This article is from The Swaddle.
By Liesl Goecker
Sometime in the last decade, there was a paradigm shift in what we know to be the biggest threats to our kids. If you're wondering how you missed it, it was released in late 2014 in a low-key World Health Organization report (and first reported by The Telegraph earlier this year). Which means that, while we have all been worried about junk food, drunk driving, and dengue, the biggest threats to Indian teens are teens themselves.
In South-East Asia, which includes India, self-harm is the leading cause of death for boys and girls 15 to 19.
It's not easy to talk about suicide in India. The country has a complicated history with the act of self-harm; ancient religio-cultural texts at turns seem to deplore it (Upanishads), forbid it (Quran), and glorify it in some religiously motivated instances (Vedas). And at some point early in the last millennia, it became an honourable, even auspicious option for death, particularly for women; jauhar, among the Rajputs, and sati, more widely, were practiced well into the last century (and unfortunately even into this one).
On top of all this (or perhaps in response to some of it) suicide remains illegal in India, despite last year's misleading reports of decriminalization. This reduces a sophisticated topic to a one-dimensional caricature; what should be a discussion around the intersection of personal motivations, societal pressures, and public mental health, is hijacked into a conversation about law and order.
Let's reclaim it. Indian statistics on death by self-harm - acknowledged by most experts to be underreported for fear of investigation - support the regional trend; among Indians age 15 to 29 (the National Crime Records Bureau's closest matching demographic) there has been a slight uptick in suicides since 2002. It crosses gender and socio-economic divides; if anything, India defies typical public health paradigms in that suicide rates are higher in more developed states, says Vikram Patel, Goa-based psychiatrist and co-director of the Centre for the Control of Chronic Conditions at the Public Health Foundation of India.
So what is driving these young people to take their own lives?
"[W]ith the cultural stigma around mental health struggles, many people's problems go untreated and even unacknowledged."
Half die by self-harm as a result of mental illness. Mental disorders - such as clinical depression, bipolar disorder, schizophrenia, etc. - are responsible for "40 to 50 percent at least of all suicides in young people" in India, Patel says. These conditions don't have to end in suicide, but with the cultural stigma around mental health struggles, many people's problems go untreated and even unacknowledged.
The remaining half are lost to a cocktail of social mores, taboo topics, and basic biology, better known to those of-age by its trivializing epithet, 'teen drama.'
Patel - who was named to TIME magazine's annual list of 100 influential people this year for his global work in mental health - posits that in India, traditional gender roles are responsible for much of the misery in young people, who are navigating rapid social change while still feeling the weight of traditional expectations.
"Adolescence is a period of profound psychological and social change," Patel says. "It's the period of life when you are doing some major things about your adulthood: finding a partner, completing education, finding a job."
However, the economic and social reality that confronts Indian teens today is often very different from the possibilities they've been exposed to through education or the Internet, he explains. A girl with an education, who has the opportunity for a higher education or a career, may struggle to conform to expectations that prioritize marriage and motherhood. A boy is more likely to struggle with expectations to pursue a high-earning job above all other interests.
Too often these and other struggles - academic failures, pre-marital and/or same-sex relationships - are dismissed out of hand. Whether out of discomfort with taboo possibilities or out of a mature, 'big picture' world view, parents may understandably be impatient.
"The step between unhappiness and death is a large one, and parents play a big role in keeping teens out of the chasm."
"Children reach out to us because they have no option but to hide their troubles at home, but at the same time they need to talk to somebody," says Paras Sharma, a programme coordinator at iCall, a phone- and email-based helpline run out of the Tata Institute of Social Sciences. The 11 to 20 age group is one of the most common demographics to seek iCall's help, he says.
"For a lot of them, it's very, very real and feels like the end of the world," Sharma says. "A lot of adults think, 'Oh, it's just young love,' but it's very, very real for the person going through it."
Combine this with the fact that teen brains aren't wired to make sound judgments or consider long-term consequences (that part of the brain doesn't develop fully until around age 25) and the result can be disastrous. For some teens, "an impulsive act can translate a flash of misery to something fatal," Patel says.
But teen suicides are neither inevitable nor by chance. The step between unhappiness and death is a large one, and parents play a big role in keeping teens out of the chasm. When parents are unwilling to discuss certain issues or concerns, kids can feel hopeless, isolated, and out of options, Sharma says.
"Always come across as someone who is open to discussing everything," Sharma advises. "You may agree or disagree, but you should at least be open to discussing it."
For parents, this requires a degree of forbearance around emotional or controversial issues like academic ability and interests, failure, financial and social status, premarital relationships and relationships that are not traditionally gendered.
Sometimes, it also means accepting a situation can't be handled within the family. Even when parents are open to all troubles, kids may need objective, professional help.
"It may not be that you should talk to your parents or your friends about everything," Sharma says. "But there shouldn't be any issue that you don't talk to anyone in the world about."
Changing India's suicide statistics doesn't start with changing laws. It starts at home, where traditions and expectations are instilled, where social norms are born and bred.
It will be a slow and uncertain change; even as we make our homes places of honest and open discussion, as we make our communities places of tolerance, and as we begin to appreciate the normality and benefits of counselling, our children are still part of a broader milieu indifferent to their best interests. This means tragic, early deaths might still happen through self-harm, despite our best efforts. But they are efforts worth discussing and making.
"Any condition that accounts for the highest deaths among the most productive age group has to be the most important priority for the country," Patel says.
Especially for its parents.
If you are concerned about someone you love, learn more about the warning signs of suicide. If you are considering suicide or know someone who is, please know there are people who can help. Call or email the iCall helpline at 022-25563291 (Mon-Sat, 10 am-10 pm) or firstname.lastname@example.org.