Obfuscating Suicides On Suicide Prevention Day

Today is the World Suicide Prevention Day. By the end of the day, there would have been seminars, awareness rallies, talk shows, discussions, debates, political finger pointing and everything else associated usually with this day in the past plus of course experts advising parents to spend quality time with their kids so that they do not fall prey to the fatal charms of the blue whale.(Incidentally what happened to spending quantity time with children? Quality time so means very little time and how does one distil time anyway ?)

It would also have been pointed out that 200,000 thousand Indians commit suicide every year according to WHO figures and that each suicide inherently is an avoidable death.

We in India do not get the right answers because we keep on asking the wrong questions. In the wake of a suicide there is a strong and urgent impulse to project its sole causation to something or preferably somebody out there. We do it because then it ceases to be our responsibility and we are saved from asking ourselves uncomfortable questions. Hence, the National Crime Research Bureau lists causes of suicides committed in 2015 as ‘non-settlement of marriage’, extra-marital affair, property dispute, failure in examination, failure in love affair, failure in business etc etc. The category of ‘Cause Unknown’ is just 12%.Rest all stands ‘explained’ The same defence mechanism of projection by the society is responsible for looking for an ‘abettor’ in all cases of suicides .

To say only on the basis of temporal proximity that these were the causes of suicide in the sense that had these factors been absent the person would not have committed suicide is not logical. It is like saying in the case of man being run over after a breakfast of scrambled eggs, that scrambled eggs are cause of being run over.To say that such common life situations could on their own lead a person to suicide would mean that most people will die of suicide sooner or later. Suicides are multifactorial and the most important cause is psychological vulnerability, most other so called causes being the triggers. In a very large number of cases of suicides there are no triggers at all.

There is no doubt that farmers’ distress is one of the most tragic fact of our times and needs the government’s support on a priority basis. It is also important that a focus on the topic has brought much needed help and some infusion of ideas to reform the agricultural sector. But to say that farmers suicide are disproportionate in numbers as compared to any other occupation, is not just not correct but comes in the way of offering mental health solutions to farmers themselves. Financial support is necessary to provide succour to the devastated family but will do nothing to prevent future suicides. As per an affidavit submitted by the central government to the Supreme Court, farmers’ suicides constituted just 9.4% of total suicides in the country. When an issue becomes as emotive and as political as farmers’ suicides, a rational pursuit of solution is the first casualty and the intended beneficiaries first victims.

Does it mean that everybody who commits suicide has mental health issues? Not at all. Choosing to terminate one’s life in the face of a painful terminal illness or a major unavoidable adversity as a matter of conscious choice does happen but with much less frequency.

Prevention of suicide starts with asking the right questions and providing mental health services both as part of the general health services and as standalone service . All cases of suicide are subject to a post- mortem examination by law. What is also required and eminently feasible is a psychological autopsy in all cases of suicide. This data when compiled will give precise answers much better than the kite flying going on currently. Sometimes being politically incorrect is the only correct way.

“So, we need to evaluate more in depth each suicide and get to know the other causes like emotionally disturbed individual , inadequate support and means of problem solving, depression and major life crisis. Every effort should be made to prevent suicide. This is responsibility of every mental health professional and the whole society”

Prof. Anirudh Kala is the Director of Mind Plus Healthcare.

Know Your Parenting Style

The other day I was watching Slumdog Millionaire on television for the nth time, and it got me thinking. Here are two brothers – Jamal and Salim. Two brothers with similar genetics and experiences, and yet who are diametrically different in every possible way. Which evoked the whole nature vs. nurture theory debate in my head.

There is no doubt in my mind that we all our predisposed to be a certain type of individual, and that is what governs our personality. However the events we experience, the kind of exposure we get in life and our learning from those, also has a huge impact on shaping us. But which has a bigger role – our genetic make up or our life experiences?

Either ways there is no doubt each has a contribution to creating the individuals that we are. The more important point to remember is that we cannot control the genetic make up of our children, but what we can control is the environmental factors that might influence them. Have you ever thought about what is your parenting style and is it helping your child to get the right opportunities to be the best version of them?

Here is a quick quiz for you to help identify your parenting style. Don’t worry the responses and results are only for you to know.

Q1. Your son wants to start soccer classes, what do you do?
(a)You enroll him in a sports academy that has an alumnus of good performers, and make sure he does not miss out on any class.
(b)You ask him for further information and together go see a few places and then enroll.
(c)You buy him an entire soccer gear and enroll him in the best academy in town
(d)You enroll him in a class closest to home, so that he can manage the routine on his own.

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Mental Health Care Act 2016

According to a rough estimate 60 million Indians suffers from mental health difficulties. Nearly 1-2% of the population suffers from severe mental disorders, such as Bipolar disorder and Psychosis, and 5% suffers from common mental disorders like depression, anxiety and stress. These numbers are based on a research conducted by National Commission for macroeconomics 2005.

However these figures are in all likelihood a significant understatement, as most of the times psychological difficulties are  unreported due to either lack of awareness, or stigma, or a combination of the two. This is also associated with lack of competent psychiatric consultations or simply the unavailability of qualified and trained persons to tackle these issues. There are only 3800 psychiatrists, 898 clinical psychologists, 850 social workers and 1500 psychiatric nurses across a nation of 1.2 billion people.

Mental Health Care Act 2016 (hereby referred to as The Act) passed in the upper house on 27th March, 17 is a big step in the right direction taken by the government. The mental health legislation that it replaces is outdated, and not fit for purpose. Since India is a signatory to the United National Convention for Rights of People with Disabilities (UNCRPD), the law had to be updated to make it compliant with this international rights convention. Some key provisions under the Act are:

  1. Rights of person with mental illness: Every person will have the right to access mental healthcare services which are funded or operated by the government. People will have the right to equality of treatment, right to protection from inhuman treatment, right to access free legal service and right to complain with regards to any discrepancies.
  1. Advance Directive: It empowers the patient to decide how he/she would like to be treated and the right to choose a nominated representative.

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