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Affiliation
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Department of Psychiatry, National Institute of Mental Health & Neurosciences (Institute of National Importance), Bengaluru 560 029, Karnataka, India. |
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Abstract
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The WHO estimated worldwide suicide rate in 2016 as 10.5/100,000 which accounted for 7.6 in females and 13.5 per 100,000 in males[1]. Seventy nine per cent of global suicides (800,000/yr) occur in low- and middle-income countries[2]. In a meta-analysis of 71 longitudinal studies from 30 different countries, 90 per cent of studies were found to be conducted in North America and Europe. There was under-representation of data from low- and middle-income countries, which account for a large proportion of global suicidal deaths[3].
According to the WHO report of 2016, the suicide rate in India was 16.5/100,000 population, which was higher than the global average of 10.5/100,000[1]. In India, 15-29 yr is the most vulnerable age group; data also report increased suicidal rate in males (18.5/100,000) compared to females (14.5/100,000)[4]. The National Crime Record Bureau (NCRB) data report 133,623 committed suicides, with a rate of 10.6/100,000 in 2015[5]. NCRB report also shows lesser suicidal rate compared to the WHO report[6]. This discrepancy has led to serious criticism that NCRB data are not true representative of suicidal rates[6]. This is because for NCRB data systematic verbal autopsy is not used, but a passive surveillance is done. The data are mainly gathered from the First Information Report (FIR) from the police. The reporting of suicide faces many challenges such as stigma attached to suicide deaths, post-mortem procedure and legal issues involved in completed suicide[7]. However, the new Mental Healthcare Act 2017, Section 115, has decriminalized suicide[8], facilitating help seeking.
Strategy approach to prevention of suicide
A National Imperative was published by the Institute of Medicine[9], in which the prevention programmes were organized at three different levels; (i) universal (addresses the entire population irrespective of the level of risk of the individuals in the population), (ii) selective interventions (address at-risk groups with the goal of preventing the onset of suicidal behaviour), and (iii) indicated (interventions address individuals deemed high-risk by virtue of a prior suicidal attempt or suicidal ideation)[9]. Based on the similar strategy, we propose a model which could be adopted to our Indian setting ...
Language: en |