Opinion Express View on suicide prevention: Pull back from the edge

In the alleged death by suicide of a 21-year-old student at IIT Guwahati — a month after a 23-year-old was found dead in her hostel room at the institute — is another grim reminder of a looming public health crisis. The numbers tell a sobering story: According to data from the most recent National Crime Records Bureau (NCRB) report, 1.71 lakh people died by suicide in 2022. At 12.4 per 1,00,000 individuals, it is the highest ever rate recorded in the country. Globally, the number stands at a stark 7,26,000 people. That the widely-prevalent medical model is not sufficient to tackle this worldwide crisis has long been flagged by health professionals and suicide-prevention bodies. Their claim is now backed by a study, published as a six-part series called “A Public Health Approach to Suicide Prevention”, in The Lancet Public Health. It calls on policymakers and governments to consider the larger causes that can drive people over the edge.

The conventional framework for suicide prevention has typically focused on individual risk factors such as family history, mental ill health, drug and alcohol use. This is the approach taken by India’s National Suicide Prevention Strategy, unveiled in November 2022, which laid out three objectives: One, establishing surveillance mechanisms for suicide; two, setting up psychiatric outpatient departments that will provide suicide prevention services and three, integrating a mental well-being curriculum in all educational institutions. What such an approach fails to account for, as the Lancet study points out, is the role played by social determinants, such as macroeconomic policies, healthcare coverage and social and cultural values, and commercial determinants like the alcohol and firearm industries, in exacerbating tendencies for self-harm. This, in turn, means thinking about suicide prevention on a larger scale, relying not just on targeted interventions, but considering how policies, such as those aimed at poverty alleviation or reducing homelessness, might help. In the US, for example, it was found that a one dollar rise in the minimum wage between 2006 and 2016, resulted in 8,000 fewer deaths by suicide per year.

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According to NCRB data, as many as 154 farmers and daily-wage labourers died by suicide everyday in 2022. In the same year, there were over 13,000 student suicides. The scale of the problem, which affects many sections of the population, calls for creative thinking on the part of the government, and for a wider policy approach that leaves no one behind.