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Journal Article

Citation

The Lancet Regional Health-Southeast Asia. Lancet Reg. Health Southeast Asia 2023; 16: e100276.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.lansea.2023.100276

PMID

37849651

PMCID

PMC10577089

Abstract

In August 2023, India was shocked when a teenage medical aspirant and his father died by suicide. In India, the suicide death rate (per 100,000 population) increased from 9.9 in 2017 to 12 in 2020

. Considering its large population, India reports the largest number of suicides in the world with 164,033 cases reported in 2021. A highly effective suicide prevention strategy is therefore of the utmost importance.

Depression is one of the most common mental health conditions among people who die by suicide. However, the stigma associated with suicide usually discourages individuals with suicidal ideation from seeking help or confiding in others about their problems. Risk factors
for suicide are sometimes not externally evident. Childhood trauma, unemployment, and being socially disadvantaged may contribute to an individual's predisposition or vulnerability to mental health issues. For example, childhood trauma might affect the DNA methylation and expression of the hippocampal glucocorticoid receptor gene

, leading to more cortisol release (enhanced stress response) during adulthood. The first step towards the elimination of stigma associated with suicide is progression of the public's opinion towards empathy for people experiencing suicidal behaviour.

Gender discrimination, gender-based violence, and early marriage lead to increased suicides among adolescents in India. Unemployed married women constituted 51.5% of the women who died by suicide in 2020. However, the pattern of deaths by suicide in India is changing. In their Comment
in this issue, Yadav and colleagues discuss the increasing suicide death rates among men compared with women in India (2.5 times higher in 2021). Compared with 2014, the suicide death rates among daily wage workers increased by 170% in 2021. It is worrisome that the suicide death rate in married men was three times that of married women. Impulsivity, fearlessness about injuries, and alcohol or drug consumption, especially in men, can increase vulnerability to suicide. Family problems and reluctance to seek help must be resolved by continued follow-up and community support.


Language: en

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