India needs national suicide prevention strategy, stresses NIMHANS study

Bangalore, India: A comprehensive national suicide prevention strategy for any country, and for India in particular, needs information on both suicide and suicidality, a recent study in the journal Lancet Psychiatry has suggested. 

"Though we have national information on suicide mortality in India from the National Crime Records Bureau and Global Burden of Disease Study, such information on suicidality is relatively absent in India; even when available has major limitations. As individuals experience or live with suicidality, there is a great opportunity for professionals, family, friends, colleagues and others to extend a helping hand for such individuals. Thus, understanding and helping individuals with suicidality becomes a key component of any suicide prevention. By providing comprehensive and reliable information on the prevalence and risk factors of suicidality for the first time, the findings of this scientific paper will complement the available data on suicide mortality to inform policy and action for suicide prevention in India," Dr Senthil Amudhan, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India, and the lead author of the study informed Medical Dialogues.

Suicide is the act of deliberately ending one's own life (fatal outcome), whereas suicidality refers to all thoughts, plans and acts of suicide without a fatal outcome and thus excludes those acts of suicide that resulted in death. Suicidality is an important predictor and precursor of suicide.

Dr Sethil and his team performed the study where trained field data collectors from the NMHS obtained information on suicidality (during the past month) from a community sample of adults aged 18 years and older using the suicidality module of the Mini-International Neuropsychiatric Interview (version 6.0). Suicidality was categorized as low, moderate, high, and overall (representing any suicidality), and examined for sociodemographic differentials using normalized sampling weights. For each of the 12 surveyed states, the age-standardized suicidality prevalence was calculated for men and women, men-to-women ratio of weighted suicidality prevalence, ratio of suicidality to suicide deaths, and ratio of suicide attempts to suicide deaths.

Among 34 748 participants with complete interviews, 5·1% had some level of suicidality, and 0·3% (0·2–0·4) had at least one suicide attempt in the past month. 

Key findings of the study revealed:

Dr Senthil Amudhan also provided MD team with some key takeaways from the study. These included

1. Suicidality emerged as another unrecognized public health problem with greater occurrence than suicides and other mental health disorders of public health importance.

2. For every death by suicide in India, there were more than 200 people with suicidality and more than 15 suicide attempts the extent of which varied largely across the states.

3. At any time point in 2015, over 30 million Indians aged 18 years & above had thought about ending their own life, and 2.6 million had attempted suicide; a number higher than the population of few countries in the world.

4. About 1 in every 100 adults aged 18 years and older in India were reported to have a severe form of suicidality that required urgent intervention.

5. As India accounts for 18% of the global population, suicides and suicidality in India have global implications towards achieving the sustainable development goals (SDGs) that target a reduction by a third in premature mortality from non- communicable diseases by 2030, with the suicide mortality rate as one of the key indicators.

The study, "A population-based analysis of suicidality and its correlates: findings from the National Mental Health Survey of India, 2015–16," is published in The Lancet Psychiatry.

DOI: https://doi.org/10.1016/S2215-0366(19)30404-3

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