The numbers speak for themselves: 1,64,033 Indians died by suicide in 2021, with the national suicide rate being 12 (calculated per lakh of the population), the highest rate since 196, according to NCRB data. Suicides during 2021 increased by 7.2% in comparison to 2020, with Maharashtra having the most number of cases, followed by Tamil Nadu, Madhya Pradesh, West Bengal and Karnataka.
To mark World Suicide Prevention Day, experts share preventive measures and also indicators of suicide.
Indicators of suicide
Many people contemplating suicide communicate or give away their intentions in advance. They talk about harming themselves, write and frequently speak about death and can be seen looking for things that can be used in a suicide attempt, such as drugs and weapons.
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When someone is thinking of suicide, the hopelessness they feel as they consider suicide may be a side effect of a difficult situation or an illness that can be treated. This emotion, which clouds their judgement and leads them to believe that taking their own life is the best, or only, option, is often very apparent.
Crisis aituations & mental disorders
While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established, many suicides happen impulsively in moments of crisis. Some risk factors include: the experience of loss, loneliness, discrimination, a relationship break-up, financial problems, chronic pain and illness, violence, abuse, conflict, or other humanitarian emergencies.
An attempted suicide in the past is one of the biggest risk factor for suicide.
These include loss of interest in day-to-day activities, withdrawal from social circles, decreased personal care, decreased appetite, disturbed sleep, feeling worthless, shame, guilt and self-hatred.
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At an individual level
Understanding the feelings
Recognize that negative feelings about yourself. Tension, helplessness, hopelessness, and depression can cloud your judgement and make it harder for you to make wise judgments. Recognise that the sentiments of suicidality are a symptom of solvable issues.
Think of other options
Think of other options instead of suicide, even if you cannot see them right now.
Look for Treatment
Try to recognise that these feelings are temporary and that, with appropriate treatment, you can learn how to help yourself feel better about life again. Review why your life is valuable and the reasons to live. Don't try to manage suicidal thoughts or behaviour on your own. In order to overcome the issues connected to suicidal thinking, you need support and professional assistance.
Speak to loved ones
Asking others for support can help you see that you have other options and give you hope for the future. Speak to a loved one or close friend. Make a call to a loving relative or friend who can assist you in overcoming your suicidal thoughts. Speak with a member of your religious community or a spiritual leader.
Engage in healthy activities
When unfavourable thoughts begin to creep in, engage in a specific healthy activity that you enjoy. Scheduling some daily activities that brought you small pleasure in the past can make a difference—such as listening to music, watching a funny movie, or visiting a museum. Or try something different. Even if you don't feel like it, try to be social to avoid loneliness.
Join support groups
Join a support group so that you can learn how to deal with suicidal thoughts and realise that you have many other options in life except taking your own life. Internet hazardous sites should be avoided. Avoid visiting websites that can recommend suicide as a solution to your difficulties.
Express your feelings
Write about your thoughts and feelings. No matter how insignificant they may appear at the time, think about writing about the things in your life that you cherish and appreciate. You might not feel better right away, and it might not be simple.
Get Professional Help
Make a call to your mental health professional. Call the suicide prevention hotline. Ask your doctor or another healthcare professional for assistance.
Preventing suicide as a society
Have public education initiatives
To prevent suicide, public education initiatives should be taken up in schools, colleges and workplaces. Such initiatives have been found to be effective in creating awareness as well as support facilities for vulnerable individuals.
Initiatives at physicians’ clinics
Another avenue where such individuals can be identified and addressed is at the physician's clinic. Physicians can play a vital role in educating families and creating necessary support networks for vulnerable individuals as well as at-risk families as a whole.
Media strategies like awareness campaigns, motivational media and mass education material can also play a positive role in preventing suicide. Celebrities who have overcome emotionally negative and difficult stages can also positively impact the minds of vulnerable people by sharing their coping strategies and success stories.
Large-scale psychometric assessments
Identification of at-risk individuals is possible by screening human populations at schools, colleges, workplaces and community centres using psychometric assessments/tools. Those identified as high-risk populations must be supported at thefamilial, institutional and social levels.
Easy access to mental health care
Relevant treatment facilities like psychotherapy and counselling should be made widely accessible at theinstitutional, and community levels. Also, all possible stigma against accessing these services should be eliminated; the use of these services must be normalised using media campaigns. In the age of advanced telecommunications, the internet and social media, the strength of these mediums should be harnessed by creating functional and active hotline support facilities, support groups and communities and educational material.
(Inputs provided by Dr Roma Kumar, co-founder, Emotionally.in, Dr Kaushtubi Shukla, clinical psychologist at PSRI Hospital and Dr Minakshi Manchanda, Associate Director Psychiatry, Asian Hospital)
Divya Naik is a Mumbai-based psychotherapist