“People think that those who commit suicide are against life — they are not.
They are too lusty for life, they have a great lust for life;
And because life is not fulfilling their lust,
In anger, in despair, they destroy themselves.”
The tormenting death of the famous Bollywood heartthrob Sushant Singh Rajput, along with nearly 300 unnamed suicide cases amidst the corona pandemic, clearly justifies India’s title of “the most depressed country in the world”, according to the WHO. This nationwide lockdown has unveiled the fatal socio-economic impact on the COVID-19 survivors, frontline medical workers, youth, differently-abled people, womxn, queer people, workers in the unorganised sector, and the aged population, who have to comprise with an ultra “high-risk” vulnerability to mental health.
But is the intentional killing of our aspirations, love, happiness and future by our own hands the only solution? How hard it is to ward off suicidal thoughts? Why should we allow the prison of our own silence to strangle our identity and the beautiful creation of our existence? How Herculean is it to seek timely intervention — tender support or a warm hug?
A renowned Hyderabad-based psychiatrist Dr. Gopala Sarma Poduri tried to estimate the short-term as well as long-term economic cost of a suicide death for the Indian Journal of Psychological Medicine. He calculated that in the first year alone, each death costs Rs 2,65,000, which includes the immediate price of hospital expense, autopsy charges, police investigation and funeral expense.
This excludes the immense human sorrow, which definitely costs more than an arm and a leg. The long-term economic dimension included in it is the lost income that could have been earned by the person till their retirement, the tax that the government lost from that income, and many other things.
One of the prime reasons pushing India to the brim of a mental health crisis is the abysmal budget allocation for mental health and its operationalisation. In 2019, out of a gargantuan healthcare budget of Rs 62,398 crores, the allocation of funds for the National Mental Health Programme saw a decline from Rs 50 crores to Rs 40 crores.
Despite unbridled hue and cry made by health warriors, the situation in the 2020 budget didn’t improve. Budget 2020 has not increased a single penny for the NMHP, even though the total healthcare budget saw a 7% increase. This means that India invested only 0.05% of its health budget on the NMHP.
One cannot ignore the huge paucity of appropriate medications, doctors, expert trained paramedical staff and social workers working for mental illness. In hindsight, the total number of mental hospitals since independence have only increased from 31 to 47, with National Institute of Mental Health and Neurosciences (NIMHANS) located in Bengaluru ranked as the 4th best medical institute in India, according to the National Institutional Ranking Framework ( NIRF) medical ranking for 2020.
At the underbelly of this emergency lies the failure of the Government to realise the importance of appointing a minister-head for the mental health and well-being department under the Ministry of Health and Family welfare. As stated in the Mental Health Care Act 2017 (MHCA), each State is supposed to have a Mental Health Authority, but alas, this has been far from reality. The estimated total cost needed in the proper implementation of the MHCA 2017 is Rs 94,073 crores, which can easily be extracted from the PM CARES fund or other fiscal policies of the government.
Mental health warriors and many society-driven initiatives are undoubtedly creating waves of positive change on mainstream social media platforms. A popular phased model of community-based care for vulnerable persons with severe mental disorders is successfully run under INCENSE programme in a collaborative partnership between the two largest mental hospitals of India and two NGOs.
Similarly, public-private partnership projects or creation of mental health startup incubators under Startup India Scheme should be chalked out and adequately funded by authorised policymakers.
In this era of technological revolution, India should not fear venturing into uncharted territories of technology to seek a tangible way out. Digitally-mediated therapy, telepsychiatry, artificial intelligence, machine learning, chatbots and text messages can prove to be a one-click solution to prevent suicide without requiring physical presence.
The extended lockdown has definitely seen a surge in the demand of alcohol, and number of domestic violence cases and unstable emotional behaviour. So, the primary healthcare sector should be well-equipped with ASHA workers who are capable enough to provide psychological first-aid in order to help prevent mortality or long-term trauma of patients. This ought to immediately swing into action in the States of Tamil Nadu, Kerala, Goa and Telangana because of their higher burden of mental disorders.
School-going children should be taught how to effectively call out people on their toxic behavioural patterns like – gaslighting, peer pressure, narcissism, and inculcated help-seeking attitude so that they don’t have to silently battle against the monster known as depression. In classroom programmes like “Happiness Hour” initiated by Delhi Government, students should be acquainted with stress-relief yoga, meditation, and solving personal problem creativity so that they can adopt these life skills as lifestyle choices.
It will be unfair to let the citizenry off the hook because stigmatisation of suicide and mental hospital by people around is also equally blameworthy. It is often seen, especially in rural landscape, that people with mental disorders or trauma are pushed to the fringes of society. The lackadaisical attitude of relatives makes patients feel undignified. Youths suffering from chronic stress fear opening up, and queer people are forced to lead normal lives with a mismatched identity, otherwise they will be abandoned too.
The bone-chilling suicide note written by a 16-year-old boy who hanged himself to death in UP on 17th June 2020 after gender-based bullying is a grim reminder that we are now at the eleventh hour of this swelling mental health catastrophe. So, proper rehabilitation facility in small towns and villages is the utmost need of the hour.
People with pre-existing suicidal tendencies, bipolar disorder, anxiety, trauma, emotional distress etc should be kept under close supervision of their family members. Food poisoning items (pesticides), sharp objects( knife, scissors) and ropes should be kept out of their purview. Such sensitive cases require immediate medical attention but sadly, these concerns are raised only after someone’s demise.
This particular moment, as I am typing this (19th June 2020), I have already read about the suicide case of a couple after killing their children, and a 19-year-old Telangana girl hanging herself. My heart is thumping and I wonder what I can do to trade these lives so that they can be back again in this sea of people.
History has witnessed many stress-induced deaths all over the world in the wake of financial calamities. Reports of panic-stricken investors jumping from buildings caused a rapid increase in suicide rate from 17.0 per 100,000 people in 1929 to 21.3 in 1932 during the Great Stock Market Crash of United States. Let’s not forget the startling statistics of 12,602 farmer suicide cases in 2015 as mentioned in The National Crime Records Bureau (NCRB) report.
A predicted reality of post-COVID India would be crammed with millions of stressed, depressed, drug-consuming and self-harm inflicting humans unable to cope with the fatal consequences of mass unemployment, migration, starvation, homelessness and clutches of a debt trap.
Before it’s too late to change anything, let’s wake up from our highly-privileged slumber. I have purposefully listed some of the active suicide prevention helpline numbers operated by pan-Indian organisations below because I strongly advocate that help is just an effortless two minutes call or a text away.
1. AASRA Suicide Prevention and Counselling NGO: +91-9820466726
2. Sanjivini Society for Mental Health: +911124311918
3. iCall: +91 222552111 and +91 9152987821 ( Monday to Saturday, 8:00am to 10:00pm)
4. Fortis Stress Helpline: +918376804102
5. Sneha India Foundation: 044 2464 0050
6. SAHAI: 080 25497777 ( Monday to Saturday, 10am to 6pm)
7. Sumaitri: 011-23389090 ( Monday to Friday, 2pm to 10pm and Saturday-Sunday 10am to 10pm)
8. One Life: 7893078930
9. Vandrevala Foundation: +91 7304599836, +91 7304599837 and 18602662345
10. Connecting..NGO: 09922004305 ( Monday to Saturday, 10am to 6pm)
11. Cooj Mental health Foundation: +832 2252525 ( Monday to Friday, 1pm to 7pm)
12. The Samritarians Mumbai: +91 84229 84528, +91 84229 84529 ( 3pm to 9pm)
13. Arpita Foundation: +91 802365557 , +91 8105247529 ( 2pm to 5pm)
14. Parivarthan: +91 76766 02602
Note: The helpline numbers mentioned here are not sponsored or endorsed by the author or any organisation. This list is purely informational.