Why a young Indian dies every 8 minutes and the ‘communicative act’ behind the crisis; insights from ‘Young Lives Matter’ project

These are a few personal stories from people who survived a suicide attempt and were included as part of the unique ‘Young Lives Matter’ project in Pune. Published in SSM-Mental Health and BMC Psychiatry, the incidents provide a rare and vital look at the process of a crisis before it becomes fatal.

The Wellcome Trust-DBT India Alliance-funded project led by Madhumitha Balaji from Sangath, in collaboration with Dr Smita Panse and Dr Manjit Santre from the Pimpri Chinchwad Municipal Corporation’s (PCMC) YCM Hospital in Pune, moved beyond the simple explanation of ‘mental illness’. The project identified eight factors, such as low socioeconomic status, impulsivity, infrequent social interactions, negative life events, and relationship difficulties involving partners or family, as significant risk factors for the suicide attempt.

The project interviewed young survivors at YCM Hospital, Pimpri. Less than half the young survivors had clinically significant depressive or anxiety symptoms; instead, socio-cultural norms and interpersonal conflicts were dominant.

“Many research studies are from other countries, leaving a knowledge gap about why young Indians are struggling,” Balaji explained.

“These qualitative and quantitative studies explored personal stories of young suicide survivors as well as assessed risk and protective factors by including comparison subjects,” Balaji, a public health researcher, currently pursuing her PhD at Maastricht University, told The Indian Express.

The lead researcher of the project explained that the primary contribution was highlighting important social issues as being as important as mental illness, unlike findings from Western countries, which suggest that over 80 per cent of suicidal behaviours are caused by mental disorders.

“There is a range of factors associated with suicide attempts in young people in India, which calls for a multifactorial approach towards suicide prevention,” Balaji said. By identifying eight such factors, the project provides a holistic risk profile specifically for Indian youth.

“A primary finding was that relationship difficulties involving partners or family were a significant risk factor for the attempt. Abusive romantic or marital relationships and dysfunctional parenting characterised by frequent arguments, excessive control, and conflicting needs and expectations were major problems,” Balaji added.

While feelings of depression and anxiety were often present, they were usually reactions to the stacking of negative experiences, she said.

“Coming from a lower socio-economic background was also a major factor; it wasn’t just about the money- it was about the social adversities and limited choices that come with financial hardships. Interestingly, alcohol use was found to be a risk factor only for young men,” Balaji added.

Study authors include Arjun Shah, Kavita Mandhare, Kalyani Nikhare, and Prajakta Kanhare (previously at Sangath), Vikram Patel (Harvard Medical School), Lakshmi Vijayakumar (Sneha Suicide Prevention Centre), Soumitra Pathare (Centre for Mental Health Law and Policy), Michael Phillips (Shanghai Mental Health Center), Thomas Krafft, Katarzyna Czabanowska, and Genc Burazeri (Maastricht University).

The research provides a potential “pathway” to the attempt from ‘vulnerability to action’ and suggests that for many youth, the attempt is not necessarily about wanting to die, but a communicative act.

“When young people feel their voices are unheard or their situations are stagnant (for example, being in a toxic relationship), the attempt serves as a desperate effort to force a change,” the study authors added.

Suicide rates in young Indian men twice global average 

Suicide is the third leading cause of mortality in young people worldwide, and in India, it has emerged as the principal cause of death in persons aged 15-29, surpassing fatalities from road accidents and infectious diseases. Rates of suicide in young Indian men are twice the global average (25.5 vs 13.1 per one lakh) and around six times higher (24.9 vs 4.1 per lakh) in young Indian women. India is home to the largest youth population with nearly 400 million people (15-29). Sadly, a young Indian dies by suicide every eight minutes. Pune has an estimated population of 6.8 million, 60 per cent of whom are below 30 years. Pune recorded 1,018 suicides in 2021, an increase of 38 per cent from the previous year (National Crime Records Bureau, 2021). Maharashtra is the third-largest state in India, with a population of 120 million, and recorded the highest number of suicides in 2021 in India (National Crime Records Bureau, 2021).