stigma

170,000

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– the number of suicides in India every year. India holds the top position in the world in very few things. This is one of them. Of these deaths, more than 40% are under the age of thirty. Both these facts possibly underestimate the problem due to poor data collection, criminalisation of suicidal attempts, inefficient registration systems, lack of medical certification of deaths and biggest of all, stigma. Every eight minutes a young Indian person dies by suicide. Year on year, the rates are rising by 4-7%.

The incidence of student suicides surpasses population growth rates. Over the last decade, the number of student suicides increased from 7,696 to 13,089.

Source: A report released on Sept 10th 2024: Student Suicides: an epidemic sweeping India.

Today, to mark World Mental Health Day, a brave young lady, Jayeta Biswas, published an article remembering her brother, Jayanta. Aside from revealing some shocking statistics, it lamented the seriously negative societal attitudes towards poor mental health and suicide in India:

“A home that was always filled with visitors when my brother was alive saw no one from his school, college, professional life or network after his departure. None of his friends, including those he had contacted in his last hours – attended his funeral, nor did they visit our house. I am certain that this is because they heard that he died by suicide.”

We have a long way to go as a society but small school initiatives such as SEHER give me hope.

Ordinary people

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Once upon a time there was an ordinary person. Making a living, being honest, spending time with the family, having a few friends and simple pleasures. Nothing special. Just ordinary.

Then they lost their child to the monster of unbearable pain. They carried on breathing and giving and receiving love. There was nothing ordinary about that. They couldn’t bear the thought of the same thing happening to anyone else. So, they went out to tell the stories of their angels to everyone. To exhibit the smithereens of their bleeding hearts. That was not easy or normal but they did it anyway. To say that there were other options that they wish their kids had been encouraged to explore. To give out the phone numbers of the good people out there who can help. To remind everyone that there was hope. There is hope.

These 3 dads were ordinary people. Now they are walking together for 300 miles over 2 weeks, making waves all over the country, connecting with people, smashing the stigma and sharing the stories of their lovely girls. Ordinary and beautiful. Just like you.

Please listen and take a look at what’s possible when love speaks and acts.

India – talking Mental Health.

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Asian countries account for more than 60% of world suicides.

According to the WHO, in the year 2016, suicide was the most common cause of death in the 15-39 age bracket in India, the highest in the South-East Asian region. India’s own official statistics, which map the number and causes of suicides in the country, have not been made public for the last three years, hindering suicide prevention strategies and efforts to implement the WHO’s recommendations in this regard.

In 2014, the WHO released a report with a series of recommendations for successful suicide prevention. It proposed a public health model for suicide prevention, consisting of four steps:

  • Surveillance
  • Identification of risks and protective factors
  • Development & evaluation of interventions
  • Implementation

India has not progressed beyond the first step. Lack of political will, social stigma and inadequate mental health awareness in the general and medical communities contribute to the continuous rise in the death rate of young people by suicide in India.

A Junior Doctors World Congress was held at my alma mater, Christian Medical College Ludhiana in April 2019. Si and I ran a Mental Health Workshop that was attended by 75 medical students from India and the wider South and South East Asia region. 

Motivated by this event, some students have established community mental health support networks and mentorship programmes at their respective institutions.  I am impressed with their passion to make a difference.

Here is an example:

Early March I was back in Delhi and was honoured to be invited by Shruti Verma Singh, the founder of a Youtube channel, Zen-Brain.com. She is determined to increase the emotional awareness in India and does it gently, through a series of interviews. We met one afternoon to talk about Saagar. I hope her work will help wake up the government, break social stigma and drive understanding and compassion.

Our own voices

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Paramedics and trainee paramedics rotate through our Department of Anaesthesia to learn to manage airways safely. A few weeks ago, I had a young man in his mid-thirties, a trainee paramedic with me, learning about airway management. Out of curiosity I asked him, “What is the most annoying part of your job?” He was straight-up, “When people inflict injuries on themselves, I think it’s such a waste of time. It takes away from others with real problems, who really need our attention.” I just smiled. I wasn’t surprised. I know full well that paramedics do a great job of looking after all kinds of people in all kinds of trouble. But attitudes can only be changed through education.

A professor of Psychiatry tweeted today “Twice in the last week I’ve been told of cruel comments by health staff to people who had self-harmed. I really believe this is unusual now but it shows there is something deep-rooted that we have to eradicate.” A classic example of ignorance within medicine of attitudes within medicine.

No training of first responders is complete till someone with lived experience of a mental illness has spoken with them, be it a police academy, social workers, fire fighters, nursing or medical students or ambulance crew. Lived experience includes suicide attempt survivors, others who have experienced a suicidal crisis and those who have lost a loved one to suicide. Sharing by these individuals can be a powerful agent for challenging prejudice and generating hope for people at risk. It enriches the participant’s understanding of how people with these serious disorders cope with their symptoms, recover and lead productive lives with hope, meaning and dignity. The program also empowers those who are faced with mental illness and provides living proof that recovery is an ongoing reality. Presenters gain confidence and self-esteem while serving as role models for the community.

Disproportionate focus on research and clinical expertise too frequently fails to see the person at the centre of a crisis as well as their loved ones who ride the wave of terror of suicidal behaviour. This needs to change and with urgency.

Lived Experience is an underutilised and underappreciated resource in the UK.

Roses in the ocean, a charity in Australia is an excellent example of harnessing this invaluable resource and making a huge difference.

Shauna’s Mum says

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” A schoolgirl’s been murdered in our area. It’s a horrible, horrible thing to happen – never should have and is just another reminder of this shit world we live in. I’ve been trying not to follow the news on it but they released CCTV footage of her last known moments and it was actually somewhere my brother drives past on the school run four times a day so I did watch it all and check the timings to just make sure he wouldn’t have been there and possibly seen something. (Different time of day)

I’ve just been struck by how it’s pulled the community together. There’s been balloon releases, marches, leaflet drops – the mum is clearly being very much supported ….I couldn’t find one person willing to have a cup of tea with me; three years on I still can’t. And I know suicide is different. Murder is evil; what was done to this poor girl, there’s absolutely no doubt people should be outraged by it…and I know suicide is about making a decision – albeit a stupid and flawed one…. but there are things I don’t understand why they’re quite so different.

The Head teacher of the girl’s school implored students to come forward because answers were needed. We needed answers with Shauna and anyone at her school who knew anything got told it wasn’t an appropriate thing to discuss. We even had a girl go to her teacher with some information, get told off for it and then to choose to write independently to the Coroner’s Court (with info we found hugely relevant but was promptly disregarded.)

Today the girl’s school announced that they’ll be making a memorial garden for her with lots of nice words about there always being a place for her and her never being forgotten. Shauna’s name wasn’t even allowed to stay on the Year 11 hoodies. The gesture is nice but the words; it would have made such a difference to us if someone had said stuff like that to us.

There was just both girls of a similar age and it’s just really brought it home how differently people see these things. I’m glad this Mum has the support that she so desperately needs, I don’t begrudge her it – I just wish it wasn’t so glaringly different how people reacted – this Mum is a heroine because of what she’s had to endure, we’re just potentially neglectful parents who should be forgotten about/ignored 😦

I don’t know if I’m making any sense. Like I say I do understand it. It doesn’t stop it hurting though. 😦 “