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This article has been written by Khushi Ahuja, from Vivekananda Institute of Professional Studies, and it is on the prevalence of suicides, factors involved, the importance of discussing this topic and the recent developments in this field.

Introduction

“We can never imagine the emptiness of a creature who put a razor to the wrist and opened up the veins, the hopelessness and the calm” 

                                                                               – Jeffrey Eugenides

Puberty is the process of rapid physical, mental and social changes in adolescents which begin around 11-13 years of age. These teenage years of significant changes can be quite confusing for the youth, leading to restlessness and moodiness. Deep emotional changes and physical development can be an emotional assault on these youngsters which makes them uncomfortable and vulnerable to temptations and wrong decisions. While this period is marked as a tough challenge, it also crowns it as a typical gulf between the child and its parents leaving no room to overcome or talk about the pressures they face or the feelings they experience. 

Teenagers at times may feel that no one understands their feelings, especially parents. As a result, they feel angry, alone and confused while facing complicated issues about identity, peers, sexual behaviour, career, studies, drinking and drugs. Families are usually successful at helping their children accomplish the developmental goals of the teen years, However, several warning signs indicating things not going well should be addressed and identified on time so that outside help can be sought. Aggressive behaviour or violence, school truancy, drug or alcohol abuse, promiscuity, brushes with the law, lack of concentration, decrease in productivity, changes in food patterns, loneliness or runaway behaviour. With the tragedy of suicides becoming popular, no one can imagine the kind of failure the parent’s experience, this being a nightmare of their child being dead, especially when it’s self-inflicted and wished for.

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Why is it becoming more prevalent? 

Suicide is a fatal self-injurious act with some evidence pointing out to the intent to die. More than 800,000 people die due to suicide each year around the globe. The rates of suicide and suicide-related behaviours increases with age and a gender-biased study exists concerning youth suicidal behaviour. While suicide rates have been noted to be higher among boys than girls, girls have higher rates of suicidal ideation and attempted suicide. Although any firm causes of the increase in suicide rates among adolescents and young adults are uncertain at the moment, public health experts have no idea why the suicide rate for young adults have been increasing drastically. Ursula Whiteside, a researcher with the University of Washington, talked about this in the Washington Post. “The truth is anyone who says they definitely know what is causing it doesn’t know what they’re talking about,” “It’s a complex problem with no easy answers so far.”

Adolescents and young adults at this age start to think and feel differently. They feel confused about being stuck in a weird mid-position where they are neither kids nor fully grown adults. They feel isolated and uncomfortable. Unfortunately, some may at one point or another believe suicide to be a permanent answer to problems that can be talked about and solved with the right guidance. Self-doubts, confusion and pressures to succeed or conform can come at a very high price for adolescents.

Suicides among young people is a serious problem and are the world’s second-largest leading cause for deaths in adolescents aged 15-to-24 years. The majority of children and adolescents who attempt suicide have a mental health disorder that needs attention. Among younger children, suicide attempts are often impulsive. They associate themselves with feelings of confusion, sadness, anger, problems with attention and hyperactivity, feelings of stress, self-doubt, the pressure to succeed, financial uncertainty, disappointment, and loss.

Warning Signs 

There are several symptoms or warning signs that indicate the gravity of the situation-

  • expressions of helplessness.
  • hopelessness and loss of faith.
  • Extreme shame or guilt.
  • a dramatic change in personality or appearance.
  • irrational or bizarre behaviour.
  • changed eating patterns.
  • Irregular sleeping habits.
  • Lack of enthusiasm.
  • A downfall in school or work performance.
  • lack of interest in things previously important.
  • writing, speaking or joking about suicide.
  • giving away possessions.
  • increasing alcohol and drug use.
  • withdrawing from friends, family or society.

Factors involved

The factors that contribute to suicide are the effective variables that increase the likelihood of the tragedy occurring. A huge number of causes can devote or build-up to the end consequence of suicide:

  • Uncontrollable impulses.
  • suicide attempts in family history.
  • An already existing suicide plan.
  • aggressive or disruptive behaviour.
  • exposure to violence like domestic violence.
  • access to firearms like a gun at home.
  • bullying.
  • acute loss or rejection.
  • Changes in their families.
  • Work stress.
  • Problems in school.
  • Career issues.
  • physical or sexual abuse.
  • emotional neglect.
  • alcoholism at home.
  • substance abuse.
  • Past suicide attempts.
  • Imprisonment.
  • Exposure to suicidal behaviour like through fiction stories.
  • Stigma against the LGBTQ community.

Mental disorders

Suicide is a major health problem, and the global suicide mortality rate amounts to 1.4% of all deaths in the world. It is believed that people who end their own lives, at times do not want to die but they feel that there is no other option to relieve them of their pain and agony. Those who end up taking their own life may feel overwhelmed and tired, thus seeking release from their stress and suffering. 

It is very important to understand that suicide is the result of many factors that contribute to a person’s life and not just one particular event or discussion. Research shows that approximately 90% of people who have died by suicide were suffering from mental illnesses. Most suicides are related to psychiatric diseases, like depression, substance abuse and psychosis being the most relevant risk factors along with anxiety, personality, eating disorders, bullying, and trauma-related disorders. People who deal with issues, at times might find it difficult to say it out loud, express or take care of themselves while handling the stresses and all the stuff that goes on in their mind. They keep quiet and suffer in silence while the people around them are not able to identify the changes in them. They start to develop feelings of loneliness, hopelessness and in the end, they believe that they might be better off as dead.

Mental health disorders that can lead to suicides are:

  • Depression.
  • Bipolar Disorder.
  • Post Traumatic Stress Disorder.
  • Schizophrenia.
  • Borderline personality disorder.
  • Substance abuse.
  • Mental illness and the LGBTQ community.

Previous suicide attempts

A very common yet inadequate belief says that if a person who attempts suicide, fails, the person would not try again. But according to reports, the person is at the highest risk of attempting another suicide within three months or up to a year of the first fails attempt.

Research shows that this phenomenon has a little biased factor to it with boys who have a previous suicide attempt tend to have a 30-fold increase in suicide risk compared to boys who have not attempted suicide. In comparison girls who would have attempted suicide previously would have a threefold increase in suicide risk. Studies indicate that 1–6% of people attempting suicide die by the end of the first year of attempt. 

Hence, it is important to pay attention to the signs of suicidal intent and attempts along with appropriate action to diffuse it. The person should be taken to get immediate professional help even if the person resists.

Personality characteristics

Psychiatric disorders and personality traits are the significant factors that lead to suicide but their interrelationship remains a complex issue. Studying these relationships in the context of attempted suicide help to define mechanisms underlying attempted suicide and identify the risk behaviours that can be predicted. Personality traits affect situational and emotional perception, decision making and behaviour.

The five-factor model of personality i.e. neuroticism, extraversion, conscientiousness, agreeableness and openness to experience rules the prediction of suicide-related behaviours in humans. In a few findings, suicide-related behaviour was characterized by a passive attitude, ill-problem-solving skills even for simple problems along with a rigid thinking process. The characteristics of empathy and cooperation are related to lower suicide rates, while people who are impulsive and hostile, are at a higher risk. Suicide prevention requires attention to selected personality characteristics.

Family factors

Family is the aspect of life that no one can choose or replace. While the family is considered to be your home and the place where you feel safe, people can have varied opinions about it in general. Family can be the biggest support or one of the factors in youth suicide, depending on cases. Several risk factors concerning the family structure and its whereabouts have been linked to suicidal behaviour. In approximately 50% of youth suicide cases, family factors play a major role in the advent of the tragedy.

A child who commits suicide might have a family history related to it or there may be a hint of augmented suicidal behaviour in the family members. It also certainly can be a kind of imitation behaviour in the child. Thus there can be both, a play of imitation as well as genetics.

With a tough age of these youngsters where they already have so much pressure and stuff on their plate, their consistent fights and arguments with their parents are a source of stress in them. Not being able to talk to their parents makes them feel isolated, lonely and vulnerable. Poor communication creates a huge gap between parents and their children. Some children are also exposed to family issues like economic problems, substance abuse and domestic violence which harm the minds of these children. Lack of money, early responsibilities burdened on their shoulders, easy access to alcohol and drugs, severe effects of overdose and withdrawal effects, violence at home, corporal punishment and violent disciple are the leading causes of suicides. With the rise in divorce rates, these children are not able to accept and get comfortable with the concept of single parenting and practical, financial and socio-economic implications of divorce.

Specific life events-traits

Risk factors are directly linked to several life changes and events that change the course of life of adolescents and young adults. With the already hovering issues of identity-crisis, bullying, challenges, physical development, stress and self-confidence, they are faced with high expectations, career goals, job searching and the need to think about the future. They face the need to belong to their peer groups, break-ups, dating violence, losing friends, death of beloved and rejections that create a long-lasting impact in their memories, which burdens them with fear and they are unable to handle the pressure. They might be faced with sexual and physical abuse, ragging, violent form of discipline and insults, punishments and major events that force them to take this drastic step. Events like bullying also cause a major sense of low self-esteem. Rejection,  frequent insults and shame can lead to steps like suicide to escape the wraiths of the bullies.

Contagion-imitation

Suicide contagion is where any direct or indirect exposure to suicide increases the risk of suicidal behaviour in the audience or witnesses. This includes both, exposure to real-life suicides as well as exposure to media portrayals.

Media exposure and vulnerable young adults and teens are a lethal combination to begin with. The reports show that the portrayal of suicides through mass media influences these youngsters and have a dramatic effect leading to the rise in suicides and suicide attempts. This kind of “copy cat” suicide makes these young ones indulge in taking their lives by imitating the methods and tools used by the other victims and characters of television in newspapers and social media. This has started a new trend of cluster suicides.         

Ample evidence from the literature and records on suicide clusters support the contention that suicide is contagious, as a behavioural contagion, which is a situation in which the same behaviour spreads quickly and spontaneously through a group creating a mass impact. 

A phenomenal example can be seen through the case of a Netflix series “Thirteen Reasons Why” which talks and depicts the life of a teenage girl who ends her life in a gruesome manner. She leaves behind a set of 13 tapes pointing out the people who were the cause of her death. Some took it as a positive sign of people opening themselves up to the idea of understanding sensitive issues like suicide that occur due to the angst of an individual, what they go through and the motivations behind suicidal behaviour. It was a step forward to create awareness and give some light to the people going through similar predicaments. On the other hand, the critics defined it as the glorifying of suicide which would eventually lead to a rise in numbers of the same 

According to the BrainLine Blog “A study that examined whether the airing of the series “13 Reasons Why” on Netflix prompted suicide contagion among youth or not, observed a 30% increase in the suicide rate among 10-17 year-olds between March and April of 2017, that is when the series was aired.”

Excessive media coverage of suicides of celebrity figures has led to an increase in suicide attempts and ideation. For example, women were more at risk of suicide after Marilyn Monroe’s death in 1962. Another notable example provides the basis for the famous Werther effect in 1774, i.e. a rash of suicides followed by the publication of Goethe’s novel, The Sorrows of Young Werther. Similarly, William Shakespeare’s Romeo and Juliet has also been accused of glamorising suicide.

Imitation is learning by modelling and the acquisition of new patterns of behaviour through observation of the idol’s behaviour. 

Several factors influence this phenomenon-

  • If the characteristics of the model are strikingly similar to the young person, there is a strong bond between them or the model is someone they idolize and aspire to be. 
  • It is important to ask about the extent of the model’s behaviour that is being reinforced. The more the behaviour is appreciated and accepted, the more likely it is to be imitated by the youngsters.
  • It is necessary to analyze the frequency and manner of presentation of the model’s behaviour. Even the slightest slip in the intensity of information can lead to suicide clusters.

The role played by news and media portrayal influences these young minds by giving them the idea of committing suicide or by providing the youngsters who are already waiting to attempt suicide with information about a specific method to kill themselves through imparting this information where it is easily available at the click of a button.

Dramatic increases in the number of suicides in the days after a celebrity suicide, suicide-related news and media portrayal have been noted and suggest the need for contingency plans to meet increased rates of suicides. There is a need to carefully consider communications and messaging around suicide, follow guidelines and prevent any further harm.

Impact of Social Media 

The way today’s young people communicate and spend their leisure time has fundamentally changed as they have leapt with more time on digital media than spending time with their friends in person, extra-curricular activities and sleeping. The rise in attempted suicides by young people correlates directly with their access to smartphones, internet and social media. Dealing with the problems in this generation is already tough which has been further elevated by these problematic sources.

Teens and young adults are way too busy scrolling through Instagram, tweeting every second, updating their status on Facebook and making streaks on Snapchat that they hardly sleep enough. All they are left with is a sheer waste of time, energy and resources, feeling jealous of each other due to the fake life being portrayed on social media where it is all about flowers and rainbows while nobody is showing their struggles, insecurities, truth and flaws. 

Being blindsided by the sunlight shining in the virtual world, these children are quick to give up and end their lives at the simple sight of a grey cloud and thunder. In their bedrooms with a smartphone and sufficient internet data, It’s too tempting to stay up late looking at the phone, with the blue light that it emits keeping the brain awake thinking it’s daytime. Everything done on these devices is psychologically stimulating and the brain is not able to slow down and relax.

Availability of means

Most youngsters at the time of attempting suicide are confused and unsure of their decisions. There is a process that involves the transition from suicidal ideation to actual suicide which occurs impulsively as a reaction to acute psychosocial stressors. If during this uncertainty and process of transition the aspect of availability of means is added, the action can be lethal. These children usually commit suicide by slitting their wrists, hanging themselves from the ceiling, jumping from a high place, running into traffic, and poisoning with substances like prescription drugs and firearms. Easy access is a great motivation for them to attempt suicide. Besides that, with just click of a button, a youngster can easily find innumerable sites to look up tools that can be used to attempt suicide. This kind of information is easily available which can cost the lives of youngsters and adults as well.

Mental Illness and the LGBTQ community 

Depression, anxiety, and mood disorders are commonly found in the LGBTQ community due to the prejudice and discrimination faced by them which cause low self-esteem and negative sexual and gender identity.

  • Lesbian, gay, and bisexual kids are three times more likely to attempt suicide 
  • Lesbian and bisexual women and girls are twice as likely to attempt suicide.
  • Gay and bisexual guys are four times likely to attempt suicide.
  • Almost half of young trans people have seriously considered taking their lives and a quarter has attempted suicide.
  • Lesbian, gay, and bisexual young people who belong to families that do not accept them are over eight times more likely to attempt suicide. 
  • Every time an LGBTQ person becomes a victim of physical or verbal harassment or abuse, they become two and a half times more likely to hurt themselves
  • Conversion or reparative therapy is ineffective and can lead to increased depression, substance abuse, and suicide attempts.
  • Suicidal lesbian, gay, and bisexual people are more likely to attempt suicide after seeking religious or spiritual treatment. 

Importance of discussing this topic 

Words like “it is just a bid for attention” and “a cry for help” are used a lot to explain the erratic behaviour and suicidal attempts in young adults as well as teens. It is a common myth that they are just being dramatic or overreacting. Suicide attempts and mental health is a major issue, and not just a construct of the people that have no sense of meaning attached to it, The seriousness of the problem needs attention and reconstruction. This subject can no longer be taken lightly or just termed as being a phase. It is very important to respond to the threats and other warning signs responsibly to prevent the rising rate of suicides all over the world. There is a lack of stringent policy for educational institutions and organizations to pay heed to the mental needs of the people and provide them with proper counselling and therapy. If they do not find help in time and nobody to talk to, they begin to feel lonely and alienated thus falling into the pits of addictions. Most of them do not have adequate resources to deal with the issues making them emotionally vulnerable, tired, restless, hopeless and clueless.

The conversation around mental health and suicides need to be normalized and accepted. To begin with, there is a need to take a step forward and discuss the topic with friends, teachers, parents and family. We need to stand together and bring this up as a society to curb this tragedy and prevent youth suicides. These vulnerable youngsters need to know that they have someone by their side to help them through the difficult times. 

Suicides in India 

Suicide in ancient India has been talked about and influenced by sacrificial motives, for the sake of honour, religious, and sociocultural beliefs. Ramayana and Mahabharata, the twin epics of India have time and again influenced the thoughts, temper, conduct, and culture of our people.

In Mahabharata, after hearing about the death of Abhimanyu, Arjun’s son, he tries to attempt suicide but is stopped by Krishna. The practice of “Sati,” where the widow has burned alive along with her dead husband has been classified as the obligatory duty of the wife by many theorists. Even in modern times, altruistic suicides have been witnessed as done by the great leader Potti Sriramulu who gave up his life by fasting for the creation of the state of Andhra Pradesh.

India has one of the highest suicide rates among youth in the world. The reason for such high numbers is the lack of economic, social, and emotional resources. There is a huge burden of academic pressure, modernisation of urban centres, social pressures, relationship concerns, workplace stress and the breakdown of support systems. The clash of values within families is an important factor for young people in ending their lives. The traditionalist households are less supportive of their financial independence, marriage age, premarital sex, rehabilitation and taking care of the elderly. Every hour one student commits suicide in India according to data provided by the National Crime Records Bureau.

People in India are so entwined in the myths and stigmas that they do not reach out or seek help. Using words like ‘Pagal’ and ‘Pagal Khana’ instils the sense of fear of being labelled as a loser. They worry about what society would say, who will marry them if people hear about them seeking therapy and the shame that follows. So, they hide inside their tiny hole and reach the depths of the problem from where they cannot come back and in the end take their lives.

Suicides in premier institutes such as IITs and suicides due to ill performance in the board exams hold a mirror to the education system. 27 students across 10 Indian Institutes of Technology (IITs) committed suicide between 2014 and 2019 as per data from the Department of Higher Education, under the Ministry of Human Resource Development (MHRD). The education system is slowly becoming about marks and ranking the best while no one is paying attention to talents, hobbies and learning which puts youngsters under extreme pressure and they take the drastic step to save themselves from facing failure and shame. Even if they get into good schools and colleges, employment issues and lack of jobs create situations of stress and failure.

India does not have a uniform policy that makes it compulsory for educational institutions to keep a trained counsellor among its regular staff to address the students’ needs and acknowledge their cry for help.

Recent developments to curb this 

To address these challenges and successfully cope with the emotions, young people must have access to significant supporting resources that are easily available. Risk factors that undermine this support or hinder access to these resources should be overcome while protective factors that strengthen and protect these resources should be encouraged.

Prevention

The after-effects of suicide can have a long-lasting impact on the parents, schools, institutions, peers and society. To curb this menace, warning signs should be taken seriously and should be paid heed to. The following steps should be followed to bring the numbers down-

  • Suicide prevention clinics have been opened up to prevent attempts. Schools, colleges and organizations have also opened their doors to the screening of such students and people.
  • Teachers and staff are being trained to cope and deal with depressed students and anxieties.
  • De-addiction and Marital Counseling Clinics are being welcomed to solve family and addiction issues.
  • There has been a consistent effort to create equality across genders and bring awareness to stop bullying and discrimination.
  • Educational programs are being conducted periodically to detect and manage depression and other psychiatric conditions
  • The consulting psychiatric services should be promoted in all institutes 
  • Strict restrictions are being enforced on the access to means of suicide including measures for control of availability of such tools and weapons
  • Installation of barriers in high places and bridges is being followed along with restricted access to weapons that could be a potential threat. 
  • Holistic development of the child is being promoted in schools and colleges.
  • Restrictions on media have been strengthened concerning publicity on suicides and displays of information related to suicide which can have negative effects on the society.
  • The people with some mental health condition and at risk of suicide are being accepted and treated with care, patience and love. 
  • Awareness about the suicide helpline numbers is being distributed to students in case of emergencies.
  • A change in educational institutions is being marked with focussed learning and a shift from just earning marks

Laws in India 

Till 2017, in India, a failed attempt to commit suicide was considered to be a crime under Section 309 of the Indian Penal Code 1860 with any person who attempted it would be imprisoned for one year post the committing of the crime.

In 1996, there was a debate in which it was argued that section 309 of the IPC violated Article 21 of the Constitution of India which talked about the right to live for every individual in the case of Gian Kaur Vs State of Punjab. It was further contended that if a person had a right to live he should also have the right to end his life on his/her terms. The contention was struck down and section 309 was held to be valid and constitutional.

In P. Rathinam case a contrary view was taken into account where Section 309 IPC was not treated as unconstitutional and it was held that Right to Life is a natural right, but suicide is an unnatural termination or extinction of life and thus inconsistent with the idea of the concept behind Article 21. It was slowly realized that punishing a person for attempting suicide would be more harmful because the punishment was not needed, the person needed help and counselling along with therapy to realize the gift of life. 

Thus, The Mental Healthcare Act, 2017 came into existence where Section 115 talks about the presumption of severe stress in case of attempt to suicide. The person under this section who attempts suicide would be presumed to have severe stress and would not be punished. The government took upon itself the responsibility to provide care and rehabilitation to any such person.

The 210th Report of the Law Commission of India – Humanisation and Decriminalisation of Attempt to Suicide. states that, “Section 309 needs to be effaced from the statute book because the provision is inhuman, irrespective of whether it is constitutional or unconstitutional. The repeal of the anachronistic law contained in Section 309 of the Indian Penal Code would save many lives and relieve the distressed of his suffering”

The Act has banned electric shock as a method of treatment for mentally ill children along with electric shocks for adults with mental illness without the use of muscle relaxants and anaesthesia. Sterilisation of men and women was also prohibited along with tying mentally ill persons with chains considering the right to live with dignity concept enshrined in Article 21 of the constitution, 1950. There is an attempt to integrate the patient into society and not put labels or segregate him/her from the society.

This step was a major stepping stone to the progress in the field of acceptance of mental illnesses.

Conclusion

There is a suicide occurring right now while we are busy doing our work. These people need help, love, motivation and understanding. WE together have the power to stop the menace and provide an environment where people vulnerable to suicide can talk openly, express their feelings and talk about their problems. At times they just need someone to tell them that everything is going to be okay. Just do your part, listen to people and help them overcome drastic steps like taking their life. Empathise and understand that suicide is not the nature of a person but just a state of mind that can be dealt with positively. Just like any of us, they deserve to have a good life and that can be possible only when the society comes together and joins hands to solve this problem. Life is a gift, we can use it to its fullest and help save the lives of the people who can have an equal opportunity to enjoy their gift. Problems are not the end, they can be sorted out and dealt with and ending your life is no solution to it. Throwing our book of life in the fire is no solution. We were not born to be quitters, ask for help and speak up about your problems. Live a life that would uplift you and you will look back one day, all proud of how far you have come. If you or any of your friends are facing any form of suicidal thoughts or attempts, The suicide helpline number of AASRA in India is 022 2754 6669. Do not hesitate and use it if you feel like taking the wrong step 

References 

  1. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Teen-Suicide-010.aspx
  2. http://teenmentalhealth.org/learn/suicide/
  3. https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00540/full
  4. https://www.brainline.org/research/suicide-contagion-impact-13-reasons-why-and-celebrity-suicide
  5. https://www.scientificamerican.com/article/13-reasons-why-and-suicide-contagion1/
  6. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1453-5
  7. https://www.youthkiawaaz.com/2019/10/india-having-the-highest-rate-of-suicide-among-youth/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127810/
  9. https://save.org/lgbtq-resources/lgbtq-adults/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711233/
  11. https://www.thebetterindia.com/108700/suicide-prevention-a-growing-public-health-concern-in-india/
  12. http://archive.nmji.in/archives/Volume_18-3_May_June2005/editorial/EDL18-3.pdf
  13. http://www.legalserviceindia.com/legal/article-1423-suicide-law-in-india.html
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711233/
  15. https://youth.gov/youth-topics/youth-suicide-prevention/preventing-youth-suicide

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