The
WHO constitution states: “Health is a state of complete physical, mental, and
social well-being and not merely the absence of disease or infirmity.” A
healthy life includes both physical fitness and mental well-being. A good
health reflects positivity and functioning of one’s potentialities with the
society and environment around. There is a famous proverb, “He who has health,
has hope; and he who has hope, has everything.”
“The
key to a healthy life is having a healthy mind” this is a simple wellness quote
with strong message which has been ignored in today’s times. According to WHO,
“Mental health is a state of mental well-being in which an individual realizes
his or her own abilities, can cope with the normal stresses of life, can work
productively and is able to make a contribution to his or her community.” Mental
health encompasses emotional, psychological, and social well-being, influencing
cognition, perception, and behavior.
Mental
Disorders:
Unlike
physical disease and wounds, mental wounds are often not seen and ignored. People
strive to conceal their mental health difficulties because people view them as
taboo. They avoid discussing about mental disease and depression. Fever is considered
more vulnerable, serious than depression in our society because fever can be
diagnosed, expressed and visible unlike mental illness. A person with mental
health problem is viewed as a lunatic who needs a mental institution. Example,
visiting a dentist is much comfortable to share than visiting a psychiatrist in
our society. People are scared to disclose their mental health problems in
public as they fear losing face or bringing shame to their family. Mental
health is often viewed through a lens of superstition, misunderstanding, and
ignorance. The link between suicide and mental disorders (in particular,
depression and alcohol use disorders) is well established. Therefore, “Mental
illness is an unnoticed wound in our country.”
Suicide
in Sikkim:
Every suicide is a
tragedy that affects families, communities and entire countries and has
long-lasting effects on the people left behind. As per WHO reports, more than
720,000 people die due to suicide every year. It is the third leading cause of
death among 15-29 years old. 73% of global suicides occurred in low- and
middle-income countries in 2021. Suicide is a serious public health problem
that requires a public health response.
The prevention of
suicide has not been adequately addressed due to lack of awareness of suicide
as a major public health problem and the taboo in many societies to openly
discuss it. Only 38 countries report having a national suicide prevention
strategy. Raising community awareness and breaking down the taboo is important
for countries to make progress in preventing suicide.
In 2008, Sikkim
earned the dubious distinction of being the state with the highest suicide rate
(48.2) in the country and in the last decade the state has continually been
referred to as the ‘Suicide capital of the Northeast.’ The rate of suicide is
increasingly high in Sikkim as compared to its population density. Over the
span of thirteen years (2008-2020), Sikkim has consistently registered the
highest suicide rates, followed by Tripura in second position.
According to the
National Crime Records Bureau (NCRB) report, Sikkim registered a 43.1 per cent
suicide rate, followed by 42.8 per cent in Andaman and Nicobar Islands. The
national average was 12.4 per cent, with a total of 1,70,924 suicides reported
across the country in 2022. Sikkim reported 293 suicide cases in 2022 according
to the report.
As per sources,
the counselling helpline number in Sikkim need to be expanded and information
spread about the helpline. More awareness and sensitizations including free
counselling to persons suffering with depression and suicidal tendencies is crucial
and urgent.
Concern and
Causes:
· Many
suicides happen impulsively in moments of crisis with a breakdown in the
ability to deal with life stresses, such as financial problems, relationship
break-up or chronic pain and illness.
· Experiencing
conflict, disaster, violence, abuse, or loss and a sense of isolation are
strongly associated with suicidal behaviour. By far the strongest risk factor
for suicide is a previous suicide attempt. Suicides rates are also high amongst
vulnerable age groups from 15- 35 years old in Sikkim.
· Rapid
urbanization, unemployment, depletion in the traditional source of income,
depression, and substance (narcotics) abuse are some of the key reasons.
· High
expectations from parents, society and extreme academic competition often lead
the students to suicide.
· Use
of narcotics leads to intense depression and which eventually leads one to
commit suicide.
Prevention
and control:
·
Suicides are preventable
by limiting access to the means of suicide such as pesticides, firearms,
medications etc.
·
Interaction with the
media for responsible reporting of suicide.
·
Fostering socio-emotional
life skills and Life skill education (LSE) must be imparted to adolescents and
young adults in schools and colleges.
·
Awareness raising, proper
sensitizing, and health counseling is important for suicide prevention efforts.
·
Vocational and livelihood
oriented academic programs need to be introduced at school and colleges.
·
It requires coordination
and collaboration among multiple sectors of society, including the health
sector and other sectors such as education, labour, agriculture, business,
justice, law, defense, politics, and the media.
·
Local bodies,
representatives, neighborhoods, and society at large should analyze, coordinate
and work for the awareness of mental health to avoid depressions and mental
disorders.
·
A comprehensive
multisectoral suicide prevention strategy is needed.
·
Improved surveillance and
monitoring of suicide and self-harm are required for effective suicide
prevention strategies.
·
Vital registration of
suicide, hospital-based registries of self-harm and nationally representative
surveys collecting information about self-reported self-harm.
·
Breaking the taboos of
suicide. Openness and discussion on the topic are vital for proper diagnosis of
the problem.
The
family who has succumbed to such tragedy, their pain and loss cannot be
expressed and explained. It is important to understand the importance of mental
health and well-being in our society. Its time for the representatives, state
authorities, health sectors and educational sector to imbibe life skill
consciousness, awareness, and activities to indulge young minds. The loss of
life between 15- 32 years old is the loss of state and country for nation
building. Hence, attention and concern are crucial and urgent to prevent
suicide and suicidal environment in Sikkim.
Sources:
·
World Health
Organisation, 2021. Suicide worldwide in 2019: global health estimates.
·
“SUICIDE AND SUICIDAL
BEHAVIOUR IN SIKKIM: AN OVERVIEW” by Nancy C. Lhasungpa, post on September 16,
2022 at SIKKIM PROJECT, the land and its people. (https://www.sikkimproject.org)
·
“This State Had The
Highest Suicide Rate Per Lakh In India: Centre’s Report”, article from Dec
05,2023. (https:/www.ndtv.com)
·
“Sikkim is Suicide
Capital”, an article by Kunal Rai.
(The writer can be reached at: sandhyasubba310@gmail.com)