The Telegraph
Friday , January 6 , 2017

Experiment in suicide zone

New Delhi, Jan. 5: Depression levels and suicidal thoughts declined across rural households in 30 villages in Vidarbha, India's epicentre for farm suicides, after a mental health experiment that its proponents say illustrates a new measure to curb suicides in rural communities.

The experiment, called the Vidarbha Stress and Health Programme and implemented in Maharashtra's Amravati district, appeared to pull down the prevalence of suicidal thoughts from 5.2 per cent to 2.5 per cent in 18 months, researchers said yesterday.

Doctors and community health specialists who designed and conducted the experiment also observed a drop in the prevalence of depression from 14 to 11 per cent, and a six-fold rise in the proportion of people with depression who sought care from 4 per cent to 27 per cent.

They said their findings provided the first evidence of how a grassroots programme relying on health workers and lay trained counsellors could raise awareness about depression as a mental health problem and increase care seeking for depression, ultimately contributing to reducing the risk of suicides.

"We believe a typical farm suicide in Vidarbha is the final act by a person who has experienced extremely challenging economic or social difficulties," said Vikram Patel, professor at the London School of Hygiene and Tropical Medicine and the New Delhi-based Public Health Foundation of India.

"The effects of a mental health intervention need to be seen as complementary and in addition to various economic and financial interventions that governments have introduced over the years."

The government has over the past decade documented suicides by several thousands of farmers in Vidarbha facing crop losses or persistently poor yields, unpaid debts, or lack of alternative means of livelihood among other factors that contribute to economic or social distress.

While various arms of the government have over the years launched schemes such as agricultural debt relief and waivers, rehabilitation packages and increased credit flow, the farm suicides have persisted.

Patel and his colleagues from collaborating institutions and non-government organisations - Prakriti and Sangath - launched their mental health programme in a rural area of Amravati covering a population of about 100,555. Their findings were published yesterday in The Lancet Psychiatry, a medical journal.

They designed a programme to raise mental health literacy and provide psychological first-aid through trained lay counsellors and use psychiatrists in district hospitals or private sector to provide medication to patients with serious mental health disorders.

"We're not saying the economic and financial interventions from the government are not important - they are, but this is a new strategy that hasn't been tried in this manner before," said Rahul Shidhaye, associate professor at the Public Health. "Our findings suggest that this needs to be scaled up to cover more areas," he said.

Patel too asserted that the findings should not be interpreted to lower the emphasis on the other interventions.

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