Epidemiology of Suicides in India: Analyzing Trends, Patterns, and Regional Variations

Epidemiology of Suicides in India: Analyzing Trends, Patterns, and Regional Variations

ABSTRACT

● Each suicide is a personal tragedy that prematurely takes the life of an individual and has a continuing ripple impact on the lives of friends, family, and communities.

● The most significant and sharp increase in the total number of suicides and the suicide rate was reported during the COVID-19 pandemic years.

● Maharashtra, Tamil Nadu, Madhya Pradesh, Karnataka, and West Bengal: These states collectively account for nearly 50% of the total suicides reported in the country.

Background

Each suicide is a personal tragedy that prematurely takes the life of an individual and has a continuing ripple impact on the lives of friends, family, and communities. Every year, more than one lakh people commit suicide in India. The World Health Organisation (WHO) has already acknowledged suicide as a serious public health concern and as a result, this organisation initiated several measures to raise awareness about the public health significance of suicide and attempts to make suicide prevention a top priority on the global public health agenda. These initiatives aim to support and encourage countries to develop and enhance comprehensive suicide prevention strategies through a multisectoral public health approach.

In 2008, for the first time, suicide was highlighted as a priority condition in the WHO Mental Health Gap Action Programme (mhGAP). This program provides evidence-based technical guidance to scale up service provision and care for mental, neurological, and substance use disorders in various countries. The suicide mortality rate is a crucial indicator for target 3.4 of the United Nations Sustainable Development Goals (SDGs). This target focuses on reducing premature deaths from noncommunicable diseases by one-third by 2030 through prevention and treatment, as well as promoting mental health and well-being.

Worldwide, Over 7 lakh people die by suicide annually, and many more attempt it. According to several studies, prior suicide attempt is a major risk factor for future suicide. Suicide is the 4th leading cause of death among individuals aged 15–29, with 77% of global suicides occurring in low- and middle-income countries. 

In India, suicide is an emerging and severe public health issue, but it is preventable with timely, evidence-based, and often low-cost interventions. In 2017, Indian govt. decriminalized suicide in India (Mental Healthcare Act of 2017), to ensure adequate medical relief for those who attempt it. This landmark development promoted a dignified and humane approach to the critical & sensitive issue. Apart from legal initiatives, the Indian government has also introduced several programs to reduce suicide rates in the country, such as the “National Mental Health Programme” and the “Ayushman Bharat Program’s Health and Wellness Programme”. These programs provide high-quality primary healthcare, drug addiction clinics, and rehabilitation services.

This article analyzes the trend of reported suicides in India from 2012 to 2022, with a focus on the spatial distribution across states and union territories in 2022, based on the latest data from the National Crime Records Bureau (NCRB) published in 2022. This data provides valuable insights into regional differences, identifying areas that may need targeted interventions and improved mental health support.

Causes of Suicides 

The association between suicide and mental health disorders, particularly depression and alcohol use disorders, as well as a history of previous suicide attempts, is already well established in high-income countries. However, many suicides occur impulsively during moments of crisis, where individuals experience a breakdown in their capability to deal with stresses, such as financial crises, relationship break-ups, or chronic pain and illness. Additionally, experiencing conflict, disaster, violence, abuse, loss, or a sense of isolation is strongly correlated with suicidal behaviour. Suicide rates are also notably high among vulnerable groups who face discrimination, including refugees and migrants, indigenous peoples, LGBTI individuals, and prisoners. According to public health researchers, the key causes of suicides include:

Economic Distress: Financial instability, unemployment, and poverty are significant contributors. Farmers, in particular, face severe economic hardships due to crop failures, debts, and lack of support, leading to high suicide rates in agrarian regions.

Mental Health Issues: Due to stigma and limited access to mental health services, depression, anxiety, and other mental health illnesses are common and frequently go untreated. The societal stigma associated with mental health prevents many individuals from seeking help.

Social Factors: Family disputes, marital issues, and social isolation can lead to feelings of pessimism and despair. Additionally, the pressure to meet societal expectations, particularly among the youth, can be overwhelming.

Substance Abuse: The abuse of Alcohol and drug abuse poses a serious concern, often exacerbating underlying mental health issues and leading to impulsive decisions.

Cultural and Societal Pressures: In a society with rigid social structures and expectations, individuals often face immense pressure to conform, leading to stress and mental health issues.

The impact of  ‘once-in-a-century’ health crisis : COVID-19 pandemic

In India, a total of 1,70,924 suicides were reported in 2022, representing a 4.2% rise from 2021 and a 3.3% increase in the suicide rate from 2021 to 2022.

Fig: 1

In India, a noticeable decline was recorded in the total number of suicides and the suicide rate between 2012 to 2017. During these five years, the total number of suicides decreased from 135,445 in 2012 to 129,887 in 2017, and the suicide rate also dropped from 11.2 to 9.9 during the same period. The most important fact is, in this period the YoY growth of the suicide rate remained below 0%. Between 2018 to 2019 A gradual increase in both the number and rate of suicides was observed during this period. In this pre-covid phase, the total number of suicides rose from 134,516 in 2018 to 139,123 in 2019, and the rate also increased from 10.2 to 10.4 (1.96% rise).

Fig: 2

The most significant and sharp increase in the total number of suicides and the suicide rate was reported during the COVID-19 pandemic years. The number of suicides surged from 153,052 in 2020 to 170,924 in 2022 and the rate climbed from 11.3 to 12.4, during this period. In 2020, India reported the highest surge in suicide rates, with an increase of almost 8.5% compared to 2019.

According to experts, the alarming rise in suicide rates during the pandemic to several interrelated factors. Social isolation and anxiety surged due to lockdowns, social distancing, and quarantine measures, leaving many people feeling lonely and anxious, which contributed to an increase in mental health issues. Economic hardship also played a significant role, as widespread job losses, business closures, and financial insecurity became major stressors for individuals. Additionally, the strain on healthcare systems during the pandemic restricted access to mental health services, leaving many without adequate support. The grief and trauma of losing loved ones, the fear of the virus, and the overall experience of living through a global crisis further exacerbated mental health problems, leading to higher suicide rates.

South Indian states, recorded a paradoxical prevalence of higher suicide rate 

Maharashtra, Tamil Nadu, Madhya Pradesh, Karnataka, and West Bengal: These are the top five states that reported the highest number of suicides in India during 2022. These states collectively account for nearly 50% of the total suicides reported in the country. The national rate of suicide in India was 12.4 during the year 2022. 

Fig: 3

Sikkim and the Union Territories of Andaman & Nicobar Islands and Puducherry present another dimension of this issue. Sikkim has the highest suicide rate at 43.1, followed closely by Andaman & Nicobar Islands at 42.8 and Puducherry at 29.7. Karnataka, Kerala, Tamil Nadu, and Telangana – these southern states exhibited alarmingly high suicide rates. Among these states, Kerala had the highest suicide rate at 28.5, followed by Telangana at 26.3 and Tamil Nadu at 25.9.

Fig: 4

In contrast, states like Bihar, Uttar Pradesh, and Jammu & Kashmir have relatively lower suicide rates. Bihar’s rate stands at a mere 0.6, the lowest in the country, while Uttar Pradesh has a rate of 3.5. Even though the South Indian states have relatively better healthcare systems and higher literacy rates, they have reported comparatively higher suicide rates. A cause-specific and profession-specific analysis corresponding to state-specific economic stress, agrarian crisis, mental health issues, cultural factors, substance abuse, and reporting and awareness can provide deeper insights into why South Indian states have a higher prevalence of suicides.

The Urgent Need for a Multi-Pronged Approach

In India, the significant means of suicide include the use of pesticides, firearms, self-hanging, and jumping off bridges or in front of trains. Implementing policies limiting pesticide and firearm access and installing barriers on bridges and railway platforms could be effective preventive measures. Additionally, providing counselling services and creating destigmatized platforms for open discussions on these taboo subjects could further aid prevention efforts. Addressing the suicide crisis in India requires comprehensive, multifaceted approaches such as:

(a) Mental Health Awareness and Services: Raising mental health awareness, eradicating stigma, and guaranteeing easily available and reasonably priced mental health care are vital. Including mental health in primary care can aid in reaching a broader demographic.

(b) Economic Support and Social Welfare: Providing financial support, especially to vulnerable groups like farmers, and implementing social welfare programs can alleviate economic distress. Job creation and employment support are essential to reduce financial pressures.

(c) Community Support Systems: Strengthening community networks and support systems can provide emotional and psychological support to distressed individuals. Community-based interventions and peer support groups can play a vital role.

(d) Education and Counseling: Schools and colleges should incorporate mental health education and provide counselling services. Early intervention can help identify and address mental health issues among the youth.

(e) Substance Abuse Prevention: Implementing effective substance abuse prevention and rehabilitation programs can reduce the risk of suicides related to Alcohol and drug abuse.

The rising trend of suicides in India is a complex issue that demands urgent and comprehensive intervention. Understanding the underlying causes, addressing regional disparities, and implementing a multi-pronged approach are crucial to tackling this crisis. By fostering a supportive environment, improving mental health services, and addressing economic and social factors, India can make significant strides in reducing the tragic incidence of suicides and building a healthier, more resilient society.  

References

  1. भारत में अपराध | National Crime Records Bureau. (n.d.). https://www.ncrb.gov.in/crime-in-india.html
  2. Jha, R. (2024, May 16). Crime in India: A Critical Review of Data Collection and Analysis. Observer Research Foundation. Retrieved October 28, 2024, from https://www.orfonline.org/research/crime-in-india-a-critical-review-of-data-collection-and-analysis
  3. India sees highest suicides in the world – 12.4 per 1,00,000: national data. (n.d.). NDTV.com. https://www.ndtv.com/india-news/india-sees-highest-suicides-in-the-world-12-4-per-1-00-000-national-data-6082407
  4. Sharma, S. (2024, August 28). Which Indian states have the highest student suicide rates? A look at the top risk factors. The Times of India. https://timesofindia.indiatimes.com/education/news/which-indian-states-have-the-highest-student-suicide-rates-a-look-at-the-top-risk-factors/articleshow/112859156.cms
  5. Pti. (2024a, August 29). India’s student suicide rate has surpassed overall trend, population growth rate: Report. The Hindu. https://www.thehindu.com/sci-tech/health/indias-student-suicide-rate-surpassed-overall-trend-population-growth-rate-report/article68577171.ece
  6. Yadav, S., Aathavan, K. K., Cunningham, S. A., Bhandari, P., Mishra, U. S., Aditi, A., & Yadav, R. (2023). Changing pattern of suicide deaths in India. The Lancet Regional Health-Southeast Asia, 16.
  7. Patel, V., Ramasundarahettige, C., Vijayakumar, L., Thakur, J. S., Gajalakshmi, V., Gururaj, G., … & Jha, P. (2012). Suicide mortality in India: a nationally representative survey. The lancet, 379(9834), 2343-2351.

 


 

About Author:

Pankaj Chowdhury is a former Research Assistant at the International Economic Association. He holds a Master’s degree in Demography & Biostatistics from the International Institute for Population Sciences and a Bachelor’s degree in Statistics from Visva-Bharati University. His primary research interests focus on exploring new dimensions of in computational social science and digital demography.

Ananya Geetey is pursuing a BSc in Economics and Analytics at Christ University, with core interests in Economics, International Trade, and Machine Learning.

Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect the views of 360 Analytika.

Acknowledgement: The author extends his gratitude to the National Crime Records Bureau for providing data support.

This article is posted by Sahil Shekh, Editor-in-Chief at 360 Analytika.

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