Events & Issues

New Delhi, 12 July 2017

Preventing Suicide

HUMAN, NOT TECH INTERVENTION

By Dr S Saraswathi

(Former Director,  ICSSR, New Delhi)

The use of smart phone apps for suicide prevention, ever since the launch of iBobbly in Australia, is receiving attention in India which is identified as one of the top suicide capitals in the world. Some believe that technology will help as in other branches of medicine and provide support strategies.

The rapidity with which suicide ideation and risk are growing everywhere including India has intensified the need to introduce some instant intervention techniques for prevention and cure of the malady. It has become so common that a school teacher in the UK is reported to have asked 60 teen-age students to write a suicide note for home work. In Australia, the app is said to be specifically targeting young people in Aboriginal communities.

In India, three categories of suicide cases are found – one, financial and employment related causes; second, concerned with age-related adolescent and youth problems; and a third caused in domestic settings and mostly pertaining to women.

About 45 years ago, a study by the WHO found that suicide was one of the major causes of death in the West, but at that time the rate of suicide was not high in India. Only some young men and women driven by unemployment, unhappy marriage, or failure in love affairs or extreme poverty developed suicidal tendency. The over-all situation remaining static, by the beginning of this century, South India earned the reputation of being the “world’s suicide capital”.

The British medical journal Lancet reported in 2004 the findings of a study by doctors at the Christian Medical College at Vellore in Tamil Nadu on teen-age suicide that while global rate was 14.5 per 100,000, the rate in Tamil Nadu was 148 per 100,000. In 2013, the Lancet Commission found that suicide was a leading cause of death among youth in 15-24 age group.

It is estimated that currently about 800,000 people commit suicide worldwide and 17 per cent of them are residents of India. The National Crime Records Bureau (NCRB) reported 131,666 cases of suicide in 2014. Its report for 2012 has given break-up of causes of suicide in percentage as – family problems (25.6); illness (20.8); drug abuse or addiction (3.3); failure in love affairs (3.2); bankruptcy or sudden economic loss (3.1); poverty (1.9); other causes (26.5); and the rest unknown causes. The Mental Health Division of the WHO took up the issue of suicide in India to tackle the causes of social distress.

In an environment that is fast growing complex and competitive, the chances of youth getting affected by depression more than adults is also growing. The age-group 15-29, unable to continue the life pattern of the earlier generation, and unprepared to adapt to changes is the most vulnerable group.

Ancient Indian historical and religious texts have some reference to suicide in varied contexts. It is considered as a sign of valour to avoid shame and disgrace. Suicide for selfish personal reasons is disapproved in the Gita. Vedas allow suicide for religious reasons by fasting as a path to “moksha” (liberation from cycle of rebirth). In medieval historical period, “sati” (entering the funeral pyre of husband by the wife), and ‘jahuar’ (suicide by women to avoid humiliation at the hands of victorious Muslim invaders) were practised in Rajasthan.

Under Section 309 of the Indian Penal Code framed by the British Government, attempt to commit suicide was originally an offence punishable with simple imprisonment up to one year or fine or both. In 2008, the Law Commission recommended de-criminalisation of suicide attempt   on the basis that it requires care and treatment and not punishment. With many of the States agreeing with this contention, Section 309 was struck down by the Mental Health Care Bill passed in 2017. The law now presumes that unless proved otherwise, attempt at suicide is a case of “severe stress”.

In our own times, voluntarily taking away one’s life by fast unto death is practised as part of religious ritual among some Jains known as “santara” among Swetambara Jains and “sallekhana” among Digambars. It was banned by the Rajasthan Court in August 2015, but has been permitted by the Supreme Court on appeal.

Suicide involves personal, social, and health factors. Its prevention cannot be achieved solely by public health strategies, screening at-risk individuals, applying targeted interventions, and continuing follow-up of survivors.

In India, the very topic of suicide today brings forth farmers’ suicide reported daily in newspapers. Debt-ridden farmers and weavers, unemployed and under-paid workers carry and spread the suicide virus thus emphasising the economic factors behind the growing number of suicide cases though statistically they constitute a small portion of total suicide instances.

It is under such conditions, development of information technology has created new opportunities and tools for suicide prevention. Tech-based programmes include interactive education and social net-working web-sites, e-mail outreach, and programmes that use mobile devices and texting.

To look upon suicide as a mental problem and seeking clinical, psychological remedies is one aspect of handling suicide. The treatment here is individual. But, a cursory survey of cases of suicide in India even by a layman may point to the predominant presence of social inadequacies and positive human impediments encouraging suicide mentality.

Farmers’ families committing mass suicide are driven by economic privations; untimely death of young women are caused by domestic cruelty; stress of the educational burden to cope with competition breaks the minds of students; unemployment drives youth to lose hope in life.

Indeed, behind every case of suicide, more social than any other factors seem to be present. We, therefore, have to go back and re-read Emily Durkheim’s (1858-1917) famous sociology of suicide which is relevant even after more than a century despite incredible changes in life to explain current suicide cases in India.

For, suicide is a social phenomenon related to social conditions and relationships. It is likely to occur where social ties are weak between individuals as friendly humans and are strong collectively as restrictions to individual freedom and social change. Personal failure in life leading to suicide is an instance of the former. Persecution by vague concepts like social honour leading to suicide is an example for the latter.

Modern society being highly individualistic and dangerously alienating, there is need to strengthen healthy social ties of friendly nature. It requires on the part of every member of a society a strong sense of understanding, tolerant disposition to diverse ideas, and readiness to accept deviance as normal and healthy for a society.

As in the days of Durkheim, suicide is a result of lack of adaptation to changing society. It is a question of mismatch between individual and society. And it occurs as a group mania or a contagion where a number of people fail to counter common problems.

Interventions by technological tools to fight suicidal tendencies may be helpful in cases of personal adjustment problems. But mass suicide committed by farmers and weavers facing financial crisis cannot be treated by technology. So also, student suicides, even though they are individual cases in different places need social (in this case academic) intervention to address the problems. It is, therefore, necessary to deal with suicide as a social problem emanating from social-economic conditions. The remedy lies in human and not technological intervention.--- INFA

(Copyright, India News & Feature Alliance)