Startling suicide statistics in India: Time for urgent action

The National Crime Records Bureau (NCRB) released data on suicidal deaths in India in August, 2022 and the figures were startling. A total of 1,64,033 suicides were reported in the country in 2021 which is an increase of 7.2% in comparison to the previous year in terms of total numbers. In terms of rate of suicide, India reported a rate of 12 (per lakh population) and this rate reflects a 6.2% increase during 2021 over 2020.[¹] The number reported is the highest ever recorded in the country since inception of reporting of suicides by the NCRB in 1967. This is a genuine cause of concern. A majority of suicides were reported in Maharashtra followed by Tamil Nadu, Madhya Pradesh, West Bengal, and Karnataka. These five states together accounted for 50.4% of the total suicides reported in the country. In terms of rates of suicides, Andaman and Nicobar Islands reported the highest rate of suicide (39.7) followed by Sikkim (39.2), Puducherry (31.8), Telangana (26.9) and Kerala (26.9). Family problems and illness were the major causes of suicides as per the report. The overall male-to-female ratio of suicide victims for the year 2021 was 72.5:27.4, which is more compared to that of the year 2020 (70.9:29.1).[¹] Thus, the rate of male suicides increased further last year. One of the reasons could be rising unemployment and economic downslide following the pandemic. Male members, being the major bread-earners of the family, bore the maximum brunt of economic debacle through pay cuts, interruptions of payment or, in worst cases, loss of jobs. This is further supported by the fact that out of a total of 1,18,979 male suicides, the maximum number of suicides were carried out by daily wage earners followed by self- employed persons. Daily wage earners constituted the third position even among female suicide victims. Again, among the total number of suicides by people in the farming sector, 50% was constituted by agricultural laborers. The financial instability that severely affected daily wage earners—many of whom migrate from other states—during the pandemic due to lockdown and subsequent unavailability of work seems to have taken its toll. Thus, government policies aimed at suicide prevention should take a serious look at the damage caused by the economic downturn and make serious efforts to address this issue.

Among the females who committed suicide, the highest number involved “Marriage Related Issues” (specifically “Dowry Related Issues”) and in terms of profession, homemakers constituted the highest number. Thus, social issues including gender inequality and dowry practices continue to make marriage stressful to Indian women rather than protective as portrayed by Western studies.[²]

The age group of 18 to <30 years and persons of 30 to <45 years of age accounted for 34.5% and 31.7% of total suicides, respectively. A significant proportion of these individuals were students. As many as 13,039 students died of suicide. The highest percentage of suicides consistently occurring in the young, productive population of the country over the years calls for serious action from the Union and the State governments.

When we take a look at the economic status of the suicide victims, 64.2% (1,05,242) were having annual income of less than Rs. 1 lakh. This income bracket has consistently contributed the highest percentage of persons who die by suicide every year.

Once we look at the overall picture, the areas of concern include financial problems, suicide in young adults, daily laborers, and marriage-related stressors in women victims. Thus, policies focusing on the economically marginalized section of the society should be an area of major focus if we need to bring down suicide in this group. Employment generation and a stable source of income for daily wage earners, including a chunk of migrant laborers, could go a long way in reducing suicidal deaths in this group. Academic failures and relationship issues dominate the causes of suicide in the young. Other causes reported in literature include substance abuse and impulsivity. Introduction of supplementary exams in schools in Chennai was shown to be successful in reducing suicides in schoolchildren. A similar model could be adopted in other parts of the country. Regulation of sale of harmful pesticides has shown initial favorable outcome in Kerala in terms of reduction of suicide rates.[³] Likewise, provision of safe storage of pesticides has been found effective in Tamil Nadu and can be followed across the country.[⁴] Policies regarding regulation of sale of alcohol to minors must be framed and properly adhered to. Strict implementation of such policies could go a long way in preventing suicides in the young student population. Untreated mental illness contributes no less than half of suicidal deaths in the country. Efforts to reduce the mental health gap should be carried out at all levels. Training of general physicians in mental health and suicide prevention could be one of the most effective ways for increasing detection of suicidal behavior at the level of physicians and ensuring proper referral and treatment. Finally, the country needs a well-designed national policy on suicide prevention to ensure that all these evidence-based prevention methods come in force at all levels: country, state, districts, cities, towns, villages, and the entire community. Reduction of death from non-communicable diseases and promoting mental health is one of the targets of the World Health Organization’s (WHO’s) Sustainable Development Goal on “Good Health and Well-being” to be achieved by 2030 and India is a signatory to these global goals. Suicide, being one of the highest contributors to deaths from non-communicable diseases, a national policy on suicide prevention is an urgent step in fulfilling India’s commitment to health in general and mental health in particular and towards fulfilling WHO’s Sustainable Development Goals.