Suicides don’t take place in a vacuum. They take place in a society. A society that is full of stratification, oppression, and discrimination — both in microcosmic and macrocosmic social spaces. If we are to even think of a subject as complex as suicide prevention, especially in a country where suicide rates are alarming among vulnerable populations, we have to take several steps back from the individual suicide. Suicide cannot be blamed on an individual — no matter how much our society loves to do it, as it did even in the case of Dr Payal Tadvi. But it can be blamed on a social context — the caste system, for one.
In the case of the suicide of doctoral student Rohith Vemula in the University of Hyderabad in 2016, the culpability of the then Vice-Chancellor Apparao Podile, of various politicians, and most of all, of the caste system itself, were crystal clear, in part thanks to Vemula’s eloquent suicide note. The “annihilation of caste” was clearly the answer there. But we can’t expect to be so well-informed with every suicide, to be spoonfed the causes. We need to do some thinking of our own, and for that, we need to take several steps back from the actual event of any given suicide. In other words, suicides are just the tip of an iceberg. The rest of the iceberg is the place where we have to look for answers to the question of suicide prevention.
As we observe World Suicide Prevention Day on September 10, we can think of suicides that happen due to long-standing mental illness, and those that don’t. Not all suicides are said to be linked to mental illness, and that means we need to focus on socio-economic factors as well. In this article I would like to discuss the suicides that are not linked to long-standing mental illness, although the trauma inflicted by socio-economic oppression could be argued to be a type of mental illness too.
The physical and mental stress of facing daily microaggressions due to discrimination has been studied comparatively well among African-Americans, but not as well among the oppressed people of our own country, where the need for such studies is equally dire. In my opinion, this complicates the distinction between suicides due to mental illness and those due to socio-economic marginalisation. Mental illness is itself referred to as a psychosocial disability these days, adding a social dimension to it.
Just some simple Googling turns up alarming headlines such as:
>98 Students Died By Suicide In Colleges In Last 5 Years: Central Report (26th July 2023)
>Govt: 122 students in IITs, IIMs, Central universities died by suicide in 2014-21 (21st December 2021)
>In three days, 5 farmers in Vidarbha die by suicide (19th August 2023)
>What's behind suicides by thousands of Indian housewives? (16th December 2021)
And these two headlines which deserve a study all on their own:
>With 14 cases in 10 years, IIT-Madras tops list of suicides among contemporaries (14th November 2019)
>IIT-Madras student dies by suicide in hostel, 4th case in three months (22nd April 2023)
Given the number of people who have died by suicide – college students oppressed by caste, college students in general, farmers, and housewives, for example – can we conclude that serious and numerous studies need to be conducted on this?
Saravana Raja, founder of the Chennai-based mental health peer support group Mind Matters Circle, says of the mainstream media’s attitude to suicide and of suicide prevention: “The current major disturbing factor about suicides is the irresponsible reportage by both print and other media, violating all standard protocols. We need both top-down and bottom-up efforts to end the recklessness of the media. At the same time, suicide prevention may not be 100% possible in my view, owing to multiple complex factors of human nature. What we can aim for is to increase the prevention percentage. It cannot be individualistic pep talks but highlighting the social determinants to establish a continuous discourse on an inclusive and egalitarian ethos.”
An “inclusive and egalitarian ethos” is exactly what does not prevail in the structures (institutions, families, socio-economic structures) where numerous suicides take place. Additionally, it is exactly what is missing from the bottom of the iceberg mentioned above, where we are likely to find solutions to suicide prevention. Such an ethos would be a huge factor in suicide prevention, but unfortunately our society often has the opposite kind of ethos.
My attention was directed by a friend towards the work of Yashpal Jogdand, who is a professor and a researcher of social psychology at IIT Delhi. He has done invaluable research on caste and trauma. After the suicide of 18-year-old Dalit student Darshan Solanki at IIT-Bombay in February of this year, Yashpal gave a must-read interview titled “The Indian classroom is a site of routine humiliation for Dalit students.” In the interview, the professor explains in great detail the various facets of caste-based trauma and humiliation. In other words, he shows us the bottom of the iceberg, not just the tip. He explains using the latest neuroscientific research that “physical harm and being humiliated on the basis of caste are equally damaging.” He goes on to say:
“A critical point here is that we depend on others for satisfaction of our need for meaning, value and purpose. [...] So, at the very least, we need two things to exist and function in an environment – meaning and recognition by others. Flourishing of an individual’s capability can happen only when these minimum requirements are met. Now let’s think of the situation of Dalit students in the Indian higher education establishment from this perspective. What is the meaning, value and purpose that is accessible to Dalit students? [...] You may think of yourself as a worthy and capable person but others perceive you only in terms of their stereotype about your group. Others simply refuse to see you as an equal student inhabiting a common space. How would you feel?”
Here is a very clear picture of the inner life of a college student who is oppressed by caste. After it has been painstakingly researched and clearly explained to us in this manner, how can we fail to imagine the plight of such students?
Preventing suicides is also about preventing the high rate of individual misery in the country due to social and economic factors. Last year, when Tamil Nadu CM MK Stalin announced a mental health counselling programme for students of government medical colleges across the state, to address mental health issues and suicide prevention, it was a welcome move in terms of being a start in the right direction. But if you’re providing psychological counselling for someone who is already suicidal, you are at the last stage of the series of psychosocial and socio-economic pressures in the individual’s life that led to their suicidal thoughts and feelings.
Psychology alone cannot be expected to take on the entire burden of psycho-social issues, let alone socio-economic issues, especially when it comes to late intervention. We can’t expect psychologists to pull off miracles at the last minute, especially given the difficulty in accessing counselling in general (though hopefully not in the above-mentioned colleges) and the poor counsellor-to-client ratio in this country.
As for educational institutions installing spring-loaded fans or removing fans altogether, I don’t even need to explain how cruelly late such interventions are. Similarly, offering vipassana or Art of Living courses to Vidarbha farmers (as the government has done and as this study from 2006 advises) cannot even be called a Band-Aid measure when heavy economic reforms, restructuring, and waivers were called for. In fact, the issue continues in present times too. And it’s not just farmers. Anyone who is facing poverty or debt is facing numerous psychological pressures that take a toll on their physical and mental health.
Oorja, a student of a private medical college in Tamil Nadu, has this to say about suicide prevention among college students: “While the causes leading to student suicides and stress in general may be multifactorial and individualised for each student, there is, in my personal experience, a very simple and cheap solution for its prevention — compassion. In most situations of perceived stress by the student, a little compassion, empathy, understanding, etc. shown by the management, faculty, professors, parents, or friends can take a lot of pressure off the student in question. In the medical field, doctors are now being taught the importance of showing empathy to patients, but it is important to recognise that empathy and understanding also need to be directed towards other doctors and staff, and especially students.”
According to Oorja, the recognition that people can’t and shouldn’t be expected to meet generalised standards, which are quite high in the medical profession, is the key. In Oorja’s words, “Counselling students, while necessary, will not solve the problem of suicides because in most cases it is not the student who is wrong or weak or mentally ill but rather it is the individual’s environment that is becoming hostile. An assessment of the external factors and some help can go a long way. Compassion needs to be preached and practised by everyone and towards everyone, starting from the self.”
Although discrimination and marginalisation take place in general in society in spaces like the workplace, there are two institutions that stand out for me currently — the educational institution (schools, colleges, universities) and the family unit as twin sites of pressure and misery. In my opinion, suicide prevention also includes studying how parents treat their children and how housewives are treated.
In general, women (especially younger women) and children (especially daughters) are on the receiving end of the patriarchal structure of the household. And we need not even expand on the phenomenon of dowry harassment and the psycho-socially unhealthy lifestyle forced on some housewives (even without overt abuse) to understand the housewife suicide epidemic in India, which constitutes more than 50% of suicides by Indian women.
The pressures that Indian parents put on their children are terrifying to think of. Every one of us has either experienced or witnessed them. These pressures take the form of abuse, neglect, coercion, emotional blackmail, and so many others that it’s no wonder that academic difficulties sometimes lead to suicide in children and the youth.
Ahla Matra, a psychotherapist based in Mumbai, opened my eyes to the wide range of reforms and changes that suicide prevention constitutes, and how much potential there is in reforming that bottom of the iceberg where the pre-suicide world exists. She says, “Suicide prevention is often seen as a strictly mental health issue, but this might not be the case for the country. This crisis finds its roots in the disenfranchisement suffered by individuals marginalised on the lines of caste, class, gender, and religion. Depression and anxiety emerge as natural responses to social exclusion, persistent harassment, and being constantly told that you don't belong or deserve to be here. The trauma of blatant casteism and bigotry inflicts deep, lasting wounds on one’s mental well-being.”
When the work of suicide prevention is limited to mental health intervention, it can look like the presence of counselors or mental health workers on campus or mental health awareness drives, says Alha. “While this might bring some relief to the students, it does little to dismantle structures and cultures that are oppressive,” she adds.
According to her, our culture of suffering in silence adds to the problem. “The ability to keep trucking on despite suffering is seen as an admirable quality. In the aftermath of such incidents, the discourse is often around personal resilience. The stigma around suicide perceives people as weak rather than correctly identifying the system that failed them.”
There is usually a barrage of hashtags on social media asking people to reach out and talk to someone. “If one, miraculously, manages to reach out and speak to someone, we do not have adequate structural support available in the form of affordable and accessible quality mental health care,” Alha says.
Explaining that mental health is just one piece of the puzzle when it comes to suicide prevention, she says that we need to look at what systemic forces are at play that create and maintain the mental distress that may drive someone to suicide. “Providing stable housing, economic security, employment, food security, and equal human rights along with mental health support is suicide prevention,” Alha says.
Ultimately, we are a country with scarce resources, most of which are hoarded by a minority of people. In a world of all kinds of scarcity, empathy and kindness towards those around us can sometimes feel like a luxury. Some of us might even think, “I never received any particular kindness from anyone. Why should I show kindness to others?” But, as medical student Oorja says, compassion is part of what is needed if we are to provide adequate social support systems for suicide prevention. We are only just at the beginning on this journey, and we need all the studies and expert inputs we can get.
Sneha R is a Bengaluru-based writer. She has been trying to make sense of her bipolar diagnosis since 2006. She loves trees and reads too many self-help books.