Never judge a book by the cover, they always say. This suicide prevention month coming as it does in, the midst of mental fatigue and a blurry silver lining, needs us to dig in deep and not just for ourselves.
Sometimes a smile hides, at other times the silence is really a cry for help — the inner darkness plays the devil every forty seconds when somewhere in the world a person finally gives up on the struggle within and takes their life. The pandemic has only brought those emotions more on edge.
Suicide is a giant killer and of particular concern for India which has one of the highest mortality rates- the country accounts for almost 37% of global numbers with every two in five women being Indian as per a Lancet study.
These statistics are only those tragedies that are reported, the stigma around it often allows the extreme act to be buried as an inherent weakness, with those around hushing it up for fear of invoking section 309 of the Indian penal Code that makes attempted suicide a punishable offence.
But the uncertainty and festering distress- both emotional and economic of almost two years has made it abundantly clear that the ostrich cannot be burying its head in our sand.
In Kerala, local media reports at least 30 deaths by suicide in the last three months. A doctor treating COVID patients in Delhi killed himself during the second wave as did a woman and her two sons in Gujarat after her husband passed away with the virus. This is just the tip of the iceberg.
In 2017, India decriminalised attempted suicide, the new Mental Healthcare Act stated that any person who tries to kill themselves, unless proved otherwise shall be believed to be under acute stress and will not be punished. Instead, the onus was on the respective government for rehabilitation.
But informally, it is still considered a character flaw. Lack of acceptance is at the core of our mental health struggles, and although the pandemic has allowed more conversations, suicide still remains a taboo. We are by and large still unable to understand that depression or anxiety are not by choice.
At other times, we become immune- the headlines on farmers suicides in Maharashtra don’t move us any longer, most often they are dismissed for what they are- a political game. Compassion comes from a place that first normalises mental health.
Change needs to begin from the top but the 2019-2020 budget for mental health was just 0.05% of the entire health budget and this year, despite expert warnings of a mental health epidemic, only 40 crores- same as last year, have been allocated for the government scheme, the National Mental Health Programme.
A big chunk of the budget has been granted to just one centrally-run institution in Bengaluru at a time when the pandemic has made mental health a physical ache across state boundaries.
Even in a pandemic free world- hard though that is to imagine- we were really not shining a light on our darkness, especially the ones our teenagers and young ones found themselves surrounded in. Between the ages of 15-24, suicide is the largest cause of death in India. Although many reports show a demographic bias towards south India, crossing the line at that age anywhere- in a tempestuous generation can be just an impulse.
‘I have self-harmed many a times- not eating, not leaving my room, cutting my skin like my wrists or biting the insides of my cheeks excessively. Bleeding is the point of self-harm and sometimes I would realise what I have done only when the bleeding began.
Peer and parental pressure
I am not sure why I do it. Maybe because I deserve it? I kind of don’t like myself and sometimes I just see no way out other than death.”
These were words from a 16- year- old to me when I was writing my book ‘Stoned, Shamed, Depressed.’ Another girl who was younger even overdosed with the intent of killing herself, her parents she told me were doctors, so she knew a thing or two about medicating. Fortunately, help came on time.
The trend of adolescents resorting to self- harm in tier 1 and 2 cities has been alarming, many of those who don’t get help on time are students. On Saturday, a 20-year-old student killed himself in Tamil Nadu just ahead of the NEET premedical exams, as did another girl on Monday fearing poor marks.
While peer and parental pressure is dominant among this age group, aspirational expectations not being met also become a burden.
We may have felt otherwise but time didn’t stand still since the pandemic outbreak. A study done by the All India Institute of Medical Sciences (AIIMS) earlier this year reported that 22.5% of children developed a real fear of Covid with “anxiety, depression, irritability and inattention” as their key symptoms. Those looking in the right place will admit that this is not surprising — the social, physical isolation along with education inequality will have a cost.
Despite the overwhelming statistics, India has never treated suicide as a public health care crisis that requires polices looking to pre-empt rather than curative or post haste action. For instance, lack of proper data over pesticide poisoning- especially by farmers- makes informed decisions tough.
Time is running out but the national suicide prevention strategy is yet to see the light of day, the task force that was meant to be formed in 2017 is still missing — this when we know that WHO has flagged the suicide rate in India and timely intervention can make it preventable.
India is ranked 139th out of 149 countries in the latest World Happiness index, far behind even Pakistan and Bangladesh. Read between the lines.