Suicide Prevention: Need of the Hour

In the aftermath of an alleged suicide of a popular actor in June 2020, most media houses breached the suicide reporting guidelines of WHO. Alarmingly, a substantial increase in suicide related keywords were documented in the web. There is an urgent need for Press Council of India's, suicide reporting guidelines to be strengthened and strictly enforced.

The indices of suicide deaths in India is amongst the highest in world. More than one lakh lives are lost to suicide every year. As per the National Crime Records Bureau, from 2019 to 2022 suicide rates have increased from 10.2 to 11.3 per cent per 100,000 of the population. This undoubtedly presents a grim picture of the mental health scenario of the country. A complex interplay of influences pushes a person to self-harm. Understanding them is crucial to prevent and mitigate suicidal thought and behavior.

The French novelist and philosopher Albert Camus in his seminal work The Myth of Sisyphus wrote "There is but one truly serious philosophical problem and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy. All the rest- Whether or not the world has three dimensions, whether the mind has nine or twelve categories-comes afterwards…" He calls man an absurd hero, who is condemned like the ancient Greek character Sisyphus to live a life of futility devoid of any meaning. He is to push a heavy stone uphill, only for it to roll back down again. And this continued up and down, up and down forever…Portraying the absurdness of human existence.

The intense disconnect, the divorce between man and his life, the actor and his setting, is at the core of the decision to end one's life. This gap, impulse, or repulsion, once it takes its place in the human heart, develops into an abyss with no escape. Varied reasons from social to economical, from political to deeply personal create this suicidal pit, entrenching man in a deep inescapable emotional pain. In suicide theory, emotional pain is a recurring theme. As Camus points out, "We are concerned here…with the relationship between individual thought and suicide. An act like this is prepared within the silence of the heart, as is a great work of art. The man himself is ignorant of it."

Psychology in the beginning of 20th century came with the first major theory as to why people die by suicide. Freud believed that an individual possesses a "death instinct" which is balanced by life instinct, which is externalised as anger. When anger is curtailed through social codes and mores it is repressed and turned inwards. In extreme cases, this results in suicide or self-murder.

Questions may be raised as to the need of theorising the act of self-harm. It is far more complex and psychologically varied to be explained in a few brief words. But theory is an important tool in transforming information into knowledge. It explains a phenomenon and gives its practitioners a tool to work it into their practice. As suicidologist AntoonLeenaars wrote, theories must have sound "clinical utility". This explains the broad spectrum of academic theories that have emerged on the topic of suicide. Biology, sociology, medicine, humanities, social sciences to name a few. It has allowed different treatment strategies like –pharmacotherapy, psychotherapy family therapy, etc.

Given the complex process involved, the genesis of suicidal thoughts is difficult to ascertain. But it can be safely assumed that societal interactions play a vital role. Society can act as a safety net, or let the person fall through. An elevated sense of awareness is thus the basic premise on which the superstructure of suicide prevention should be built.

Mental health issues till recently had been pushed into the peripheries of the health care system. Due acknowledgement about the severity of the problem, was painfully found to be wanting. Various factors ranging from social to religious, cultural to archaic traditions, had impeded a broad-based understanding of the issue.

It was only in the year 2017, that suicide was decriminalised through the Mental Health Act of 2017. It replaces the earlier Mental Health Act of 1987, which had been criticised for its limited definition and narrow perspective. The new act states that "Notwithstanding anything contained in section 309 of the Indian Penal Code any person who attempts to commit suicide, shall be presumed, unless proven otherwise, to have severe stress and shall not be tried and punished under the said Code". The act further mentions that it is the duty of the government to provide care, treatment and rehabilitation to the person who attempts suicide.

The government has recently outlined the National Suicide Prevention strategy. The document envisions to "create a society where people value their lives and are supported when they are in need" It sets a target of reducing suicide mortality by 10 percent by 2030. It broadly seeks to establish effective surveillance mechanism for suicide within three years, psychiatric outpatient department in all the districts of the country through District Mental Health Programme in the next five years and integrate mental well being curriculum in all educational institution.

It's probably the first time that the government has acknowledged suicide as a public health emergency, and seeks to address it through efforts of the stakeholders involved. A key element of the strategy of the is to develop "guidelines for responsible media reporting". Research had shown that suicide reporting in Indian press is explicit, repetitive, simplistic and potentially harmful. Disclosure of the name of deceased and method of suicide with little mention of preventive services is a routine followed by the media.

In the aftermath of an alleged suicide of a popular actor in June 2020,most media houses breached the suicide reporting guidelines of WHO. Alarmingly, a substantial increase in suicide related keywords were documented in the web. There is an urgent need for Press Council of India's, suicide reporting guidelines to be strengthened and strictly enforced.

Mental health awareness among the community is vital for suicide prevention. Early detection and adequate treatment of a primary psychiatric disorder is of paramount importance. It is only when everyone acts in unison to create an atmosphere where suicide is destigmatised, and a support system is built for those in need, that we can minimise the loss of valuable life.

By Emon NC

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