In one of the articles in the series, the authors claimed that there is a link between low economic status and suicide in low- and middle-income countries (LMICs) | Representative image
National strategies to prevent suicide should include measures to address social issues to prevent people from reaching “crisis point”, even though clinical services for those in crisis are essential, argue the authors of a new series of six papers published in The Lancet Public Health journal.
The international team of authors, including those from the Public Health Foundation of India in New Delhi, called for a shift in the narrative around suicide from presenting it as a purely mental health issue to recognising the impact of social risk factors such as poverty, domestic violence, addiction and isolation.
This was particularly relevant for India, which published the National Suicide Prevention Strategy in November 2022 and based most of its proposed solutions on the mental health domain, even though police data shows that factors such as gender, employment and stressful life events have a significant role to play, the researchers said.
The strategy aims to reduce suicide deaths in the country by 10 percent by 2030. Goals include establishing effective suicide surveillance systems and integrating a mental wellness curriculum into all educational institutions.
Published on World Suicide Prevention Day, the authors of the series outlined six aspects of a public health approach to preventing suicide. These included a model that looks at the social determinants of suicide to show how it can arise.
“With more than 170,000 lives lost annually to suicide in India, addressing underlying socioeconomic pressures in addition to mental health is a key national priority. By taking a public health approach and fostering collaboration across multiple sectors, we can create a more enabling environment that prioritizes early intervention, reduces stigma, and ultimately saves lives,” said series author Rakhi Dandona, Professor of Public Health at the Public Health Foundation of India.
The public health approach should also consider national policies aimed at cushioning the effects of economic crises, including maintaining minimum wage levels, and how exposure to suicide cases (whether through the media or in real life) can increase suicide risk, the authors say.
In one of the articles in the series, the authors claimed that there is a link between low economic status and suicide in low- and middle-income countries (LMICs).
In India, higher suicide rates among men are seen in states with higher unemployment levels, they said, adding that unemployment was also one of the most important risk factors among women.
They also said that a model that took into account farmers with marginal holdings, indebted farmers and the proportion of land used for non-food crops (or cash crops) could explain 75 percent of the changes in suicide rates between states.
In another paper, the authors drew attention to the “transmissibility of suicide” to arrive at optimal ways to address the problem. Transmission can occur when a person is exposed to suicide-related information, including another person committing suicide, that draws attention to or highlights specific suicide methods.
They called for “restricting cognitive availability of media through attention to media and other depictions of suicide methods.”
“In simple terms, it means that the media should consider whether the information is necessary, how it should be reported without increasing the risk to others and whether it is accurate reporting of the circumstances, as well as promoting help-seeking for those in need. There are guidelines in this regard,” Dandona told PTI.
In the fifth article, the authors described a range of interventions that could address four major risk factors for suicide: alcohol use, gambling, domestic violence and abuse, and suicide bereavement.
At the individual level, there are signs that can be looked out for, such as the language used in conversation, Dandona said.
“It’s important to listen to what people have to say, the language of despair they may use to indicate these risk factors. Anecdotal evidence suggests that these types of statements highlighting suicidal thoughts are often overlooked or not taken seriously,” she said.
“This means that for these conversations to happen, people need to feel in a supportive environment to be able to share what they’re going through and be taken seriously,” Dandona said.
Suicide is the third leading cause of death among people aged 15 to 29, claiming an estimated 720,000 lives each year, according to the World Health Organization. About three-quarters of suicides worldwide occur in low- and middle-income countries, it said.
(Only the headline and image of this report may have been reworked by Business Standard staff; the rest of the content is auto-generated from a syndicated feed.)
First published: September 10, 2024 | 7:47 am IS
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