The National Crime Records Bureau (NCRB) in 2014 reported 50-60,000 youth suicide deaths each year. The Million Death Study (2012) said this figure underestimated true suicide numbers by upto a third: thus, the actual numbers may approach even one lakh deaths a year. Now, the Lancet Commission report, released in UK on Tuesday, reaffirmed the findings but the number of suicides among in the 10-24 years old age group is shocking.
The Global Burden of Disease Study 2013 (GBD 2013) includes an annual assessment covering 188 countries, from 1990 to 2013. The study covers 306 diseases and injuries, 1,233 sequelae, and 79 risk factors. This study provides a comprehensive description of the burden of disease for young people worldwide.
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It shows that injuries, mental health disorders, sexual and reproductive health problems are leading causes of morbidity and mortality in young people. In India, suicide was the leading cause of death among youngsters (10-24) years with 62,960 deaths in 2013. What is alarming is that 28.65 lakh youngsters (10-24 years) have suffered depressive disorders in 2013.
The health of young people (10 and 24 years) has emerged as a neglected but pressing issue in global development. Our knowledge of many risk factors is lacking in this age group, especially those associated with mental health. The major health and nutrition surveys have generally started from the age of 15 years (eg, household surveys) or in some instances, 25 years, with little data for the 10–14-year-old age group.
Many concerns about privacy in doing these surveys have been raised – this has reduced the extent to which sensitive information is collected from younger age groups. More recent school-based surveys, such as the ongoing Centre for Disease Control and Prevention’s Global School-based Student Survey (GSHS), have covered lower age group school attending children (ie, ages 10–17 years), but many young people who are out of school are not included. This is especially true of low-income and middle-income countries where retention rates, even for early secondary school, remain low. It is problematic because young people from poor backgrounds face higher health risks, George Patton and Ali Mokdad, lead researchers and author of the GBD study have said.
Young people face stress in terms of worrying about school performance, admissions to tertiary education, or securing a job and an income. We also have little information on how interpersonal relationships, social support, and loneliness affect young people says Sunil Mehra, executive director of MAMTA , a Delhi based NGO that works on women, adolescents and children. Mehra who is making a presentation to the parliamentary committee on the issue has now emphasised that the focus should be on mental health interventions and has suggested that Right to Education (RTE) in schools be increased from 14 to 18 years apart from addressing issues like child marriage and sex education.
The rapid and widespread changes in how young people conduct their social relationships through social media is another aspect of youth health that needs assessment. Also, stress related to perceptions of masculinity and femininity, or fear of sexual violence, for example, are very real for young people. These factors are usually not discussed by young people or properly addressed by their parents or health systems; however, they are key drivers for risky behaviour and can limit young people’s development. Dr Hamid Dabholkar, psychiatrist and the son of slain anti superstition activist Narendra Dabholkar feels unidentified and untreated depression, substance abuse, reduced family support due to changing family structures, emotional disturbances in friendship, career related dissatisfaction, dispute with parents could trigger the youth to take the extreme step.
In a recent presentation `The Loss of Hope’, one of the key researchers of the Lancet report and an international mental health professor, Dr Vikram Patel raises the first key question – why are the youth at risk? He tries to debunk myths like `youth behave the way do because of their hormones’ and `the brain has completed most of its development by middle childhood’. The fact is that the brain is `plastic’ well into young adulthood and the `front’ of the brain matures last as late as mid-20s. Patel says that it essentially means the youth are biologically `primed’ to behave the way they do.
Online pressures creating a nation of unhappy children, violence , psychological distress and the risk of suicidal behaviour in young people of India are just no longer catchy headlines but reflect how changes in adolescence lead to mental health problems and suicide.
A toxic social environment leads to vulnerability and impairs resilience. This leads to poor grades, despair, hopelessness and violence — even mental health problems.