NCRB report 2021: 7.2 per cent increase in death by suicide; experts say ‘busting myths, stigma is crucial’

The latest statistics from the National Crime Records Bureau (NCRB) note that the burden of deaths by suicide has increased in India — by 7.2 per cent from 2020 — with a total of 1,64,033 people dying by suicide in 2021. NCRB, which collects data from police recorded suicide cases, further stipulates in Chapter-2 of the report that every year, more than 1,00,000 people die by suicide in the country. The report follows a 2021 Lancet study that noted “India reports the highest number of suicide deaths in the world”.

Delhi, the most-populous union territory (UT), reported the highest number of suicides (2,840) among UTs, followed by Puducherry (504). A total of 25,891 suicides were reported in the 53 megacities of the country during 2021, it added.

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Notably, the four metropolitan cities — Delhi City (2,760), Chennai (2,699), Bengaluru (2,292) and Mumbai (1,436) have reported a higher number of suicides, and together account for almost 35.5 per cent of the total suicides reported from 53 megacities. While Delhi showed “a decline during 2021 over 2020”, Chennai showed an increase of 11.1 per cent (from 2,430 suicides to 2,699 suicides), Bengaluru 4.4 per cent (from 2,196 suicides to 2,292 suicides) and Mumbai observed an increase of 12.0 per cent (from 1,282 suicides to 1,436 suicides), the report mentioned.

suicide NCRB data Rate of suicide according to NCRB 2021 report (Source: NCRB)

State-wise, the majority of suicides were reported in Maharashtra (22,207) followed by 18,925 cases in Tamil Nadu, 14,965 in Madhya Pradesh, 13,500 in West Bengal and 13,056 suicide cases in Karnataka, with the five states together accounting for 50.4 per cent of the total suicides reported in the country.

Further, they accounted for 13.5 per cent, 11.5 per cent, 9.1 per cent, 8.2 per cent and 8.0 per cent of total suicides respectively. “Eight per cent students died by suicide (one of the fastest increase) and failure in examinations accounted for 1 per cent of the cases,” it said, stressing that the rate of suicides (the number of suicides per one lakh population) in the country “increased by 6.2 per cent”.

“There are various causes of suicides like professional/career problems, sense of isolation, abuse, violence, family problems, mental disorders, addiction to alcohol, financial loss, chronic pain, etc.,” the report noted.

As such, much like The Lancet Psychiatry‘s 2021-paper National Suicide Prevention Strategy: Contexts and Considerations for Urgent Action‘ that made recommendations in the wake of the absence of a national suicide prevention strategy, inappropriate media reporting, legal conflicts in the interpretation of suicide being punishable, and inadequate multisectoral engagement for suicide prevention, mental health professionals urge for a “scaffolding approach” to reduce the risk.

“It has been seen that a large percentage of those who die by suicide have an undiagnosed, untreated mental health illness,” said psychologist Kamna Chhibber, adding that it is “imperative we encourage help-seeking and focus on the early identification of mental health illnesses.”

“Imparting knowledge for the same is as essential. Concurrently, busting the myths and the stigma is crucial. We need to work towards building a national suicide prevention policy and also follow media-related guidelines around the reporting of suicides by using sensitive language, not sensationalising the death, not providing details of the method, removing graphic imagery, focusing on the distress and providing resources for help-seeking including helplines,” the psychologist told indianexpress.com.

Agreeing, Dr Jyoti Kapoor said that with “suicide becoming a major public health concern over the last couple of years, the recent NCRB data on death by suicide has again shifted the focus on suicide control.” “Most suicides are related to psychiatric disease, with depression, substance abuse and psychosis being the most relevant risk factors. Suicides, however, are preventable with timely and evidence-based interventions,” the senior psychiatrist and founder of Manasthali said.

Priti Sridhar, CEO, Mariwala Health Initiative, stressed on the need to devise a public health approach strategy, adding that the subject is “beyond that of individual solutions.

“We need a public health approach to preventing suicide, where multiple stakeholders work together to make an impact. For example, one of the ways to reduce suicide is to ban highly hazardous pesticides which require the support of the Ministry of Agriculture. Similarly, there is research from Tamil Nadu that showed that introducing and promoting supplementary exams reduce death by suicide among students. This would require collaboration between the Education department at the Centre and the States,” said Sridhar while asserting the “urgent need to have a National Suicide Prevention Policy which clearly articulates suicide as a health indicator”.

suicide NCRB data Percentage share of suicides in states (Source: NCRB)

Experts further said that since suicides are preventable, awareness needs to begin early. “Mental health topics and emotional behaviours should be introduced at a young age in schools and teachers must be sensitised. Parents should be encouraged to talk about the importance of mental health at home without being uncomfortable. The image of mental health providers and professionals has to undergo a change so that their acceptance can be increased. Medical treatment of depression must be emphasised and psycho-education regarding signs of depression and suicidal behaviour should become more available,” Dr Sonal Anand, Psychiatrist, Wockhardt Hospitals, Mira Road told indianexpress.com.

According to Dr Kapoor, the first step to preventing suicide is to limit access to the means of suicide (like pesticides, firearms, and certain medications). Further, multiple sectors of society should come forward and create multi-sectoral collaboration, awareness raising, capacity building, financing, and surveillance that can keep the issue in check. “These efforts must be integrated and comprehensive because complex problems like suicide can’t be managed through a single approach,” said Dr Kapoor.

Local crisis centres can provide immediate counselling and therapy services on a regular basis, said Sana Rubiyana, counselling psychologist, Fortis Hospital, Richmond Road, Bangalore. “Evidence has shown that providing counselling and therapy services, talking about suicide, reducing access to means of self-harm and following up with loved ones, all these small yet significant actions can help others,” she said.

Dr Kedar Tilwe, consultant psychiatrist, Fortis Hospital Mulund and Fortis Hiranandani Hospital, Vashi shared tips that can help:

Develop healthy coping mechanisms: The increased stress in our current life necessitates us to develop effective healthy stressbusters to reduce the burden associated with mental health. Even small activities such as developing a new hobby or restarting exercise can help.

Practicing yoga, meditation, relaxation exercises and even mindfulness can go a long way in improving resilience.

Stop consumption of alcohol: It has long been known that a person is more likely to act out on impulse if they are under the influence of alcohol. So, stopping the intake of alcohol and other addictive substances is a major lifestyle modification which will help.

Unmute yourself and reach out: Many of us are surrounded by a supportive network of family, friends, well-wishers, and trusted confidants. So if you feel the need, please reach out immediately. You can always consult a professional, too.

Effective treatment protocols can help reduce and even stop self-harm impulses.

“A combination of properly supervised psychotropic medications and psychotherapy (such as CBT, DBT, supportive counselling, etc.) have been proven to be effective. With the presence of tele-mental health services and ready access to stress helplines, professional help is just a call away,” Dr Tilwe told indianexpress.com.

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