New Delhi, June 21: Suicide is the second leading cause of death among young adults in India, after road accidents in men and maternity-related complications in women, new research has suggested.
The study, described as the first to provide national estimates and suicide rates, has also shown that suicides are more common among the educated in contrast to patterns observed in many high-income countries.
Doctors in institutions in India and Canada who conducted the study have estimated that there were about 187,000 deaths from suicides in India during 2010, with 40 per cent of the suicides among men and 56 per cent among women occurring in people aged between 15 and 29 years.
Their findings, based on mortality data collected by the registrar-general of India, will appear tomorrow in the journal Lancet.
“We see some unique patterns in India — an excess of suicide in the better educated and among young adults,” said Vikram Patel, a psychiatrist in Goa and professor at the London School of Hygiene and Tropical Medicine, and a co-author of the study.
Suicides claim more lives among Indians aged between 15 and 29 years than any individual disease, although all diseases taken together kill more people than suicides do.
The researchers say that suicide could soon emerge as the leading cause of death among women below 30 years of age, given India’s decreasing mortality from complications of pregnancy and childbirth.
The suicide burden estimated by the study is much higher than the figure of 135,000 a year reported by the National Crime Records Bureau (NCRB). The new analysis suggests that the NCRB underestimates suicide deaths in men by 25 per cent and in women by 36 per cent. The researchers say that the reliability of the NCRB data “is questionable” because, since suicide is still a crime in India, many cases may remain out of police records.
The study found that the number of suicide deaths among the unemployed and among people in professions other than farming was collectively three times greater than the number of suicides among farmers.
“Suicides in the non-farming population far outstrips farmers’ suicides,” Patel said.
The research has also revealed a sharp regional contrast with suicide rates in the southern states up to 10 times higher than in the north. The number of suicides per 100,000 people in a year (for the age group 15 to 69 years) ranged from 6.3 in Bihar to 66.3 in Kerala, and from 2.2 in Punjab to 39.7 in Tamil Nadu.
“This analysis reveals the magnitude of the problem but doesn’t answer why this is happening,” Patel told The Telegraph. “We need to examine what social factors might be operating in the southern states that leads to such high rates of suicide.”
He added: “Suicides are very preventable. Most of the focus on health programmes for the young in India deals with reproductive and sexual health. We need equal emphasis on mental health promotion with explicit suicide-prevention strategies.”
Studies from a few cities in India based on small sample populations had earlier indicated that interpersonal relationships, unemployment and financial difficulties, as well as mental health problems such as depression or alcohol abuse are contributing to suicides.
Psychiatrists who were not associated with the new study have said its finding of higher suicide rates in India’s relatively rich states is “surprising” as it contradicts the results of studies in high-income countries that show low socio-economic status as a risk factor for suicide.
“These are unexpected findings,” said Michael Phillips and Hui Cheng from the Shanghai Mental Health Centre in China and the Emory School of Medicine in the US, in a commentary published in the same issue of the journal.
“(The new findings) show that the importance of demographic, social and psychological factors that have been assumed to be universal risk factors for suicide can, in fact, vary greatly between cultures and over time.”
Poisoning, mainly through organophosphate pesticides widely used in agriculture, was the leading method of suicide in men and women — 49 per cent men and 44 per cent women ended their lives consuming pesticides. Hanging was the second most common method in both sexes (35 per cent for men and 26 per cent for women).
The research on suicide mortality is part of an effort to analyse the cause of deaths in 1.1 million homes across the country — the so-called million-death study led by epidemiologist Prabhat Jha at the University of Toronto with collaborators from several institutions across India.
Researchers from the National Institute of Mental Health and Neurosciences, Bangalore, the Epidemiological Research Centre, Chennai, and the Postgraduate Institute of Medical Education and Research, Chandigarh, collaborated in the analysis.