Suicide Prevention: What if No One Answers the Last Call You Make?

Knowing mental illness is treatable and hence, some deaths, preventable and not doing anything is almost criminal.

FIT investigates the state of some of India’s top 24*7 suicide prevention hotlines.

(Photo: iStock, Altered by FIT)

(This story was first published in September 2017. It is being republished ahead of the World Suicide Prevention Day on 10 September. The Quint has created an updated list of functional suicide prevention hotlines; you can find them here.)

In June 2018, US celebrity chef Anthony Bourdain, host of CNN’s food-and-travel-focused ‘Parts Unknown’ television series, hanged himself in a French hotel room, reported CNN. He was 61.

Now sample this:

• Every 40 seconds someone in this world commits suicide.
• A study finds that in 87.3% of suicide cases, the deceased was suffering from a diagnosable, treatable mental illness.
• One in every four persons will have some form of mental illness at some point in their life.

What, then, will it take for us to acknowledge suicide as a public health issue?

On World Suicide Prevention Day 2018, FIT investigates the state of some of India’s top suicide prevention hotlines.

What has suicide got to do with mental illness, you say?

Over 800,000 people across the globe kill themselves each year, with the last recorded figure being 1,31,666 people committing suicide in India in 2014, according to the National Crime Records Bureau (NCRB). Its notoreity for under-reporting suicide – especially by farmers – data aside, even going by its numbers, 15 people took their own lives during each hour of 2014.

And, while mental illness is by no means the only cause of suicide, its significance as a causation of suicide can not be stressed more. Given how only 1 in 10 people in India receive evidence-based treatment for the several types and degrees of mental illnesses, the sheer number of Indians at risk is mind-boggling.

The Damage Until Now

In 2014 in India, 18% of all people who committed suicide suffered from a type of mental illness. It was the second largest cause for it, and that, when suicide due to substance abuse/addiction was categorised separately, having a 2.8% share.

The crux of the matter is this: mental illness is understandable, diagnosable and easily treatable and hence by logic, several hundred thousand lives can be saved.

According to the most recent data quoted by the Union Minister of Health last year – further quoting a 2005 governmental study, mind you – almost 70 million people in India have varying severities of mental illnesses. It’s been awhile since 2005, things are admittedly a lot more stressful. In fact, an estimate suggests that in 2012, India had approximately 44 million people suffering from depression alone.

Estimates suggest that in 2012, India had approximately 44 million people suffering from depression. Representative photo only. (Photo: iStock)

Margin of Error 

India was declared the hip, new Suicide Capital of Southeast Asia by the World Health Organisation (WHO) in 2012 with the most number of deaths by suicides that year: 2,58,075. The NCRB reports the figure as 1,35,445 suicides that same year. This, when you don’t consider how seeking help for mental health, is not the first or the most feasible solution for millions of Indians.

Where We Stand: In Rising Waters

While the Indian government has, in all honesty, made small but confident steps towards providing better mental health care facilities, there’s an arduously long way to go; but go, we must.

Our National Mental Health Program (NMHP) has seen several upgrades, recently in 2003 with the modernisation and upgradation of mental hospitals and psychiatric wards, and then in 2009 with the manpower scheme.

But here’s the much-needed reality check: There are currently only 0.2 psychiatrists per 100,000 people in India.The District MHP is barely managing to keep its neck above the water: 40% of people have to walk 10 kilometers or more to access mental health care; 60% of people go to district hospitals and not primary health care centers where the state-run psychiatric clinics actually are. It still does not have a toll-free, 24*7, government-run suicide helpline with trained counsellors and volunteers. In fact, the words “helpline” or “hotline” or “call” don’t feature in the MNHP at all.

The Need for Something as Basic as Crisis Helplines

Suicide prevention hotlines in India are run by NGOs and public charities, with a recent, applaud-worthy branching into special crisis helplines for vulnerable persons such as members of the LGBTQ community. To assess the state of the current suicide prevention model available, The Quint called some of India’s top 24*7 suicide hotlines.

Only three of 10-11 calls were received by someone on the other end, of which one refused to believe one could be bullied for being fat, another didn’t quite understand the why behind symptoms of depression, while the third volunteer did actually check all of the boxes a suicide hotline should. 

Counsellors in helplines are trained to listen to at-risk and under stress people, and to not judge at all; their phone calls can be the difference between life and death for many. (Photo: iStock)

These helplines are riddled with a chronic shortage of funds and more importantly, manpower. Mostly volunteer-run, these organisation come face-to-face with the gripping stigma around mental illness and suicide because of which people in India don’t even entertain the notion of volunteering at a suicide prevention call center.

Suicide helplines have been acknowledged all over the world as a best practice in mental health care. They not only play a crucial role in the intervention of suicide, but their safe, anonymous nature makes them the venting point for millions and more increasingly burdened by love, competition, work, money: people with suicidal thoughts, students dealing with exam stress, couples dealing with marital problems, old people dealing with loneliness.

With statistics of such gory magnitude staring down at us, it is rather difficult to defend the pace of our community-engagement on issues of mental health and suicide. While the two are not related absolutely, engaging with one issue hugely impacts the other; both have to necessarily be engaged with, on this, there is no compromise. Not acknowledging suicide as a public health issue and further, not participating in removing the stigma from mental illnesses, knowing they’re treatable –hence, some deaths, preventable – is almost criminal.

Also See: The Quint’s Documentary: Why Does Kota Kill?

Camerapersons: Vanshika Sood, Coral Ghosh
Editor: Kammaljit Kainth
Producer: Divya Talwar

(If you have suicidal thoughts, or if you know someone who needs help, please refer to this state-wise list of credible mental health professionals.)