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| LETTER TO EDITOR |
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| Year : 2022 | Volume
: 12
| Issue : 6 | Page : 293-294 |
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Analysing suicide in India
Harish Gupta
Department of Medicine, KG's Medical University, Lucknow, Uttar Pradesh, India
| Date of Submission | 07-Jul-2022 |
| Date of Decision | 17-Nov-2022 |
| Date of Acceptance | 05-Dec-2022 |
| Date of Web Publication | 29-Dec-2022 |
Correspondence Address:
Dr. Harish Gupta
Department of Medicine, KG's Medical University, Lucknow - 226 003, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/cmrp.cmrp_62_22
How to cite this article:
Gupta H. Analysing suicide in India. Curr Med Res Pract 2022;12:293-4 |
“Heartbreaking that #mentalhealth conditions are among the leading causes of illness and disability among adolescents, including suicide, which is the 4th highest cause of death among 15–19 y/o. To help adolescents thrive, @WHO and @UNICEF published a toolkit for health and social workers.”– Dr. Tedros Adhanom Ghebreyesus, Director General of World Health Organization, 19 May 2021[1]
Dear Editor,
Tandon writes an Editorial about understanding suicide in a biopsychosocial framework article published on 30 June 2022 in the Journal.[2] Therein she highlights the causes of suicide here and mentions about the discovery of certain biomarkers which are found in individuals admitted with this diagnosis. The Journal published the related study as an original article separately in the same issue. The author has a hypothesis that inflammatory markers, for example, C-reactive protein and cytokines may be associated with heightened stress and hence may be correlated with suicidal ideation/attempt. However, whether it is the cause of the ideation or the effect of stress, we need to probe.
Nowadays in our COVID and post-COVID world, young adults are facing an epic challenge of joblessness,[3] system automation where machines have the potential to/are replacing blue-collar workers,[4] availability of contractual jobs,[5] variable dynamics of employability, resulting in job insecurity, and lack of service benefits, even when one is employed.[6] Moreover, that is a worldwide phenomenon, which got accelerated after the SARS-CoV-2 took hold of the population when attending anything in person came with its own risks.[7] Under these circumstances, they face tremendous pressure to perform just to stay in the competition. Therefore, the point to be underscored is that higher stress in low-skill jobs is the norm in our times. When the authors find markers of inflammation in blood samples of the youths presenting to them; if it is just a chance finding which may otherwise also be there, we would explore.
Although the investigators mention the lack of a control group in the study design, we need to remember that some of the recently conducted surveys underscore a bleak scenario in the employment sector. The author discovered in their study that about 10% of the people chosen for the study had regular employment. Here, I want to draw their attention to a paper of Economic Survey – our planners' body in the government.[8] In this paper at the first paragraph of the page number 398, they state that only about 8% of employment is in organised sector. Moreover, post-arrival of the COVID-19 pandemic, we know that the situation deteriorated further.
I want to emphasise that the availability of mental health-care services has its value when someone suffers from those illnesses. However, if underlying cause of the suffering is joblessness, presence of social determinants of diseases, lack of opportunities according to one's capability/skill/training/underemployment, or economic distress; these services are unlikely to come to rescue. We need to grasp a point that the mental health of the people may be a reflection of many of the undercurrents of a system and may be affected by events as diverse as economics, sociology, and larger milieu in which we inhabit.
If you have this perspective, we need to have a vision that medical services are not a cure for everything wrong with society and we need to explore disparate areas of those disciplines where the ailments lie somewhere. Lest our narrow vision may throw up unexpected results, we would widen it to look at reality in its full dimensions. For an accurate diagnosis demands an exploration of full extent of pathology and a limited field of vision may not provide a correct scenario.
In Table 4, methods used for the deliberate self-harm attempt, the investigators find that (prescription) drug overdose was a common method to commit the act. However, while working at my hospital, experience is anything but that. Rarely when a medical/dental student commits the act, there is a history of consumption of a large amount of prescription drug, but otherwise, it is not commonly observed. The authors refer to the website of the World Health Organization to cite age-standardised suicide rate. However, the UN body in another weblink mentions common means adopted to commit self-harm.[9] Moreover, the list does not find a mention of the prescription drugs' consumption.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
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| 4. | Schwabe H, Castellacci F. Automation, workers' skills and job satisfaction. PLoS One 2020;15:e0242929.  |
| 5. | Kumar S, Gupta H, Verma SK. Dealing with COVID-19: Lessons from China. Indian J Med Ethics 2020;V:169-70. |
| 6. | Peters SE, Dennerlein JT, Wagner GR, Sorensen G. Work and worker health in the post-pandemic world: A public health perspective. Lancet Public Health 2022;7:e188-94. |
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