(If you feel suicidal or know someone in distress, please reach out to them with kindness and call these numbers of local emergency services, helplines, and mental health NGOs)
“India has the highest number of deaths by suicide in youngsters. Across the world the largest cause of death in youth is road accidents, but in India, it’s suicide.”Dr Amit Sen, psychiatrist, Children First Mental Health Institute, Delhi.
Between 2016 and 2018, nearly 10,000 students died by suicide every year in India, according to data by the Human Resource Development Ministry.
This year, 4 NEET aspirants died by suicide in Tamil Nadu. Despite an ongoing COVID-19 pandemic and rising cases, the highly competitive entrance exam for medical courses was held in the state.
The NEET exam is a highly contentious topic, with many political leaders, parents, and students against the test and the undue stress it causes.
In an earlier interview, FIT spoke to Dr Soumitra Pathare, a consultant psychiatrist and Director of Centre for Mental Health Law and Policy at ILS, who explained that suicide prevention needs to be coupled with changes in education policy.
Here are some signs of suicide and how to help.
“We are looking at suicide in a very simplistic way currently. It’s great that we are talking about mental health, but suicide is an issue that is multi-sectoral. By this I mean that the causes and solutions for suicide go beyond just the healthcare industry.”Dr Soumitra Pathare
Some facts to clear the myths on suicide:
1. Suicide is preventable.
2. “Almost half of the people who die from suicide in India do not have any diagnosable mental health illnesses,” says Dr Soumitra Pathare, a consultant psychiatrist and Director of Centre for Mental Health Law and Policy at ILS
In other words, Dr Pathare tells FIT, suicide is not just a health or mental health issue.
Thirty-four years ago, Tamil Nadu achieved the unthinkable. With a simple change in the exam routine, they were able to cut student suicides by almost half.
Dr Laksmi Vijayakumar, founder of Sneha, India's premier suicide prevention centre, conducted a study that found that many students who died failed by 1 or 2 marks only. So a supplemental exam for students of class 10 and 12 could save lives. The Tamil Nadu government implemented this in 2004. “Since then the 4-450 student suicides due to exam failure dropped to 2-300 in Tamil Nadu. 215 students died by suicide in 2019,” says Dr Vijayakumar to The Sunday Times.
On 9 September, the Supreme Court declined to admit petitions seeking to defer or cancel NEET exams and instead said the authorities responsible will take all the required steps to conduct NEET safety in the pandemic, reported NDTV.
For almost 10 years, Tamil Nadu had abolished medical entrance exams due to student stress and instead admitted students on the basis of their class 12 marks alone. However, the central government has reinstated NEET.
What Causes Student Suicides?
“This is not just a problem with NEET. In almost all entrance exams in India, the competition is immense. There are too many people for too few slots. There is a lot of family pressure to get in. On top of that there is a lot of financial stress, the coaching, the hostel etc. to get through are often very expensive and for lower economic classes can be very tough.”Dr Sachin N., psychiatrist, NIHMANS
Dr Sachin adds that all these factors cause students to feel immense pressure and guilt. “They feel they are wasting or have wasted their parent's money, this adds to their negative self-esteem, hopelessness and worthlessness.”
This gets exacerbated in students who come from marginalised or economically lower classes.
Often students retake the exam multiple times owing to family pressure. “This doesn't help, it just increases their burden.”
These factors are worsened in students with existing mental health conditions. “We often miss the signs of depression and anxiety, that get compounded with these pressures.”
What Can We Do?
1. Moral support from families and teachers
Suicide is preventable and we need to normalise seeking help. Here, the family members must step in to prioritise well-being and life over academic pressures.
“Moral support from family, teachers and faculty is essential. They need to identify students who have issues, low markers and identify stressors. Gatekeeper training is a must, they can then identify vulnerable populations and cousel them.”Dr Sachin N., psychiatrist, NIHMANS
2. Gatekeepers can notice the signs and offer support
Gatekeepers can also reduce the myths associated with sucide. “Peope think, ‘Oh, suicide is weak, people who consider it are weak and attention-seeking.” This cannot be more wrong, numerous survivors and experts say that talking about suicide is a desperate cry for help.
“If a person has attempted suicide, they will likely try again if they do not get help. These people need support, not stigma,” says Dr Sachin, adding that their helpline does get a lot of students reaching out for help.
3. Better media reporting can increase awareness
Dr Sachin says it is the media’s responsibility to report sensitively and spread correct information. “After the death of Bollywood actor Sushant Singh, many people reached out and recognised their own problems.”
Of course, the insensitive reporting can also lead to copycat suicides, so reporting with care is essential to saving lives.
4. Seek help from experts
Talking and breaking the stigma is a huge first step, but suicide is a complex issue. “Counsellors and mental health practitioners can come on board to help and recognise the underlying issues. Talking is not always enough, it is a real medical issue just like diabetes. We don’t just tell a diabetic person to be strong right? Similarly, with issues like depression and heightened stress, we don’t just talk to the patients but also identify stressors, try to understand if they need social support, in-house care or medication - or a combination.”
5. Policy Changes
Of course, this can only work in tandem with structural, policy-level change.
Dr Pathare had previously explained an explain from a project called SPIRIT (Suicide Prevention & Implementation Research Initiative) which aimed to curb suicide deaths in rural India. One of the components of SPIRIT was YAM (Youth Aware of Mental Health) framework for 14-16-year youth in schools in Mehsana, Gujarat. YAM trains young adolescents to discuss issues that impact their mental health, how to articulate their experiences of distress, coping strategies to deal with distress and suicidal ideas and ways of reaching out for help.
While encouraging students to speak up is imperative, the demand for mental healthcare must also be met by providers. This means we need accessible, affordable mental healthcare
(At The Quint, we question everything. Play an active role in shaping our journalism by becoming a member today.)