written by Surjith Karthikeyan
Suicide is a common phenomenon all over the world. According to the World Health Organisation (WHO), every 40 seconds there is someone in the world who ends his or her life. The majority of the suicides are related to psychiatric problems or mental illness. Various types of mental illness include inter alia anxiety disorders, psychotic disorders, mood disorders, substance use disorders, personality disorders, and eating disorders. The other related reasons may be emotional issues, weak religious beliefs, family issues, disability, etc.
Anxiety disorders are a part of mental disorders characterised by significant feelings of anxiety and fear which may result in problems of serious concern in their areas of life, such as social interactions, school, and work. While psychotic disorders are severe disorders that cause abnormal thinking and perceptions that mainly affect the mind; mood disorders primarily affect a person’s emotional state, characterised by severe changes of a person’s mood (example, depression, bipolar).
Substance use disorder (SUD), also known as a drug use disorder, is the continuous use of drugs (including alcohol) despite substantial harm and adverse consequences.
Personality disorder, on the other hand, is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causing distress or problems functioning, and lasts over time.
An eating disorder is a mental disorder defined by abnormal eating habits that negatively affect a person’s physical or mental health.
According to various studies, 20 million women and 10 million men in America have an eating disorder at some point in their lives.
Crude suicide rates across world regions
Globally, the suicide rates are decreasing, from 12.9 per 100,000 people in the year 2000 to 10.6 per 100,000 people in 2016. It is decreasing in all the regions except Americas where it has increased from 8.3 in 2000 to 9.3 per 100,000 people in 2016.
The rates are generally high in the Europe region where it has reduced from 21.8 in 2000 to 15.4 in 2016. Eastern Mediterranean is the region where the suicide rates are generally low compared to other regions. It needs to be explored whether the same is due to under-reporting in this region.
India is included in the Southeast Asia region where the rate has reduced from 14.3 in 2000 to 13.2 in 2016. The figure below represents changes in the crude suicide rates (per 100,000 people) in WHO region from 2000 to 2016.
Crude suicide rates across countries
The crude suicide rates are the highest in Lithuania to the tune of 31.9 per 100,000 people. India is in the 21st position among the WHO member countries with the highest number of suicide rates in 2016. The other highest number of suicide rates is in the Russian Federation, which has the second highest number, followed by Guyana, Republic of Korea, Belarus, Suriname, etc, as shown in the figure below which represents the countries having high crude suicide rates per 100,000 people in 2016.
The developed countries with worst suicide rates are in France, Switzerland and Japan. In Lithuania, suicide rates are widely prevalent among the rural communities, and the weather there is extremely cold as also rainy all over the year. The alcohol consumption among the people is also high in this region. This country has separated from the Russian Federation and people here had suffered during the oppression which was due to this separation. The alcohol consumption indirectly leads to the deterioration in the living conditions of the people and thus the whole families in this region are affected due to this issue leading to extreme poverty in this region ultimately leading to increase in the number of suicides.
Crude suicide rates in India
The changes in the suicide rates in India for the last few years, especially from 2000 to 2016, lead one to interesting conclusions. As per the global trend, in India also, the crude suicide rates have decreased from 17.4 per 100,000 people in 2000 to 16.3 per 100,000 in 2016.
The sex distribution of the same reveals that it is higher for male compared to female. It is 17.8 in 2016 compared to 18.6 in 2000 for males and 14.7 in 2016 compared to 16 in 2000 for females.
This trend is also similar to the global trend. The figure below represents the changes in the suicide rates in India for the last few years especially from year 2000 to 2016, showing an irregular declining trend. As suicide is also a complex phenomenon, many of the same may not be fully reported, which may further increase the above figures.
The figure below represents the crude suicide rates (per 100,000 people) in India (10 year age groups) in the year 2016. In the age distribution, the suicide rates are high for the age 20-29 years (30.3 per 100,000 people) and 80+ years (24.5 per 100,000 people). The suicide rates are lowest for the age 10-19 years. As the age exceeds above 20-29 years, the suicide rates also decreases.
After 60-69 years, the crude suicide rates also increase. This is understood to be the general trend across the world. The reason may be the fact that 20-29 years is the crucial period which determines the life of a person and if a person is unsuccessful during this period, he may resort to alcohol and drug intake resulting in death of that person. Also, 70-79, 80+ years are the time in which a person is unable to do any work and may suffer from depression and it may further worsen if his children are not there to look after him.
Prevention and remedies
Suicide is one of the major healthcare problems and thus should be given much importance. Studies reveal that suicide is one of the second leading causes of death during the second and third decades of life. The same can partially be prevented by limiting accessibility to suicide means.
The World Suicide Prevention theme of this year is “Creating hope through action”. The suggested measures for suicide prevention include reducing the treatment gap for mental disorders, increasing the availability of mental health personnel, reducing the discriminatory attitude of health workers, promoting mental health infrastructure which involves mental hospitals, mental health units in general hospitals, mental health outpatient facilities, mental health day treatment facilities and community residential facilities. More counselling facilities especially in the rural areas, tele-medicine, internet and telephone-based helpline numbers, developing mental health apps are other aspects which may be considered.
A roadmap for mental health awareness may need to be created, encompassing conventional media, government programmes, educational system, industry, internet, social media and cell phones, and crowd-sourcing.
The writer serves as Deputy Secretary, Ministry of Finance. The views expressed are personal.