Kerala has many firsts to its credit, yet the State Crime Records Bureau statistics reflect a disturbing trend in suicides.
The past five years' statistics show an increase in the number of people dying by suicide in the State. The number of suicide cases went up 21.3 per cent to 9,549 in 2021 from 7,870 in 2017.
Looking closer, 22.86 people out of one lakh took the extreme step in 2017. It increased to 27.20 in 2021, despite Kerala boasting of achieving most of the targets the World Health Organization (WHO) has set.
The situation raises serious questions on whether the State has achieved the desired goals in case of suicide prevention and mental health.
Double the national average
The suicide rate in Kerala is more than double the national average of 11.3 in 2021. According to the National Crime Records Bureau statistics, the northeastern State of Sikkim reported the most number of suicides with an average of 42, followed by Chhattisgarh with 26.4.
Kerala now figures third in the list with an average of 24, moving two slots up from the fifth position five years ago.
The figures mentioned speaks only about suicides committed, not attempted. The number of suicide bids, too, is alarming. Studies have pointed out that the attempts are 20 times more than the reported suicides.
Going by the studies, Kerala might have witnessed about 1,90,000 suicide attempts in 2021 alone. It is both alarming and challenging to know that the State has been daily reporting, on an average, 26 deaths by suicide and 523 suicide attempts.
Suicide capital
The State capital, Thiruvananthapuram, has been reporting the most number of suicides over the past five years (36.8 suicides in 2017, 42 in 2021), which calls for a comprehensive study.
Malappuram has been reporting relatively lesser number of suicides for the past few years (7.6 in 2017, 11.5 in 2022). Data, however, points at a gradual increase in the number of suicides in the northern district as well.
Statistics revealed that those aged between 15 and 45 form the majority of people taking the extreme step. More men are committing suicide than women in Kerala, with a male-female ratio of 3:1. The universal ratio is one woman to 1.7 men.
Suicide pacts
Another disturbing factor is the suicide pacts involving the entire family. As many as 25 people were involved in such suicide pacts in 2020. Kerala figures behind Andhra Pradesh (46), Tamil Nadu (45), Madhya Pradesh and Rajasthan (39 each) in suicide pacts.
Of late, incidents of jilted lovers committing suicide after murdering their love interests, too, are on the rise in Kerala.
Suicide pacts and crimes of passion and subsequent suicides make sensational news. It is ideal not to publicise such incidents. Excessive publicity to such incidents might make some believe that suicide is the solution for issues they face in life.
Family issues
Statistics also revealed that 78 per cent of those who had committed suicide were married, whereas unmarried people comprised the majority of those who took the extreme step in western countries.
Domestic issues were the motive for 39 per cent of suicides reported in Kerala. The figure reflects the inability of the new generation in handling such issues, and their lack of patience to consider alternative solutions.
Physical and mental illnesses have been attributed to 69.5 per cent of suicides reported in the State. Those who had committed suicide due to mental illness in Kerala (20.5%) is higher than the national average of five per cent.
The National Sample Survey has found that 132 people out of a population of one lakh have been suffering from mental disorders. In Kerala, however, the number of 282, double than that of the national figure. Though the number is high, the State has been turning a blind eye to the issue.
Several suicides could be prevented if provided timely and effective treatment. The suicide tendency among those suffering from diseases such as depression, excessive alcoholism, drug addiction and schizophrenia is 10 to 15 per cent. Treating them in the initial stage itself could prevent them from pushing themselves over the edge.
The role of the society
Several factors -- physical, mental, social, financial and cultural -- influence one's decision to commit suicide, a complex phenomenon. It is unscientific to attribute only one motive to any suicide. Kerala has undergone several changes during the recent past, and they, too, should be taken into account.
Several expats have lost employment, and have returned home, businesses have gove bust due to COVID-19, more addiction to drugs, post-lockdown behavioural changes in teenagers, blind following of western culture, cultural decay, movies and television serials glorifying suicides, increasing natural calamities, etc., have been affecting the average Malayali's mental equilibrium.
Tell-tale signs
There is a misconception that those who speak of committing suicide may not take the extreme step. It is wrong. Those contemplating suicide share their thoughts, directly or indirectly, with others, which are often ignored with tragic consequences.
Even if the person considering suicide does not speak out his/her thoughts, they certainly display notable signs. Facial expressions, emotional detachment, crying, tiredness, lack of interest, carelessness, guilt feeling, unnecessary panic, introversion, insomnia, loss of appetite, drug abuse, refusal to take medicines, reckless driving, preparing the Will are some of the tell-tale signs of suicidal tendencies. Some others tend to be more energetic than usual.
Several people could be encouraged to walk back to life from the brink if they get a patient and understanding listener on whom they could pour out their woes without inhibition. Immediate treatment should be provided if mental illness is behind suicidal thoughts.
Those facing family issues should open up to someone they could confide in, friend or a family member. The help of professional counsellors should be sought if the issue is complex.
The government, on its part, could open at least weekly suicide prevention centres in all taluk and district hospitals.
Death by hanging
The majority of suicides (78%) reported in Kerala were by hanging. Easy availability of pesticides, and the provision to buy drugs over the counter contribute to 9.4 per cent and 2.6 per cent of suicides in the State.
Setting up telephone helplines accessible round-the-clock could prevent several spur-of-the-moment suicides. The way forward, however, is to equip each citizen to face social and financial issues with confidence.
(The writer is the Founding Director of Kozhikode-based Tanal, a centre for suicide prevention.)