Suicide is the third leading cause of death among young adults worldwide. Close to 800 000 people die due to suicide every year, which is one person every 40 seconds. Suicide is a global phenomenon and occurs throughout the lifespan. Studies from India consistently document the highest suicide rates in the world, and the majority of completed suicides had been within adolescents. Every hour one student commits suicide in India, with about 28 such suicides reported every day, according to data compiled by the National Crime Records Bureau (NCRB). The NCRB data shows that 10,159 students died by suicide in 2018, an increase from 9,905 in 2017, and 9,478 in 2016. As per reports of WHO, Suicide is the third leading cause of death in 15-19-year-olds.
It is a worrying situation nowadays that everyday we hear about students in the age group of 15-25 are attempting suicides in our valley. In recent past , some 3-4 days back a young girl attempted suicide in Budgam District, on next day a case was reported from North Kashmir’s Baramulla District and yesterday reported from Kulgam. We need to think effectively regarding the rising attempts and must take appropriate steps to prevent these mishapennings. The risk of suicidal behavior associated with Anxiety Disorders among adolescents is known. Anxiety Disorder is associated with the risk for potential suicidal behaviour. Adolescent boys with Anxiety and Depressive Disorders need to be identified as the high risk group for suicide prevention in the community. There is a growing recognition that prevention strategies need to be tailored and to be implemented in a culturally-sensitive manner. We must identify the factors which are pushing our young generation to attempt suicides. Is it pressure of exam, fear of failure, social negligence or something else ?. People from conflict zones have high tendency to suicide attempts also.
While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established in high-income countries, many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness.
In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behaviour. Suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; and prisoners. By far the strongest risk factor for suicide is a previous suicide attempt. In general, people try to kill themselves for these reasons:
They’re depressed. This is, without question, the most common reason people die by suicide.
They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression, and is arguably even more tragic.
They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed.
They’re crying out for help, and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong
They have a philosophical desire to die. The decision to die by suicide for some is based on a reasoned decision, often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death.
The rising incidents among students is one of the consequence of pressure from the parent side and from the society where we live. Parents usually come to psychiatrists to push youngsters harder and make sure they get into IIT, IIM,Medical Colleges if not Harvard. Everything else that they could do well like sport, music, painting are pushed to the past. The damage this can do to a child’s self-esteem is enormous. Behind the scenes, more alarmingly, students are also experimenting with performance-enhancing drugs. One such case was of a Lucknow girl, a College student who used to take Anacardium, a homeopathic solution, to keep nerves stress-free during exam. But there are others, who take serious anti-depressants and steroids. Doping for exam is prevalent among affluent students schools and colleges. Because Failure is a word that gives students continuous nightmares. After all, parents don’t give them credit for any activity they excel in, besides studies. Ingestion of pesticide, hanging and firearms are among the most common methods of suicide globally. It is estimated that around 20% of global suicides are due to pesticide self-poisoning, most of which occur in rural agricultural areas in low- and middle-income countries. Knowledge of the most commonly used suicide methods is important to devise prevention strategies which have shown to be effective, such as restriction of access to means of suicide.
Suicide does not just occur in high-income countries, but is a global phenomenon in all regions of the world. In fact, over 79% of global suicides occurred in low- and middle-income countries in 2016. According to WHO, Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions. For national responses to be effective, a comprehensive multisectoral suicide prevention strategy is needed.
Prevention and control
Suicides are preventable. There are a number of measures that can be taken at population, sub-population and individual levels to prevent suicide and suicide attempts. These include:
• Reducing access to the means of suicide (e.g. pesticides, firearms, certain medications).
• Reporting by media in a responsible way.
• School-based interventions.
• Introducing alcohol policies to reduce the harmful use of alcohol.
• Early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress.
• Training of non-specialized health workers in the assessment and management of suicidal behaviour.
• Religious leaders have a crucial role to play in order to do proper counselling.
• Follow-up care for people who attempted suicide and provision of community support.
Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labour, agriculture, business, justice, law, defense, politics, and the media. These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide.
Abid Shafi Banday is a Nursing Research Scholor