Trigger warning: Suicide, Depression, Trauma and Anxiety
It’s just two months into 2024 and multiple incidents of students dying by suicide have been reported. According to the World Health Organization (WHO), close to 800,000 people die by suicide every year globally; that’s one person every 40 seconds. Shockingly, for each suicide, there are more than 20 suicide attempts.
In January this year, an 18-year-old JEE-aspirant died by suicide in Rajasthan’s Kota two days before her examination, often called the coaching capital of India. The student left a suicide note for her parents stating that she was unable to do JEE preparations.
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This month another student, a NEET aspirant, died by suicide and the Kota district administration seized the hostel facility due to a lack of ‘anti-suicide devices’ in ceiling fans.
There are around 3,500 student hostels that are operating in Kota. India’s ‘coaching capital’, Kota, is also infamous a ‘suicide city’ due to the increasing number of suicides among student.
Over 35,000 students died by suicide in the country between 2019 and 2021, the Lok Sabha was informed in December last year. According to the data, the number of students who died by suicide in India rose by 70 percent between 2011 and 2021.
According to the National Crime Records Bureau, in 2021, students accounted for 8 percent (13,089 victims) of total suicides in the nation. In 2011, they were 5.7 percent (7,696) of the victims. In 2021, Maharashtra reported the highest number of students who died by suicide (1,834), while it was 12,659 for the entire nation.
In the 18-30 age group, 56,543 individuals died by suicide in 2021. It is noteworthy that failure in examination was quoted as a reason for suicide in 714 incidents in this age group. In the age group below 18 years, failure in examination resulted in the deaths of 864 individuals during this period. Consequently, of the suicide victims for whom exam failure was identified as a triggering event, 94.32 percent were below 30 years of age.
‘Installing anti-suicide devices like spring-loaded fans does not address underlying issues’
Last year, following multiple cases of suicides in Kota, the district authorities ordered hostels to install a spring device on ceiling fans to stop students from taking their lives.
The anti-suicide spring device will expand if an object weighing more than 20 kilos is hung from the fan stalling any possible attempt and a siren too will go off.
Additionally, a mandatory psychological assessment will be conducted for each student. According to the officials, if any student exhibit signs of mental vulnerability or negativity, counselling services will be extended, and parents will be duly informed.
According to Dr. Rahul Chandhok, Head Psychiatrist, Head Consultant, Mental Health and Behavioral Science, Artemis Hospitals, measures such as installing spring-loaded fans and nets to prevent suicides in places like Kota may offer temporary solutions but may not address the underlying issues contributing to mental health problems and suicidal behavior among students.
“While physical barriers can deter impulsive acts, addressing the root causes of stress, anxiety, and depression, and providing comprehensive mental health support services, including counseling and therapy, are necessary for long-term prevention efforts,” he told Financial Express.com.
Meanwhile, Sakshi Maheshwari, Clinical Psychologist (Child & Adolescent Psychology), Niyama Digital Healthcare claims that the effectiveness of installing spring-loaded fans and nets in addressing the student suicide crisis remains questionable and limited in scope.
“While these measures aim to prevent immediate means of suicide, they fail to address the underlying causes of mental distress and suicidal ideation,” she told Financial Express.com.
Instead, effective strategies to combat student suicides should focus on addressing root causes such as academic pressure, social isolation, and lack of access to mental health support, she said.
“This involves implementing curriculum reforms, promoting mental health literacy, and providing accessible counselling services within educational institutions and communities. Additionally, fostering a supportive environment through open communication and peer support networks is crucial. Rather than relying solely on physical measures, it is essential to adopt comprehensive, preventative measures that address the multifaceted issues contributing to student suicides,” she added.
What is the status of suicides of India?
Suicide is a serious public health issue in India. According to UNICEF’s survey findings for 21 countries in The State of the World’s Children 2021 report, every one in seven youngsters between 15 and 24 years in India reported some form of poor mental health such as feelings of depression.
However, only 41 percent felt there was a need to reach out for support when people experienced mental health issues. According to the data, India was the lowest across the 21 countries. It is noteworthy that India released its first national suicide prevention strategy in November 2022.
The mental health crisis in India is more aggravated by a severe shortage of trained professionals. According to a study by the Indian Journal of Psychiatry, India has 0.75 psychiatrists per 1,00,000 patients, which is much lower than the recommended three psychiatrists per 1,00,000.
Although there is a well-established link between suicide and mental disorders, many suicides occur impulsively in moments of crisis. According to WHO, risk factors include experience of loss, loneliness, discrimination, a relationship break-up, financial problems, chronic pain and illness, violence, abuse, and conflict or other humanitarian emergencies. However, the strongest risk factor for suicide is a previous suicide attempt.
In India, the suicide mortality rate per 100 000 population in 2016 was 16.5, while the global average was 10.5 per 100 000. The most vulnerable are the 15-29 year old’s, the elderly, and persons with special needs, as per WHO. However, it is important to emphasise that this crisis is preventable.
In 2018, India decriminalised suicide by passing the Mental Healthcare Act (MHCA), 2017. This act enables the person who attempted to die by suicide, to access free healthcare, treatment, and rehabilitation instead of punishment. While the Mental Healthcare Act, 2017 (MHCA) decriminalised attempted suicide, section 309 of the IPC continued to remain a legal provision leading to confusion among relevant stakeholders and its practical implementation.
However, as the Bharatiya Nyaya Sanhita 2023 (BNS) is set to replace the IPC, the new legislation no longer has provisions criminalising attempted suicide.
Meannwhile, amid the rise in suicide cases, the government and its educational bodies have taken various measures to address the pressing mental health challenges faced by the students. The Central Board of Secondary Education (CBSE) has provided counselling services to students and parents for the last 25 years to overcome mental stress related to exams and results.
In January 2023, the University Grants Commission (UGC) circulated the National Suicide Prevention Strategy, a collaborative effort with the Ministry of Health and Family Welfare. Additionally, the 2020 National Education Policy (NEP) also reinforces the significance of counselling systems within educational institutions, aiming to effectively manage stress and emotional adjustments. Reportedly, the ministry’s multi-pronged approach includes initiatives like peer-assisted learning and the introduction of technical education in regional languages, is designed to alleviate academic stress.
According to WHO, a strengthened system for quality data on suicides for both attempted and deaths from vital registration, hospital-based systems and other surveys for formulating policies and subsequent monitoring are effective suicide prevention initiatives.
As suicide is an avoidable public health problem, there is a need to prioritise public health strategies for suicide prevention.
‘Poor mental health among students in India is a growing concern’
An estimated 13 percent of youth under 18 years of age have significant mental health problems across the world. Studies suggest a significant percentage of mental health issues have their onset below 25 years of age.
According to Dr. Chandhok, high levels of stress, anxiety, depression, and other mental health issues among students, driven by academic pressure, competition, parental expectations, and socioeconomic factors.
“The prevalence of mental health disorders among students has been on the rise, leading to adverse effects on academic performance, social relationships, and overall well-being. However, stigma surrounding mental health often prevents students from seeking help or accessing appropriate support services. According to a report by NCRB there are over 13,000 students who took their own lives in India which is 7.6% of all suicide deaths in 2022,” Dr. Chandhok told Financial Express.com.
He also maintained that the increasing incidence of suicides among teenagers in India is a complex issue with multiple underlying causes.
“Academic pressure, failure in exams, relationship problems, bullying, substance abuse, family issues, and mental health disorders are among the leading factors contributing to suicidal behavior among teenagers. Additionally, societal expectations, lack of coping mechanisms, and limited access to mental health resources exacerbate the problem. Addressing these root causes requires a multi-faceted approach involving schools, families, communities, and policymakers,” he added.
Maheshwari told Financial Express.com that post-pandemic, concerns have escalated due to increased uncertainty and disruptions in education.
“Limited access to mental health professionals and inadequate support systems in schools further compound the issue. These challenges have led to impaired academic performance and negative long-term impacts on students’ well-being. Addressing these issues requires initiatives such as awareness campaigns, school-based programs, and access to affordable care,” Maheshwari said.
Suicidal tendencies: What are triggers?
Suicidal and self-harm tendencies among students can arise from a combination of psychological, social, and environmental factors. Dr. Chandhok, academic pressure, perfectionism, bullying, relationship issues, substance abuse, family conflicts, trauma, and mental health disorders can contribute to feelings of hopelessness and despair.
“Preventing trigger factors involves creating supportive environments, promoting resilience, teaching coping skills, fostering positive relationships, and providing early intervention and access to mental health services. Additionally, promoting open communication and reducing stigma surrounding mental health can encourage students to seek help when needed,” he said.
He also emphasised that there are some signs and symptoms that we face during anxiety and depression such as excessive worrying or over-thinking, physical Symptoms including muscle tension, headaches, fatigue, trembling, sweating, restlessness or irritability, facing difficulty in concentrating, sleep disturbance and panic attacks, change in appetite or weight, feeling of worthlessness or guilt without a specific reason and suicidal thoughts or behaviour.
“If you or any of your friends or family shows such kind of symptoms please go and visit a mental health expert,” he added.
According to Maheshwari, suicidal and self-harm tendencies among students can stem from a lot of factors, ranging from individual vulnerabilities like mental health conditions and past trauma to environmental stressors such as academic pressure and social isolation.
“Trigger factors like stressful life events, substance use, conflicts, and reminders of past traumas can exacerbate these tendencies. To prevent these triggers, promoting mental health awareness, creating supportive environments both at school and home, addressing academic pressure, promoting self-care and stress management techniques, and early identification and intervention are crucial,” she told Financial Express.com.
By tackling the root causes, fostering understanding, and providing necessary support, we can work towards mitigating the risk of suicidal and self-harm behaviors among students, she maintained.
“It’s essential to emphasize the availability of help and support for those struggling, encouraging them to reach out to trusted individuals or seek professional assistance when needed,” she added.
How to improve the mental health among students?
Improving the mental health among students requires comprehensive efforts at various levels.
“This includes raising awareness about mental health issues, reducing stigma, providing accessible and affordable mental health services in educational institutions, implementing stress management programs, promoting a healthy work-life balance, fostering supportive environments, and addressing systemic issues contributing to academic pressure and inequality,” Dr. Chandhok said.
Additionally, early identification and intervention, as well as promoting mental health literacy among students, teachers, and parents, are essential components of a holistic approach to improving mental health outcomes among students, he said.
Dr. Chandok also highlighted that the family plays a crucial role in shaping the mental health of children in India. “Family dynamics, parenting styles, communication patterns, and support systems within the family significantly influence a child’s emotional well-being. Positive family relationships, open communication, emotional support, and parental involvement can foster resilience and protect children from developing mental health issues. Conversely, dysfunctional family environments, parental neglect, abuse, or conflict can contribute to poor mental health outcomes among children,” he said.
It’s crucial to recognize that mental health is a complex and multifaceted issue that requires a holistic approach involving various stakeholders, he maintained.
“Promoting mental health awareness, reducing stigma, enhancing access to mental health services, and fostering supportive environments are key pillars in addressing mental health challenges among students in India. By prioritizing mental health and well-being, we can create a nurturing environment where students can thrive academically, emotionally, and socially,” Dr. Chandhok added.
According to Maheshwari, to address the concerning state of mental health among students in India, several crucial areas need improvement.
“Firstly, there must be widespread awareness campaigns and educational initiatives to promote mental health literacy and break social stigma. Schools should integrate mental health screening, counseling services, and peer support networks, while also training teachers and staff to recognize and address early signs of distress. Additionally, reforms in academic structures to reduce excessive stress, combatting bullying, and fostering social inclusion are essential,” she told Financial Express.com.
At the policy level, there needs to be a clear focus on child and adolescent mental health, along with increased funding for mental health infrastructure and research.
“A holistic approach involving families, communities, and digital resources is necessary to ensure students receive the support and tools they need to thrive mentally and emotionally,” she added.
DISCLAIMER: If you or someone you know is struggling with their mental health or in distress contact the Vandrevala Foundation’s helpline (+91-9999666555) which is available in 11 languages including English and can be accessed via telephone or WhatsApp 24×7. You can also contact Fortis Hospital’s National Helpline number 91-8376804102 which is available 24×7. You can also contact the Government Mental Health Rehabilitation Helpline ‘KIRAN’ at 18005990019 which is available 24×7.
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