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HomePageTurnerBook ExcerptsSuicide set to become leading cause of death in Indian women. And...

Suicide set to become leading cause of death in Indian women. And NRCB won’t tell you that

In 'Life Interrupted', the authors go behind the scenes of the suicide crisis in India, showing that women form the bottom rung of it.

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Can we trust the data? Usually, unnatural deaths in India are reported to the police. The police investigate the death and based on the evidence collected, and sometimes the autopsy report, they put together a First Information Report (FIR), which states the apparent cause of death. These FIRs are provided to the National Crime Records Bureau (NCRB), which has been publishing annual reports on suicides since 1967. The NCRB’s reports show an increased suicide rate per 100,000 of the total population from 6.3 in 1978 to 8.9 in 1990, rising between 2006 and 2011, to 11.25, finally stabilising around 10 between 2015 and 2019, and then rising back up to 11.3 in 2020.

Although the NCRB records are the ‘best’ national-level data that we have for suicide, they are beset by several problems. First and foremost, they are dependent on community reports and civil registration systems, and the former can be unreliable and latter inefficient. This is further complicated by the under-reporting of suicide due to accompanying legal consequences and social stigma. Until recently, attempting suicide was a criminal offence in India.

The archaic Section 309 of the Indian Penal Code (IPC) clearly states that any suicide attempt shall be punished with simple imprisonment for up to a year or with fine or both. The fear of punitive action and added hassle of having to deal with police and courts often results in refusal to seek help, which in turn means that the recorded numbers are not a reflection of the truth. There has been an attempt at the decriminalisation of suicide through the Mental Healthcare Act (2017) which presumes that the individual who attempted suicide be suffering from a mental illness unless proven otherwise and seeks to provide them with care, instead of subjecting them to criminal prosecution.


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Despite this attempt at decriminalisation, the social stigma associated with suicide results in the NCRB grossly under-reporting the true numbers of suicide. Some of the anticipated social consequences that lead to under-reporting include difficulty in getting
married and ostracization of the individual and their family.

On an average, the overall suicide death rate in India reported by the NCRB was 37% lower per year compared with the rates reported by Global Burden of Disease (GBD).3 This simply means that for every 100 deaths by suicide in India only 63 get reported through the NCRB. Among men, the average under-reporting was 27% per year, and among women, the average under-reporting was as high as 50% per year.

As always, P. Sainath, Ramon Magsaysay Award winning journalist who has written extensively on structural inequities in our society, pulls no punches when he addresses this issue of under-reporting. For him, it is a simple matter of wrongly registering suicide data to hide it. He says, ‘Essentially, what the NCRB are having to do is to find different places to park the corpses. And you know, anyone who works with data knows that the ultimate burial ground is a column called Others.’

Despite the under-reporting and the limitations of research studies of suicide in India, the available data offers several insights into the nature and magnitude of the problem in India. In the subsequent sections we will try to understand some of this evidence, but always keep in mind that it is not without its limitations.

We will use two studies, one a global initiative and the other a national effort, as case-studies to examine some of the nuances of suicide in India. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016, is an important global initiative that estimated the burden of diseases, injuries and risk factors using data from multiple sources. As a part of that initiative, the India State-Level Disease Burden Initiative examined the trends of diseases, injuries, and risk factors from 1990 to 2016 for every state of India.

The evocatively named Million Death Study (MDS) from India is one of the largest studies of premature mortality in the world. Like most low- and middle-income countries, the majority of deaths in India occur without medical attention and at home; and hence these deaths do not have a certified cause. To overcome this major gap in understanding of causes of death in India, the Registrar General of India launched the MDS which monitored 14 million people in 2.4 million households between 1998–2014.


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Any deaths that occurred in these households were assigned a probable cause, as determined by a method called verbal autopsy—a structured investigation of events prior to the death. Data from the MDS was used to calculate total deaths by suicide nationally and by state totals of suicide deaths and also to understand variation by age and risks. This was the first ever nationally representative survey of causes of deaths which examined suicide as a cause of avoidable deaths in India. These numbers are broadly consistent with those reported in smaller studies from India, but much higher than the official National Crime Records Bureau (NCRB)—the NCRB numbers being an under-estimate by 25% among men and by 36% among women.

India’s men-to-women ratio for suicide rates was lower than the global ratio in 2016, i.e., the gap in suicide rates between men and women in India is smaller than in the rest of the world. Some of the proposed factors that could account for the gender differential include differences between the two sexes in socially acceptable methods of dealing with stress and conflict, availability of and the preference for different means of suicide, differences in alcohol consumption patterns, domestic violence, and differences in help-seeking for mental disorders.

Additionally, there is the differentially increased risk afforded to married women compared to men because of early marriage and motherhood, lack of autonomy
in choosing partner, domestic violence, and economic dependence on the husband.

On an average, the men-to-women suicide death ratios in high income countries is approximately 3 to 1, i.e., for every woman that dies by suicide there will be three men who die by suicide.7 This is not so in India where the male-to-female suicide death ratio is about 1.5 to 1 at all ages (for every three men who die by suicide, two women die by suicide), and this gap is further reduced among young adults. Finally, the suicide rate among Indian women is more than two times greater than women in high-income countries and although it is higher among Indian men compared to men in high-income countries, the gap is to a lesser extent.

This excerpt from ‘Life Interrupted’ by Amrita Tripathi, Abhijit Nadkarni, and Soumitra Pathare has been published with permission from Simon&Schuster.

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