us immensely proud, but unfortunately it is from this youthful segment in India, that maximum suicides have been recorded.
Be it a young student (due to examination or peer pressure) jumping off from a high-rise or a heartbroken youngster gulping poison/sleeping pills, the youth in India is unfortunately being rapidly consumed by the dreadfully impulsive syndrome of suicide. Arising mostly from depressive disorder, suicides have become a common killer amongst the youth in India. In fact it is one of the biggest killers globally, with the youth being the highest in numbers committing it, especially in India.
According to Census 2011, there are 364.66 million youngsters in the 10-24 age group, making up 30.11 per cent of the country’s total population. The National Crime Records Bureau (NCRB) in 2014 reported around 60,000 youth suicide deaths each year. The Million Death Study (2012) said this figure underestimated true suicide numbers by upto a third: thus, the actual figure may approach to even a lakh deaths, a year.
Dr Samir Parikh, Director, Mental Health, Fortis Healthcare explained, “Globally in the 15-24 age group suicide is much higher than for the adult population. Suicide in the adult population is the 8th highest killer and for 15-24 years age group it is the third highest killer. While worldwide for this young age group in the last two decades suicides have actually become four times higher.
These figures indicate the need for the creation of a National Suicide Prevention Policy. Work needs to be done at multiple-layers to make sure that more trained experts on the issue are available. Wherever these experts can’t reach we must make them accessible and available. Also we need to train more of them in crisis intervention.
There is a need to create more helplines and have strong support systems at the same time to identify the key sources which include factors such as academics, finances, family, isolation, aggression, peer issues and others. We need to build a movement for early identification of symptoms in youngsters.
“Childline India Foundation (CIF) with the toll-free number 1098 is one such helpline where children can call and discuss any of their issues. Explaining the cause of the suicides, Dr Parikh said, “Primary reasons attributed for these suicides are unidentified, untreated or partially treated psychiatric disorders due to depression. A lot of academic pressure, peer pressure, change of family support mechanism, therefore being unable to deal with the stress generated from it is some of the major causes.”
According to the findings of the Lancet Commission on Adolescent Health and Well-being, “suicide is the leading cause of death among youngsters aged 10-24 in India, with 62,960 such deaths reported in 2013. Road accidents (41,168 deaths) and tuberculosis (32,171) were the other big killers, together claiming 73,359 young lives in 2013”, said the report. Globally too, accidents, self-harm (suicides), violence, and tuberculosis accounted for most deaths in this age-group.
The Global Burden of Disease Study (GBD) 2013 includes an annual assessment covering 188 countries, from 1990 to 2013. The study covers 306 diseases and injuries- 1,233 sequela and 79 risk factors. This study provides a comprehensive description of the burden of disease for young people worldwide. It shows that injuries, mental health disorders, sexual and reproductive health problems are leading causes of morbidity and mortality in young people.
In India, suicide was the leading cause of death amongst youngsters with 62,960 deaths in 2013. What is alarming is that 28.65 lakh of these youngsters have suffered depressive disorders in 2013.
Leading Psychologist Dr Sujatha Sharma explained that it isn’t depression that always triggers such behaviour.
“It is not always depression, even though it is the leading cause of suicides in young people, there are other factors which trigger such a response such as personal or academic failures, breakup of relationships, certain demands not being met by parents and other. In the younger age group it is mostly a crisis leading to an impulse action. There is a need for suicide prevention policies and also more centres and helplines to deal with this,” she said.
Dr Sharma pertinently pointed out the need for “mental screening” to deal with the problem. “One viable solution would be mental health screening, for vulnerable population. This means that there are some people who are going through difficult circumstances in their life and regular screening of them starting from the school level for suicidal signs, would help to identify who is at risk.
We need to sensitise the parents, teachers and whoever influences the child to identify suicidal thoughts and behaviour,” she added. Dr Sanjay Chugh, Senior Consultant Psychiatrist explained, “The youth, particularly teens, are going through a tumultuous phase of their lives. They are under tremendous pressure to belong / be accepted/ fit in, to perform and prove their worth whether in academics or sports or extra-curricular activities or profession, and to prove that they can be responsible and adult-like. Alongside, they are still going through the process of getting mature.
There are greater chances of them being impulsive and emotionally volatile. It is under such circumstances that the slightest of stressors can act as a trigger for a drastic step like suicide.”
Identifying the key factors that drive these kids to commit suicide he said, “The cause for suicide is usually a stressor such as a significant life event like the loss of a loved one, domestic instability, fear of rejection, break up, and fear of failure.
It’s important to understand that the same situation may not trigger such a response in someone else. It is the distorted perception of the mind, that is often depressed, that makes the situation seem impossible to cope with which is why one resorts to such a step,” he added. For a viable solution he suggested that it’s important to raise awareness about mental health issues and also remove stigma and misconceptions around these. If people can learn how to catch the warning signs of suicide, a majority of suicides can be prevented.
Each of the psychologists that we spoke to for the story insisted that the government needs to have a policy for suicide prevention in place, to address this alarming issue. Dr Rajesh Sagar, professor of psychiatry at All India Institute of Medical Sciences (AIIMS) explained the sociological stigma attached to this issue. “We need to create awareness about identification of mental health problems and its early detection because the stigma is so huge that people do not opt for treatment and suicide is the ultimate outcome of that.
We need to educate people and spread awareness about the mental health problems and that they should not hesitate to take any help and consultation. We need to be kind to these people and not just stigmatise them.”
“At the national level, we do need a policy to prevent such cases. We also need more helplines which can play a major role in addressing the problems which these children face. It has to be a multi-pronged approach to look at the vulnerable population at varied levels which include awareness spread by promotion of mental health, its treatment and rehabilitation programmes as well,” he added.