Trigger Warning: Mention of suicide.
A study conducted in Brazil on the Bolsa Familia, the world’s largest conditional cash transfer program, found that those who received benefits from the program were 61% less likely to die by suicide that non-beneficiaries.
Conditional Cash Transfers.
The treatment with amazing impact in ↓ suicides. No mental health treatment comes even remotely close to it.
Proof that social interventions have outsized benefits, frequently > conventional mental health treatment…5/n
— Dr Soumitra Pathare সৌমিত্র சௌமித்ரா பாடாரே (@netshrink) September 30, 2021
This provision of basic income led to improvement in mental health and well-being of the population, which highlights the fundamental link between mental health and societal issues.
The stark divides across diverse dimensions – the urban-rural divide, the wealth inequality, the gender disparity, caste divides and religious differences intersect and culminate to adversely affect mental health of the community leading to high rates of suicide.
According to the Oxfam report, the top 10% of the Indian population holds 77% of the wealth. The 67 million Indians who comprise the poorest section of the population saw a 1% increase in their wealth, as compared to the 73% increase of the richest 1%.
This is accompanied by a drastic increase in prices, with the inflation rate of 2020 standing at 6.62% compared to 3.72% in 2019. In the pandemic year, rising prices are accompanied by a loss of livelihood making it impossible for poorer sections of society to provide for themselves.
The relationship between education and inequality of wealth distribution has been highlighted by the COVID pandemic – students face a lack of access to resources like laptops, smartphones and the internet which are required to attend classes which has led to declining mental health and rising suicide rates among students.
Students feel as though they are a burden to their family because of the necessity of these expensive gadgets for their education.
On November 2, 2020 a student from LSR died by suicide; her heartbreaking note read, “Because of me, my family is facing many financial problems. My education is a burden. If I can’t study, I can’t live.”
Farmer deaths by suicide in the country are a highly politicized topic. The reason for over 20% of cases is bankruptcy or indebtedness – the inability to repay credit taken from banks or private moneylenders owing to crop failure.
72.4% of deaths recorded are farmers belonging to these two categories. Despite this being a pattern observed every year, there haven’t been any concrete steps to alleviate the burden on these farmers.
The per capita income of India has seen a steep decline from 2019-20 to 2020-21 going from Rs. 94,566 to Rs. 86,659. At present, 60% of India’s population (812 million people) live below the World Bank determined poverty line. Due to the pandemic, 104 million more people could fall below this line.
A 2018 study released by Lancet Public Health revealed that of all women who die by suicide globally, 40% are Indian and most are married. The age group considered (15-39) is “vulnerable to financial hardship and familial, especially marital, pressure.”
Marriage often accords less protection and security for women owing to early, arranged or child marriage which are accompanied by domestic violence, economic dependence and low social status.
The gender disparity highlighted in these numbers is a cause for concern and is a reflection of the societal and judicial systems within the country.
The rate of crimes against women was recorded as 53.9 in 2015, with the capital city, Delhi, having the highest crime rate of 184.3. This is a 43.2% increase since 2011.
Social disparities often have dire consequences for marginalized sections of society – students in institutes of repute who die by suicide tend to be from marginalized communities and face caste discrimination.
In the pandemic year, rising prices are accompanied by a loss of livelihood making it impossible for poorer sections of society to provide for themselves.
A student from IIT Roorkee died by suicide after facing caste based bullying for months; another student from the University of Hyderabad died after experiencing caste-based discrimination from his professor.
The cause of death is often reported as depression. This eliminates and exonerates external elements that could have led to the death, and shifts the blame onto the victim.
Indigenous tribes have the highest suicide rates in the country. A fourth of members from the Idu Mishmi tribe in Arunachal Pradesh have attempted suicide at some point.
These tribes are often displaced from their homeland and ridiculed in their new location. Provided with no support and no resources to sustain their livelihood in a new area, they believe that death by suicide is their best option.
Caste as a social system and mechanism demeans and dehumanizes individuals and exploits them. According to government data, crimes against Dalits increased by 7% in 2019.
This was backlash from dominant caste members to what they perceived as a challenge to the caste hierarchy. These deep-rooted cycles of oppression are built into society, and rebellion is viewed as challenging the very basis of society.
On the other hand, those on the receiving end of this culture of exploitation tend to have their mental health impacted adversely.
Integrating structural changes into society that eliminate exploitative and dehumanizing systems like the caste system and provide health care, dignified social welfare or rights based schemes are changes that need to be incorporated.
Government policies like Universal Basic Income (UBI) – providing free basic income to all citizens of the country – have been found to be very effective in reducing suicide rates among the population.
With the COVID pandemic increasing poverty in the country, we are likely to see an increase in suicide rates similar to the situation observed in Greece after the financial crisis of 2009. UBI is viewed as a tool that has the potential to eradicate poverty within the country.
The time is now for providing the workforce in the informal sector and those unemployed with regular income to ensure their well-being through these trying times.
However, there are fundamental issues associated with UBI. The main issues are the time period where this income is provided and the amount provided. Another factor to keep in mind is that income also doesn’t take into account caste identity, loss of indigenous land and other cultural factors, and so cannot improve a person’s social standing. Thus, the cycle is not broken.
ASHA workers have played a tremendous role prior to and during the COVID pandemic in ensuring the mental and physical well-being of their community.
Expanding the education of frontline workers, other medical professionals and ASHA to include basic mental health awareness and identification, prevention and treatment methods that could lead to substantial improvement.
Improving access to therapy and increasing the number of therapists in public hospitals is key. Along with this, it is important to cast away prejudices against mental health professionals and encourage individuals to seek out help.
We have a key role to play in destigmatizing mental health and providing support to struggling individuals at our level.
For society to progress, we need a mindset change that supports discussions around mental health accompanied by government policies that aim to diminish the divides in society that are responsible for declining mental health.
The author is part of the current batch of the Writer’s Training Program.