Stop selfharm from becoming a health crisis

India needs adaptable mental health outreach programmes

On the day an international report highlighted that suicides were the leading cause of death among 15-39 year olds in India, an 18-year engineering student became one of the 630 people who kill themselves each day in the country. The 18-year-old left behind a note that said, “Engineering sucks.” Most suicides among young adults happen impulsively at a moment of crisis that breaks down their ability to deal with things such as relationship breakups, examination stress or financial problems. Of the estimated 230,314 persons who killed themselves across India in 2016, 71·2% of the women and 57·7% among men in 2016 were in this group. Suicide rates worldwide are the highest among young adults — it’s the third leading cause among 15–39 year olds — but the disproportionately high number among India’s young is a cause for concern.

India was home to 17.8% of the global population in 2016, but accounted for 36.6% of the global suicides among women and 24.3% among men. Suicide rates among women are 2.1 times higher in India, which is an aberration as worldwide, more men kill themselves than women. Married women account for the highest proportion of suicides in the country.

India needs adaptable mental health outreach programmes at the community level that can be guided by an overarching national suicide-prevention strategy to prevent self-harm from becoming a public health crisis. The decriminalisation of attempted suicide under the Mental Health Care Act, 2017, in May is a start, as it is nudging people to seek social and medical support instead of fearing persecution. There are lessons from China, where the fall in suicide rates among women by 70% between 1990 and 2015 coincided with increasing globalisation and labour market opportunities that offered rural women urban employment. Young people need opportunities and social support to fight despair.