There is a need for urgent action to prevent suicides in India. This perspective was published in The Lancet Psychiatry.
India has the highest number of deaths by suicide in the world and its contribution to the global suicide rate has been increasing from 27.3% in 1990 to 36.5% in 2019.
The World Health Organization (WHO) has highlighted that suicide is a serious concern for India and the Indian Government is developing a national suicide prevention strategy. However, India is projected to fall short of its 2030 target of reducing the suicide death rate by a third.
In 2019, there were an estimated 85,900 women and girls and 109,470 men and boys who died by suicide, or 2.1% of all deaths. Compared with 1990, the rate of suicide has decreased by 40.7% among women and girls and by 22% among men and boys. Globally, the reduction in suicide deaths has been 31.4%.
However, India does not systematically collect data about causes of death. Currently, ~20% of all deaths are medically certified, making it likely that the suicide rate in India is under-reported.
The most common method of suicide in India is hanging, followed by ingesting pesticides, overdose, and self-immolation.
Among the population aged 15-39 years, suicide is the leading cause of death, accounting for 52.6% of deaths among women and girls and 47.4% among men and boys. Stratified by region, suicide deaths occur more frequently in the southern region, accounting for 3.0% of total deaths among women and girls and 3.3% among men and boys.
For every death by suicide, there are >200 people with suicidal thoughts and behaviors. The study authors projected that 5.1% of women and 4.1% of men had some level of suicidality in India between 2015 and 2016.
There is evidence that specific cultural and social risk factors contribute to the high suicide rate among women and girls in India, such as rigid gender-based roles and discrimination, early marriage, arranged marriage, young motherhood, domestic violence, and economic dependence. Throughout life, motivations of suicide among both men and women in India are reported as intergenerational conflict, interpersonal problems, physical illness, chronic pain, academic failure, substance use, abuse, sexual violence, and social isolation. In general, the contribution to the suicide rate due to severe mental disorders is lower than what has been reported in high-income countries.
Recommendations for reducing the suicide rate in India include increased access to alcohol treatment programs and expanded mental health programs, integrating mental health education programs in schools, repealing the Indian Penal Code 309 which criminalizes suicide attempt, bolstering laws for protecting women’s rights, better training for journalists about how to appropriately cover suicides in the media, and banning or reducing access to highly hazardous pesticides.
The high suicide rate in India is a substantial public health challenge and calls for immediate action, researchers wrote. A scaffolding approach across all domains that involves the community is needed to address problem areas and to save lives, the authors concluded.
L, Chandra PS, Kumar MS, et al. The national suicide prevention strategy in India: context and considerations for urgent action. Lancet Psychiatry. 2021;S2215-0366(21)00152-8. doi:10.1016/S2215-0366(21)00152-8