More and more young people are committing suicide in rural India, reveals new study

There is need for developing strategies targeted at young individuals to prevent incidents of premature mortality, says a new study by the George Institute for Global Health, India.

More and more suicides are occurring among the economically productive age group of 15 to 44 years  in rural parts of the country thus necessitating the need for developing strategies targeted at young individuals to prevent such incidents of premature mortality, a  recent research paper  by the George Institute for Global Health-India has revealed. 

The study conducted in 45 villages in the East and West Godavari districts of Andhra Pradesh and spread over 1.8 lakh population over a four year period using verbal autopsy method has revealed that the suicide rate in this part of Andhra  Pradesh is three times higher than the national average of 11.2 persons per 100,000 population. However, the findings are  in line with the rate of suicides reported in the Million Deaths Study. 

Deaths due to intentional self-harm or suicide in India are among the highest in the world and according to the global burden of disease report,  the burden caused by injuries is not well-established in low and middle income countries and  the surveillance systems are poor. "The verbal autopsy tool was deigned to obtain precise, reliable and up-to-date  information on deaths occurring due to suicides in the region under study," said Dr. Rohina Joshi,  the principal author  of the paper.

"Suicides account for  4.8 per cent of all deaths in this rural community of South India.  Approximately 70 per cent of all  suicide-related deaths occur in the economically productive age group of 15 to 44 years," says Dr. Pallab Maulik, Deputy  Director, Research and Development, George Institute for Global Health-India, and a co-author of the paper.

The study involved non-physician health care workers recording the deaths occurring in 45 villages using a verbal autopsy  method. Verbal autopsies were completed for 98.2 per cent (5786) of the deaths (5895) recorded.  The crude death rate was 8 per 1000 population. 4.8 per cent of all deaths were suicides, giving a suicide rate of 37.5  per 100,000 population. 

As per the study, 43 percent of all suicides occurred in the age group of 15 to 29 years and 62 per cent were  men. In  the younger age group (10-29  years), suicide by women (56 per cent) were more common than by men (44 per cent).  Poisoning (40 per cent) was the most common method of self-harm followed by hanging (12 per cent).  

The implications of these findings, which was recently reported in the Tropical medicine and International  Health Journal, are substantial and necessary interventions are needed at the village level to prevent the cause of premature mortality.

"Interventions such as restrictions in access to pesticides may be helpful for rural communities engaged in agriculture.  Reorientation of the health system and training of health care providers at the primary health care level is  required to enable the implementation of evidence-based strategies that can address the daunting challenge of suicides," says Dr. Maulik.

While the study did not go into the causes of suicide, identification and management of suicidal risk and  mental disorders is a key strategy that one needs to develop. "It is essential to allow people to discuss adverse life  situations in a non-stigmatising manner within their communities," says Dr. Maulik, adding : "Policy-makers should also be made aware of the various risk factors including the link between mental disorders, socio-economic and financial stress and suicide." 

Building on this research, Dr Maulik and his team, have recently started a new project in the same geographical setting covering about 50000 adults, to estimate the number of them who suffer from common mental disorders liked depression, anxiety and suicidal risk and develop a mobile based clinical decision support tool that will enable primary health care  workers and doctors to screen and treat people in the community suffering from such conditions easily.