Despite a booming economy, Sikkim has the highest suicide rate among all Indian states, second only to the Union Territory of Puducherry.
Gangtok: For Sukhrani Limbu of Sordung village, about 120 km from Gangtok, 29 May 2016, was just another usual day at work. But upon her return home, she found her eldest son, 30-year-old Aitey Singh Limbu, hanging from the ventilation shaft in his room.
Life somehow went on for the grieving mother. But then came 29 May 2018, when her third son, 27-year-old Aitey Hang Limbu, hanged himself from the same ventilation shaft in the same room.
“There was no suicide note, no signs of sickness… I am still clueless about what triggered their suicides,” Sukhrani says, fighting back the tears.
Sukhrani is not the only mother or family member in Sikkim who’s searching for answers. A National Crime Records Bureau study reported that the landlocked Himalayan state witnessed 241 suicides in 2015, 2.1 per cent of all the suicides in India that year.
But in terms of suicide rate in the last decade, Sikkim has the highest (37.5) among all states, and the second highest in the country after the Union Territory of Puducherry (43.2). Suicide rate is the number of suicides per one lakh population. According to the 2011 Census, Sikkim’s population was 610,577.
The West district, where Sukhrani lives, is Sikkim’s worst-affected region. Between 2008 and 2018, 278 cases of suicide were reported here.
Underbelly of the ‘golden state’
Sikkim joined the Indian republic in 1975, and has gradually become the poster child for development and a booming economy. Between 2004-05 and 2011-12, the state witnessed the highest net state domestic product in the country, and was the third richest state in India according to the 2015-16 Economic Survey.
In September 2018, Sikkim got its first airport at Pakyong near Gangtok, and in October, it was awarded by the United Nations for becoming the first state in the world to become 100 per cent organic. Literacy and cleanliness are high, and it’s often referred to as a ‘golden state’.
Yet, it has a sordid underbelly, which is manifesting itself in suicides and the questionable mental health condition of its residents. Regardless of age, gender, rural-urban divide, economic or health status, suicide looms everywhere.
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A number of factors
“It would be very difficult, and even unfair, to pinpoint a particular reason for why Sikkimese people are turning suicidal. There are several factors: A long history of alcohol and drug abuse, unemployment, high aspirations, ignorance of mental health illnesses and changing family structures,” said Yumnam Suryajeevan, assistant professor of sociology at the Sikkim Manipal University.
Social worker Dr Satyadeep Chhetri adds three more factors — lack of socialisation, loneliness and high rates of adultery.
“Around 70 per cent of people who have committed suicide were loners — either they were separated couples, aged people living away from their children, or kids from broken families. There is no study to connect suicide with adultery or other factors, but many people have committed suicide due to marital discord,” Chettri said.
A case in point is that of a 12-year-old girl who committed suicide on 26 June 2017 because she longed for parental love.
The seventh grader from Timberbung village in West Sikkim used to live with her old grandparents after her parents drifted apart and started living with their respective lovers, said an investigating officer from Soreng police station.
Drugs and alcohol
Many Sikkimese youth are high on pharmaceutical drugs like Nitrosun 10mg, Spasmo Proxyvon (SP) and cough syrups like Corex and Phensedyl, which are smuggled into the state from the neighbouring Siliguri in West Bengal.
“Drug users are very vulnerable to suicide,” said Prashant Sharma, member of the Sikkim Drug User Forum.
Former drug user Robin Rai recalls trying to kill himself during one of his weak moments nine years ago. Rai, who works as a counsellor at a suicide helpline centre in Gangtok, said he gets numerous calls from drug users with suicidal tendencies.
The state’s climate, geographical location, and the easy availability of alcohol has made it vulnerable to alcohol abuse as well.
Sikkim’s history with alcohol dates back to 1954, when Sikkim Distilleries was set up in Rangpo to ensure quality liquor for its citizens at a reasonable price. The then Chogyal (king) agreed to give the company absolute monopoly for the manufacture of alcohol, on the condition that the government was given 47 per cent of its shares. The state earns considerable revenue every year from alcohol sales — in 2013-14, the figure stood at Rs 120.64 crore.
K.C. Nima, a public health activist, shared the story of Suresh (name changed), a 40-year-old chronic alcoholic who had attempted suicide twice.
“The Sikkim High Court had to order the state to provide rehabilitation for him. There are many such cases,” Nima said.
Charvi Jain, a Kolkata-based psychotherapist, said that dysfunctional families, loneliness and drug and alcohol abuse are all interconnected. “It can be a deadly cocktail for suicide,” she said.
Also read: Suicides high among married women: Crisis in Indian marriages or mental health stigma?
According to a report by the Labour Bureau of the Ministry of Labour & Employment, Sikkim has the second highest unemployment rate in India.
Prawesh Lama, guitarist for the popular local band Tribal Rain, said the rush for government jobs had something to do with it.
“The problem of educated unemployed youth is high here. Sikkimese youth focus only on government jobs. But such jobs are for just a few who have the ‘right’ contacts,” Lama said.
“People are not willing to compete in the private sector. In this struggle to grab a government job, many youth get frustrated-some fall victim to drug and alcohol abuse, while a few even lose the urge to live.”
Cultural stigma of mental illness
Historically, the rulers of Sikkim have had no record of suicidal deaths. However, according to local tribal myth, adultery in a past life could lead to unnatural deaths, said L. Khamdak, professor of Limbu cultural studies at Namchi Government College in South Sikkim.
Tshering Tamang, a shaman based in Pelling, West Sikkim, added: “Every person has a predestined time to live. If someone kills themselves before time, their soul turns into Sian (evil spirit).This Sian can take lives of other people known to him or her in the similar way. More suicides will take place till the spirit completes its life-circle.”
In Sikkimese religious practices, mental health is often misunderstood. People with serious mental health illness approach religious gurus and shamans rather than coming to a doctor, said a psychiatrist based in Geyzing, West Sikkim, who did not wish to be named.
What has the administration done?
Other than an unpublished study conducted by Sikkim University, the state government has done very little research on the issue. ThePrint repeatedly tried to contact state health minister Arjun Ghatani, health secretary Vishal Chauhan and other senior officials, and emailed them questionnaires on the issue. But the only official response was an email from the health department, acknowledging receipt and saying it would take time to reply to the questions, “as this is a government procedure”.
However, that’s not to say there haven’t been efforts to curb suicides. A senior health department officer said on the condition of anonymity that the state was trying its best to combat the growing problem.
“The Sikkim Mental Health programme is operational since 2011, and we are conducting many awareness campaigns across the state,” the officer said.
In 2015, a state-funded 24×7 suicide helpline centre (03592-2021111, 18003453225) equipped with trained counsellors was started from the psychiatric department of the Sir Thodup Namgyal Memorial Hospital in Gangtok. However, the centre has received just 182 genuine calls so far, because hardly anyone seems aware of it. There were no advertisements for this number in Gangtok or West Sikkim, and helpline head Dr Jigmee K. Topgay said the reason was a lack of funding for promotion.
Hardly any local psychiatrists or health department officials were willing to speak on record when contacted for this report, because when a few of them spoke to a national daily on this issue, they were transferred from Gangtok to far-flung regions of the state.
One exception was Dr Satish Rasaily, a psychiatrist who has worked closely in the past with the government on suicide awareness programmes.
“The state has done several suicide prevention campaigns in Gangtok,” he said.
But outside the state capital, the track record of awareness programmes gets a bit murky. On the one hand, health department officials claim they conduct regular camps, as do local government officials like Hemant Limbu, vice-president of the Darap village near Pelling.
“We have a conducted a community level awareness programme where doctors, psychiatrists and suicide counsellors from Gangtok visited our area on the occasion of World Mental Health Day on 10 October 2018,” Limbu said.
But on the other hand, people in many other villages in West Sikkim said such camps were a rarity.
Also read: One in every 3 women who commit suicide globally is an Indian
How to fix this problem
Parul Agarwal, a Siliguri-based counsellor and psychotherapist suggested that the Sikkim government should work on spreading awareness about mental health.
“Forming a team of well-trained counsellors and psychiatrists who can work at the grassroots level can be a good start. Regular workshops, seminars in schools and colleges and a compulsory HR policy on mental health awareness at workplaces can be helpful,” she said.
Among all the religious groups in the state, incidents of suicide are least among the Christian community, and that’s because of a conscious effort that others could emulate, said Father Moni Clement Lepcha of St Mary’s Catholic Church, Geyzing.
“We regularly hold conversation with our parish members. When we talk about our problems, it helps a lot in venting out,” he said.
Social worker Chhetri added: “We have to tap the emotional quotient of Sikkim’s citizens. We have to tackle this situation as a society. We need to be more open to talk to each other, create occasions to meet and socialise.”