By Dr George Jacob

Kochi: In the last weekend of May, I had an extremely disturbing and difficult undertaking at hand. One of my nephews passed away. I, as family, visited the bereaved family to pay our last respects. The family was dear to mine. The person who passed way was a 27-year-old engineering graduate. He was only in the morning of his life. He took his own life one evening.

The incident shocked all of us who call ourselves ‘adults.’ We groped for nonexistent reasons, and answers to questions like ‘why?’ Not that it could have made a difference, as it was a tad too late. We were all shell-shocked, and benumbed. The parents, especially the mother was inconsolable. The household help since years, who had a big role in rearing the dead youth wailed inconsolably, drawing tears from every eye present there.

This is not a rare incident to have happened in Kerala. Suicide has taken on epidemic proportion in the so-called ‘God’s own Country,’ that one wonders if the menace has become contagious as something like scabies, or infectious as Tuberculosis! The situation is alarming in India as a nation in this one unsavory phenomenon.

About 800,000 people commit suicide worldwide annually. Of these, 135,000(17 percent) are Indians, a nation with 17.5 percent of world population. Between 1987 and 2007, the suicide rate increased from 7.9 to 10.3/100,000, with higher suicide rates in southern and eastern states of the country.

In 2012, Tamil Nadu with 12.5 percent, Maharashtra with 11.9 percent, West Bengal with 11 percent recorded the highest proportion of suicides. Tamil Nadu and Kerala had the highest suicide rates per 100,000 people in 2012. The male: female ratio was 2:1.

According to the data with the WHO, the age standardized suicide rate in India is 16.4/100,000 for women (6th highest in the world) and 25.8 for men (ranking22nd) causes for suicide in India were evaluated in 2014: they were bankruptcy or indebtedness(2,308 people), marriage-related issues(6,773), non settlement of marriage(1,096), dowry-related issues(2,261), extramarital affairs(476), divorce(333), failure in examination(2,403), impotency/infertility(332), other family problems(28,602), illness(23,746), AIDS/STD(233), cancer(582), paralysis(408), mental illness(7,104), other prolonged illness(15,419), bereavement(981), drug abuse/addiction(3,647), fall in social reputation(490), hero worship(56), poverty(1,699), unemployment(2,207), property dispute(1,067), and infidelity(458).

The situation in Kerala is bad. In fact real bad!

The population in Kerala in 2014 was 3,39,00,662, out of which 8446 took their own lives, accounting for the suicide rate of 24.9/lakh in that year, while that in 2013 was 25.6, with the total number of suicides being 8646, about and around which the rates have been remaining steady.
The darker side is that, compared to other states, suicide rate among youth and family suicides is on the higher side in Kerala. The latest figures with the National Crime Records Bureau (NCRB) show that 8,431 people killed themselves in 2011, the state accounting for 6.2 percent of the total number of suicides in the country.

Althoug Kerala’s percentage share has come down, there has been an increase in the rate of suicide from 24.6/100,000 population in 2010, to 25.3/100,000 in 2011. Around 100 people attempt suicide daily in Kerala, of whom 25 are successful. More men kill themselves than women, the ratio being 7:3. 80 percent of the suicides are by those between 15 to 59 years of age.

Hanging was the most common method (50 percent), followed by ingestion of poisonous substances (32 percent) recent reports in the media bring dismal pictures of increasing adolescent suicide in India, especially Kerala, where social, health, economic and educational advancement has taken place, keeping these indices comparable to developed Scandinavian countries to form ‘the Kerala model of development’.

The Christian Medical College (CMC) in Vellore placed Kerala with high number of suicides with 14.5 percenrt. The NCRB study discloses that in 2005, out of 2,555 adolescent suicides, 1,328 were boys and 1227, girls. A recent study conducted on 11,000 high school students revealed that among the respondents, 27 percent at least thought of suicide, while 16 percent planned and 8 percent attempted suicide.

These alarming figures unequivocally point to the fact that suicide has emerged as a public health problem in ‘God’s own Country’, which Kerala is known as. It is to be debated if the problem is really a public mental health problem, rather than just a public health problem! What prompts these adolescents, in the morning of their lives, to call it quits? The causes are many:

• Poor parent understanding of the vulnerability of adolescents form the prime reason. Adolescents and children are more vulnerable to resort to ‘ending it all’ these days, thanks mainly to their almost nonexistent capability to ‘cushion’ disappointments, setbacks, and tough times, and trivial reasons like being denied an ice-cream! The saying, ‘when the going gets tough, the tough gets going’ is foreign to their psyche. A number of factors add to their vulnerability viz:
• (a) the joint family system having given way to nuclear ones,
• (b) The limited number of children, exemplified by the two children or even, one child norm,
• (c) financial advancement, brought about by the double income pattern, with parents having no quality time to spare for their children,
• (d) later to ‘compensate’ for the aforesaid by lavishing their neglected children with consumer goods, in keeping with the ‘consumer state culture’ that Kerala has welcomed with open hands.
• (e) The parents then go on to ‘over expect’ excellence in academic and extracurricular fields to which Mushrooming coaching centers that rob children of their very childhood and holidays, and ugly skirmishes unashamedly indulged in at State- level School Arts festival venues respectively stand testimony. Adolescents and children are stretched to their limits to meet their parents’ dreams, aspirations and even highly bloated, unrealistic and self created ‘social standing’, which in fact, no one else is bothered about, or interested in.

• Biological: children with parents and even siblings with suicide tendency are known to be prone genetically to commit suicide, made worse by coexistent mental disorders and substance abuse.

• Academic reasons: there is clearly an enhanced rate of suicide among adolescents in India during the exam season. Studies disclose that boys commit suicide three times more than girls. Suicides abound when students fail in examinations, or fail to score expected marks or grades. Social scientists term such tendency as ‘Rational Disaster’, which is not curable, but certainly preventable.

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• Media and network: overexposure to modern technology such as television, internet, and ‘smart phones’. These are not bad in themselves, if used appropriately. Children and adolescents these days spend considerable time in the inanimate and virtual world of ‘technology’, than they ought to, and is necessary. Unfortunately, the above said have a certain undesirable inbuilt ability to enslave their users to addiction, like Ajinomoto does to a long list of junk food happily indulged in by modern-day ‘foodies’ ! In the process of enslaving modern-day youth, the latter become social recluses. They distance themselves from peers and close relatives. Parents become their enemies because ‘they fail to understand them’, become less alive to their surroundings and are reduced to beings, slightly better than the brain-dead! In this virtual world, naïve adolescents and children are introduced to pornography, skewed sexual tendencies and sexual promiscuity, which run incongruent to Indian culture, on which they were bred on, making them guilty, confused and robbed of self-esteem, ending up within a four walled prison from which they cannot escape, even if they want to, leading them to the easy way out- to ‘end it all’.
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• Mental illnesses like depression, major psychosis like schizophrenia, through chemical imbalances in the brain drive people to suicide. These people require dedicated and understanding therapy and healing influence of a team comprised of psychiatrist, clinical psychologist, social counselor, family, friends, spouse, and encouragement to indulge themselves in positive and wholesome activities or diversions such as a hobby that interest them.

• Numerous other causes are: infidelity, leading to breakdown of marriages (that end up in divorces), loss of identity among peers, rejection and failed love affairs, conflict within families, unemployment, debt and financial crisis, lack of spirituality which undoubtedly anchors one to stability, amidst a raging storm. Isn’t it after all said, ‘a family which prays together, stays together and longer’ (if I may add).
Are there ways to turn people away from a decision made to ‘quit’ or prevent them from taking a disastrous decision, to which chance to undo is nonexistent ? Of course there are ways one could try, rather needs to try to prevent people from dying gory deaths that suicides often are (though such attempts are often long drawn, and require patience, dedication and perseverance :

• People or youth known to have mental disorders like depression and schizophrenia, especially if coexistent with substance abuse must be treated by professionals, or a team of them adept at dealing with such cases.
• Recent changes in mood, tendency to prefer reclusion, loneliness, lack of sleep, anorexia and neglect of the self, like unkemptness, unexplained waning of academic performance, disinterest in activities and wholesome interests one was known to possess must be viewed as warning signs, and professional help sought.
• Parents must keep away from forcing their children to dream the formers’ dreams. They should be left alone, and encouraged to follow their own dreams and goals in life, as youngsters tend to tune their ambitions in keeping with their inclinations, attitude and aptitude. Children must not be utilized as tools by parents to achieve ‘social standing’. Tendency to prod children to do better than those of neighbors’ across the wall, friends’, relatives’ and colleagues’; must be resisted.
• Ways to get better than one’s colleagues and contemporaries through one’s own children must not be employed.
• Excessive use of modern-day ‘technology’ must be nipped in the bud. Though there are numerous positives in these technologies, their propensity to trap their users into addiction must be realized, looked for and quelled. The so-called ‘smart phones’ have wreaked havoc among youth. While the manufacturers of these gadgets mint smart money, their users are left far less smart. They become slaves to the inanimate and virtual digital world. They become disinterested and indifferent to the surroundings and themselves. They become ‘dull’. Overuse also causes other health problems viz: reduced visual acuity, arthritis of small joints of fingers, precocious spinal degeneration and death on the roads through carelessness and distraction.
• One-to-one personal contact with relatives, friends and neighbors must be encouraged.
• At the same time it is impertinent to keep tab on the ‘company’ the youth choose to ‘hang out’ with.
• Youth must be encouraged to imbibe wholesome and healthy spirituality (not religiosity) , as it goes a long way to have something which is wholesome and healthy to hold on to, when they fall, or begin to do so. Belief in God (not God men, warped cult practices, or self-appointed ‘representatives’ of God) and dependence on a gracious Providence surely do help, as does a regular prayer life, especially when the going gets tough.
• It is always advantageous to liaise frequently with their teachers, friends and others they are closely associated with.
• It is advisable once in a while to expose one’s children to that bed of thorns instead of the bed of roses they are accustomed to, as that would equip them to weather many a storm, and more importantly learn to adjust to unfavorable circumstances and turn of events and inconveniences, the lack of which is a huge deficiency in today’s youth.