Suicides are a growing reality of our society. In the recent years, research has revealed suicide to be the 8th highest killer in the world. According to statistical data, 90% of those who commit suicide have an undiagnosed, untreated or partially treated psychiatric condition at a root cause. The number of suicides that we see around us has undoubtedly increased. In fact the rates of suicide have quadrupled over the last couple of decades in the adolescent population. Our social fabric is changing, with reduced support systems, smaller family sizes, less peer group interactions, making loneliness a lived reality for many in the world.
The decriminalisation of suicide in the National Mental Health Act is a welcome step. Given the backdrop of the medical psychiatric conditions that typically precipitate the thought and attempt to commit suicide, it is a necessary first step in moving towards taking a collective and preventive approach to suicides in the country. In the past, the stigma that surrounds mental health problems and the humiliation many have had to endure on account of the illness made treatment seeking a difficult step. However, the decriminalisation of suicide provides an affirmation towards seeking help for mental health problems.
We now need to work collaboratively to create an environment which destigmatizes suicide further, encourages help seeking, and also provides for supports within the community to enable the said help seeking.
First and foremost, we need to take steps to talk about mental health problems and create awareness about them within the community at large. Increased sensitivity of the general population when people are aware of the challenge of mental health problems for those affected by them can go a long way in supporting identification, help seeking and treatment for them. There is a need to create a sensitised community that can respond effectively to the mental health needs of its citizens.
We need to encourage people to seek help if they are struggling with a problem. If an individual is mentally healthy and has the requisite coping strategies in place, the likelihood of committing suicide in the face of challenging circumstances is remarkably reduced. There is ample evidence to support the efficacy of mental health treatment in reducing thoughts of and attempts at suicide. This help does not always have to be professionally driven. In fact even reaching out to a friend or family member, who can appropriately provide support, without being dismissive of the issues being faced, can be helpful. Seeking professional help from a psychologist or a psychiatrist will always be beneficial.
We need to create strong social support systems and networks to help fight the challenge posed by urban loneliness. This aspect has been a cause of greater isolation of those challenged by mental health problems. It has also been responsible for more urban youth being susceptible to experiencing loneliness, which impacts moods, increases anxiety, reduces coping abilities and resources and can be a potential cause for someone to not want to live.
Given the paucity of experts in comparison to the population numbers that we have, we need to look at creating avenues for training more individuals to be able to diagnose and manage some basic mental health related conditions. Training general practitioners to anganwadi workers, social workers, NGO volunteers, nurses and other allied professionals is going to be a key step in moving towards preventing suicides. An effect method would also be engaging in PPP (public-private-partnerships) in key areas pertaining to mental health to increase outreach and have cost effective models in place.
It cannot be over-emphasised that suicide be recognised for what it is and we create measures to manage crises. It is the resultant of a mental health problem or that of inadequate coping abilities to manage a stressful situation. In such a scenario it is important to recognise that suicide does not occur because a person is weak or does not have will power or is not serious about resolving his issues. If in the moment of crisis help is available immediately it can help create an intervention. Helplines run by many organizations can play a critical role in this aspect of prevention.
Finally, the role media can play in creating awareness and sensitization cannot be overemphasised. Utilising media to encourage people to seek help in the face of a mental health problem is a big step towards solving the problem of suicide. To prevent suicide, the nature of reporting of suicides in media should be looked into alongside giving information about the helplines available for help for those in a crisis. Role models and celebrities in the areas of sport, entertainment, radio, television, to name a few, need to lend their voice to supporting people who may struggle with mental health problems and also encourage people to seek help.
Decriminalisation of suicide is, no doubt, a big step and one that needs to be supported by creating the right foundation for helping people who have mental health problems and who may not have the right resources, both in terms of abilities or coping strategies and the right people to help them tide over their circumstances. A joint collective effort, bringing together various stakeholders, bridging gaps through the utilization of a PPP model can be strong steps in this direction. We can also look towards making a policy around suicide prevention.
Author: Dr Samir Parikh