Dr Vikram Patel is a psychiatrist and a Professor of International Mental Health and a Wellcome Trust Senior Clinical Research Fellow at the London School of Hygiene and Tropical Medicine. He also is a Profession at Harvard Medical School. Vikram is a founder and past Chairperson of Sangath. He has a number of publications to his credit including scientific papers, book chapters as well as a book. He was an editor of the recent Lancet Series on Global Mental Health (2007) and is editor of a forthcoming Lancet Series on Health for All in India. He has done extensive work in the field of Mental Health and Suicide Prevention. Dr. Vikram has answered few pertinent questions relating to suicides and suicide prevention Indian
Dr. Vikram Patel welcome to akhilvaani, a platform to Own- Up, Open-Up and Talk Mental Illness. Today 10th September is World Suicide Prevention Day. akhilvaani is privileged to have a doyen like you with us to answer few questions related to prevention of growing suicides in India.
akhilvaani : Question 1-
There is nor much data available about actual incidence of suicide and suicide attempts in the country. The latest National Crime Records Bureau (NCRB) data indicates 1,33,623 Indians took their life in 2015 which is less than 1,35,585 suicides in 2011. Contrarily, the WHO Report- “Preventing Suicide- A Global Imperative (2014) indicates that in 2012, a whopping 258075 Indians (158098 males and 99977 females) committed suicide. While etiology of suicide is complex, knowing incidence and epidemiology of the same need not be. In your considered opinion what prevents the country from correctly counting the number of suicides and suicide attempts.
Answer: Dr Vikram Patel
THE MAJOR CONSTRAINT IN INDIA IS THE POOR QUALITY OF ASSESSMENT OF THE CAUSE OF DEATH GENERALLY, WHICH IS MISSING IN UP TO HALF OF ALL DEATH IN SOME STATES. THIS IS FURTHER COMPOUNDED BY THE FACT THAT SUICIDE HAS BEEN, UNTIL RECENTLY, A CRIMINAL OFFENCE WHICH, FOR OBVIOUS REASONS, LEADS TO UNDER-REPORTING.
akhilvaani: Question 2-
NCRB was set up as a repository of information on crime and criminals to assist the investigators in linking crime to the perpetrators. Do you think NCRB is the right agency to collect information on suicide and suicide attempts after Decriminalization of Suicide in new Mental Health Care Act, 2017. If not, what is the best way to know the correct number of Indian’s taking their life or trying to end their life.
Answer: Dr Vikram Patel:
IT IS TRUE THAT SUICIDE IS NO LONGER CONSIDERED A CRIME, BUT THE NCRB IS A REPOSITORY OF ALL INJURY RELATED DEATHS, WHETHER INTENTIONAL OR ACCIDENTAL.
akhilvaani: Question 3-
Irrespective of which data (WHO or NCRB) we believe, both have a very troubling revelation- disproportionately large number of Indians in the age group 14-29 commit suicide and attempt suicide annually. Millions more live with nagging suicidal ideation. What are the reasons behind growing suicide of this group which has maximum psycho social and economic collateral damage to families and nation.
Answer: Dr Vikram Patel-
YOUNG PEOPLE ARE A HIGH-RISK GROUP IN ALL COUNTRIES FOR SIMILAR REASONS: THIS IS THE PERIOD OF LIFE WHEN A PERSON TRANSITIONS FROM CHILDHOOD TO ADULTHOOD, FACES A NUMBER OF MAJOR CHALLENGES SUCH AS COMPLETING EDUCATION AND FINDING A JOB, ACHIEVES SEXUAL MATURITY AND EXPERIENCES UNIQUE NEURO-DEVELOPMENTAL PROCESSES.
IN INDIA, HIGHLY RESTRICTIVE SOCIAL NORMS WHICH DICTATE WHO A PERSON MARRIES, WHEN THEY HAVE SEXUAL RELATIONS, AND WHAT KIND OF CAREER THEY SHOULD PURSUE ARE A MAJOR CAUSE OF STRESS IN YOUNG PEOPLE’S LIVES.
MUCH SELF-HARM IN THIS AGE GROUP IS IMPULSIVE, IN THE CONTEXT OF ACUTE DISAPPOINTMENTS, AND THE REASON WHY MORTALITY IS SO HIGH IN INDIA IS BECAUSE OF THE METHOD USED FOR SELF-HARM, SUCH AS PESTICIDES OR HANGING.
Question 4: As a leading global authority on suicide prevention what are the three things you think are paramount for the policy makers to stem the tide of growing suicides. What concrete steps we as a nation have to take on urgent basis.
Question 5: On World Suicide Prevention Day, what is the central message you would like to give.
Answer: Dr Vikram Patel
SUICIDE IS PREVENTABLE.
THE FACT THAT SUICIDE IS THE LEADING CAUSE OF DEATH IN YOUNG PEOPLE IS A NATIONAL TRAGEDY.
WE CAN ACT BY IMPLEMENTING THE RANGE OF STRATEGIES OTHER COUNTRIES HAVE USED TO DRAMATICALLY REDUCE SUICIDE RATES IN INDIA, IN PARTICULAR AMONG YOUNG PEOPLE.
WE NEED A NATIONAL COMMISSION ON SUICIDE AND OTHER INJURIES WHICH HAS REPRESENTATION FROM DIVERSE SECTORS TO ENSURE A NATION-WIDE PLAN OF ACTION TO MAKE THIS HAPPEN.