Miles to go for effective suicide-prevention protocols in India'
New Delhi, June 15 2020 - The apparent suicide of rising Bollywood star Sushant Singh Rajput has once again focused on two glaring lacunae: that while mental health issues are estimated to affect 150 million Indians, less than a fifth - 30 million - are seeking care of one form or another and that suicide is the leading cause of death for Indians in the 15 to 39 age group.
This has been brought into sharp focus by "Young Mental Health" by Amrita Tripathi and Meera Haran Alva (Simon&Schuster) that was ironically launched Sunday evening, hours after Sushant Singh and points to the huge dearth of mental health professionals in the country with an estimated number of only 0.047 trained psychologists per 100,000 people who are in need of mental health care.
This in a situation where the The Mental Health Care Act 2017, a bill that replaced the older Act of 1987, mandats the state to have a mental health programme to respond to the growing need for trained mental health professionals to bridge this gap in treatment.
Of particular relevance is an interview with Tanuja Babre, coordinator of the iCall psycho-social helpline run by the Tata Institute of Social Sciences (TISS) that aims to offer counselling via phone, mail and chat to those in emotional and psychological distress.
This interview first appeared on The Health Collective website around World Mental Health Day in 2019 and has been lightly edited for clarity.
What would Babre tell people who are feeling suicidal?
When it comes to the issue of suicide, people often engage in these thoughts because they feel hopeless and worthless and probably don't see any other way to help them navigating through this particular situation. Therefore, any conversation that you are having, it is important that you are not being judgmental or taking a moralistic stance.
It is important to create a safe space. It may so happen that you do not understand the reasons that they choose to do what they are doing but at the same time know that you are there to support them through this. It is also important to give a message of hope and communicate that you may not have the answers right now, but together (we) can
figure out what the answers could be and (that) we will navigate through this. So, we need to be able to communicate that there is a way out of this, but also make sure that we do not make any false promises.
Is there a message for family, friends and institutes on how to be sensitive?
One of the important things to remember is that there are a lot of myths around suicide and self-harm. One of the most common myths is that if you ask the person about this then you instil an idea about this in their mind. This is not true. If you see someone showing signs of being suicidal then it is important that you talk to them about whether they are thinking of ending their life, whether they are feeling vulnerable. You doing that is not going to put the idea in the person's head.
We have all witnessed experiences of suicide around us. Possibly we have all unfortunately lost loved ones through it, or friends or colleagues. Another point to note is that feeling suicidal may be a sign of depression, and it is not a way to get attention or manipulate someone.
The new Mental Healthcare Act decriminalises suicide so I think there is a lot of education also that has to be done of the stakeholders around this particular change because health care professionals often fear liability and deny treatment in such cases.
Suicides by the young are a growing concern - do you get many calls from the younger demographic? What are their triggers? What are some of their concerns?
Almost 40 per cent of the people who get in touch with us are in the age group of 11-30 years. The topmost concerns that people are reaching out to us with are relationship concerns followed by sexuality related issues academic and career related, mental health related concerns, substance use, etc. These are some of the common concerns that young people are accessing our services with. The issue related to suicide is often attached to academics. We also used to run special service for students who are situated in the city of Kota.
This is where the kids are going to train for their competitive exams for engineering and medicine. We got a lot of calls from clients who are feeling suicidal because of academic pressure, or experiencing violence/abuse happening through the coaching classes.
But there are also a lot of issues related to relationships; abuse, violence, breakup.
Some young people reach out with concerns of getting married or getting a divorce, there's violence in relationships. There are also clients who deal with difficulties with family members, being a care-giver to them, and feeling the care-giver fatigue.
The iCall helpline has thus far reached out to 80,000 clients via call/ email and chat. It cites a follow-up rate of 64 per cent and crucially - offers counselling services for free in multiple languages: English, Hindi, Marathi, Tamil, Kannada, Gujarati, Bengali and Konkani. Statistics apart, in a country that often doesn't seem to have enough affordable mental healthcare facilities or even resources to refer those in need to, iCall has long been a sort of silver lining.