There is need for someone who will listen and understand
India has one of the highest rates of youth suicide in the world, and has the highest suicide rate in countries across Southeast Asia. About 800,000 people commit suicide worldwide every year, of these 135,000 (17 per cent) are residents of India. A third of the suicides in India occur in the age group of 15-29 years.
Today, suicide is an epidemic that plagues India. The stress of changing lifestyles is making the population more vulnerable to depression and/or suicidal action. It is important to take cognisance of the fact that when one person commits suicide, almost 6 people are affected directly and are at risk; thus making the act itself an antecedent to a larger cause for concern. Research suggests that almost 80 per cent of those who have lost a loved one to suicide may in fact feel suicidal during the course of grieving. The family is however at greater risk due to the stigma that engulfs suicide and mental health.
Some of the major contributors to this
- Growing incidence of mental disorders and depression: Conditions related to the brain and mind are acknowledged to be on the rise in recent times. This is probably due to the growing awareness in society, improved recognition, variations in disease patterns, changing lifestyles and biological vulnerabilities. Consequently, depression, anxiety, alcohol use, suicidal behaviour, drug use, sleep disorders and several others are on the increase.
- Shortage of mental health professionals in India: There is a huge gap in the number of available qualified mental health professionals in India vs the requirement. According to the Union ministry of health and family welfare the country needs 11,500 psychiatrists but has just 3,500. In a country where one student commits suicide every hour, according to National Crime Records Bureau, 2015 (the latest data available), the entire mental health workforce, comprising clinical psychiatrists, psychologists, psychiatric social workers and psychiatric nurses stands at 7,000, while the actual requirement is 54,750.
- Prohibitively high treatment cost: Due to the gigantic shortfall of mental health professionals in India, the cost of seeking mental health treatment is prohibitively high. This prevents a lot of people from seeking treatment. On the other hand, mental health professionals often complain of the absence of any proper regulation/licensing authorities.
- Stigma prevents people from seeking treatment: The number of Indians suffering from mental illness exceeds that of the population of South Africa. Current estimates indicate that nearly 6.5 per cent of the country’s population suffers from a mental illness. It is estimated that by 2020 this number will increase to a staggering 20 per cent. Further, the who estimates that nearly 57 million Indians suffer from depression. And yet, the social stigma and label attached to these illnesses continues to scare individuals away from seeking appropriate treatments.
- Currently, governmental support in India towards mental health is very limited: Unlike countries like the US, where the government funds mental health initiatives like the National Suicide Prevention Helpline, India still leaves a lot to be desired in this area. Indian Helplines are mostly run by independent ngos and colleges with limited financial resources, and sustained through independent donations and volunteers. At present, India spends around 0.06 per cent of its health budget on mental health. This percentage is even less than what Bangladesh (0.44 per cent) spends on mental health. According to a 2011 who report, most developed nations spend over 4 per cent of their budgets on mental health research, infrastructure, frameworks and talent pool. Last year, in his Mann Ki Baat radio speech, Prime Minister Narendra Modi urged Indians to talk about depression and seek help if needed but didn’t specify where to seek this help.
Suicide is a growing problem that needs urgent solutions.
- Making mental healthcare easily accessible by opening up of suicide prevention clinics in all the medical college hospitals, district head quarters hospitals, and if possible in taluk headquarters, as also in private hospitals, as well as opening up of special clinics such as de-addiction and marital counselling clinics in all the major hospitals, might help counter the factors arising due to substance abuse and family problems.
- Increasing awareness and de-stigmatising mental health disorders and suicide can be done through training. What would be needed is conducting educational programmes periodically for medical officers and paramedical personnel at hospitals. And through the Indian Medical Association
and other organisations sensitising those in
general practices, primary healthcare centres, especially in rural areas, for the detection and preliminary management of depression and other psychiatric conditions.
- Providing support to young people via student guidance clinics to be run by visiting psychiatrists not only to improve their psychological well-being, but also to enable them to explore their own potential to engage themselves in today’s world with immense avenues. Holding guidance sessions for parents in schools and colleges, revamping the educational system with an objective to promote holistic development of the child, rather than the undue emphasis on scoring of marks in various subjects, and opening up of employee guidance clinics in major industries is also vital.
India at present has a tremendous need for a strong suicide prevention policy which involves increasing acceptance of mental illness, sensitisation towards signs and symptoms, and ensuring that help reaches the person at the right time.
While many health issues receive regular corporate philanthropy, corporate support for mental health research, treatment and awareness efforts is uncommon, nearly non-existent. Businesses need to back mental health initiatives with funding and support. According to an Economic Times report, India’s top 200 companies spend around R1,369 crore on healthcare and wellness. About 24 per cent of the total spend on csr is focused on healthcare, but most of the funds are directed towards health camps, new hospitals or donating to existing government or private hospitals. A handful of companies like Bosch and Bayer India invest in mental health projects. Diverting increased csr funds towards mental health awareness and treatment will go a long way in building sustainable solutions.
Workplace stress should be tracked and managed. Organisations should take responsibility to create and maintain low stress work environments, and provide opportunities for employees to get help with stress management.
In recent years there have been both private and not-for-profit organisations working towards building awareness about mental health and its de-stigmatisation. There is Mpower, started by Neerja Birla, which looks at this aspect with a focus on adolescents, and the Live Laugh Love Foundation with Bollywood actress Deepika Padukone at its helm. However both organisations are focused on mental health and not directly involved with suicide. The Mental Health Foundation, an advocacy group, worked on a bill to pass the law against criminalisation of suicide.
The need of the hour is support groups for bereavement, which enables families to connect with other families with similar struggles. This holds true for other stressors that impact our society today. We Hear You is one such endeavour started by suicide beareavers along with Dr Pervin Dadachanji. Along with the support group, We Hear You aims to have a larger network of mental health professionals coming on board as resources, thus bringing the fraternity together to support bereaving families.
We Hear You aims to send the message of setting up support groups in workplaces, communities and within families to support each other who may be experiencing similar situations and can find ways to move ahead by peer support by just knowing they are not alone, and there is someone who will listen and understands.