By Emma Swanhuyser
Suicide rates in India are climbing faster than in the rest of the world with Indian women having some of the highest rates on the planet. India alone accounts for approximately 30 percent of the world’s suicide deaths. In 2013, suicide claimed the lives of more than a quarter of a million Indians. That’s five times greater than all global deaths due to war and natural disasters combined.
Suicides by country, both sexes, 2013
Leading causes of death in India, both sexes, 1990 and 2013
Rates of suicides among women in India are among the highest in the world. Surpassed only slightly by Nepal, India ranks second globally for its female suicide rate of 17.9 deaths per 100,000 people, controlling for population growth and aging. In absolute numbers of deaths, India is by far the leader for suicide among women, accounting for more than 100,000 deaths. In comparison, China, the country with the second-highest number of female suicides, has just half that number.
Suicide rates, females, 2013
Some researchers suggest that the rigid marriage system in India may be contributing to the country’s high rates. In an article published by the Indian Journal of Psychiatry, the authors highlighted the expectations placed on Indian women to marry and stay married, no matter the cost or negative circumstances such as mistreatment or mental illness. Societal pressure and abuses against women may be pushing many over the edge.
Authors of a recent paper analyzing suicide surveillance in India, published by the International Journal of Epidemiology, who included researchers from the Institute for Health Metrics and Evaluation, summarized how other papers have indicated that women are frequently subject to “psychopathology and psycho-social stressors including arranged and early marriage, young motherhood, low social status, domestic violence and economic dependence.”
In many countries men have higher rates of suicide than women. Between 1990 and 2013, the rate of male suicide rose by 63.5 percent in India, controlling for population growth and aging, according to the Global Burden of Disease 2013. Women saw a smaller increase of 23.2 percent.
Leading causes of death in India, males, 1990 and 2013
Additionally, across the life span, elderly populations have the highest rates of suicide in India. These findings also parallel global suicide trends. Although the 80 and older population has the highest rate of suicide, India’s youth and young adults have the greatest number of suicides. Particularly vulnerable are 20- to 24-year-olds. Within this age range there were 36,000 suicides in 2013, while the 80 and older age group accounted for only about 7,500 suicides. The stage of life at which individuals commit the most suicides (15 to 34 years) coincides with the same period that these individuals enter challenging life stages such as marriage and economic independence.
India, suicide deaths by age group, both sexes, 2013
Perhaps the greatest obstacle India faces in combating this suicide epidemic is a lack of clear, precise information on this complicated problem. While statistics exist, collecting information about suicides in the country can be difficult.
The recent study on suicides in India published in the International Journal of Epidemiology illustrates the limitations of the data published by India’s National Crimes Record Bureau (NCRB), which is the administrative source of data on suicides. From 2001 to 2010, 33.7 percent of suicides were attributed to personal/social reasons (see graph). This classification encompasses a wide variety of conditions such as family problems, getting a failing grade on an examination, physical abuse, pregnancy outside of marriage and infertility. Using data with broad categories such as these make it hard to draw conclusions about which policy interventions could best prevent suicide. In general, it is challenging to determine why someone committed suicide, as the reason must be deduced from family or other indirect sources if no clear note was left behind. Stigma and ambiguous terminology connected to suicide also pose challenges for understanding people’s motivations for killing themselves.
Some specific suggestions for improvement identified by the authors of the International Journal of Epidemiology article include “standardization of data collection forms across states, clear guidelines to capture specific type of data (in particular, reasons for suicide) to ensure comparability over time and area, and training of relevant staff to compile these data.”
Although there is no miracle cure for suicide in India, stronger surveillance and a deeper understanding of what’s driving so many people to kill themselves is crucial for developing programs and policies to prevent suicide. Such intervention improvements will need to be sensitive to India’s unique cultural and socioeconomic position in order to address specific barriers such as economic instability, women’s rigid gender roles, and mental health stigmatization. Without such advances, India’s high suicide rates will only continue to rise.
Emma Swanhuyser is a student assistant to the Global Engagement Team at the Institute for Health Metrics and Evaluation (IHME) in Seattle. Her primary role is to communicate and further IHME’s impact through compelling stories, policy briefings and research projects. She holds a BA in Medical Anthropology and Global Health with a minor in Spanish from the University of Washington.