The number of suicide deaths in 2021 saw a 7.2% increase from the previous year, according to the National Crime Records Bureau’s Accidental Deaths and Suicides in India report released in August.
Of these, 27% of all suicides (45,026) were women. Almost 52% of the women (23,179) who died by suicide were housewives. This is more than double the number of farmer suicides (10,881) that year.
This is not surprising. India has one of the highest suicide rates among women, accounting for more than a third of the total number of suicides among women globally. The relationship between domestic violence and mental health consequences such as anxiety, depression, and suicidal thoughts is well established.
Women facing domestic violence face additional challenges due to the stigma of reporting the abuse and expressing suicidal thoughts.
The mental health problems of women who end up in hospitals after suicide attempts are ignored. These attempts are not recognized by health care providers as a cry for help.
Every day, there are at least two cases of women who attempted suicide being admitted to a public hospital in Mumbai.
The Center for Research in Health and Related Topics or Cehat, which has worked with the health sector for the last two decades, has found that when cases of attempted suicide by women reach the hospital, they are invariably documented as “accidental consumption of poison”. or accidental pill overdose” by health care providers. The health system does not address the underlying factors that triggered the attempt or the mental health sequelae of suicide attempts.
What does the NCRB data say?
Data on the cause of suicides provide information on the links between domestic violence and suicide among women. According to the report, 7,903 suicides among women were reported for “marriage-related problems” and 15,769 for “family problems,” together accounting for more than half of suicides among women. The National Crime Records Bureau defines “family problems” as problems other than “marriage-related matters.”
Furthermore, data from the Bureau on Crime in India-2021 showed that almost a third (1,32,580) of crimes against women were classified as “cruelty by husband or relatives”.
The role of the health system
Health care facilities offer unique sites for interventions to address domestic violence, as they can be among the first places women can report such abuse. A woman facing domestic violence may not go to a police station to seek action against the abuse, but she will invariably arrive at a hospital to seek treatment for health complications resulting from the violence.
Health care providers, however, fear the law and prefer to avoid medicolegal problems, such as car accidents, that are both medical and legal. Additionally, medical education and in-service training do not prepare health care providers to recognize the effects of violence on women’s health.
Women who attempt suicide therefore receive only medical treatment and miss out on psychosocial care from health care providers to prevent future attempts. The situation is complicated when the psychiatric department of the hospital carries out a mandatory evaluation of each case and terminology such as “deliberate self-harm and care-seeking behavior” is used in different diagnoses.
If you are interested in women’s health:
1 in 6 women in the world is Indian, yet 1 in 3 women in the world who die from #suicide he is indian
Mostly young women between 18 and 39 years old.— 🇺🇦 Soumitra Pathare সৌমিত্র சௌமித்ரா பாடாரே (@netshrink) March 25, 2021
Data from Dilaasa, a hospital crisis department for survivors of violence, shows that of 3,435 cases over the last 19 years, one in five survivors of domestic violence had attempted suicide, while almost one in four had suicidal ideation.
The health system must recognize that domestic violence is an underlying cause of suicide attempts among women.
The capacity of health care providers must be built to recognize the physical and emotional health consequences of violence against women. Evidence from Cehat’s work suggests that training health providers to identify domestic violence as a risk factor for women’s physical and mental health results in comprehensive care.
Trained health care providers proactively ask women about violence and provide support if they suspect their health problems are the result of abuse. Therefore, the role of the health system in responding to the immediate psychological needs of women facing domestic violence and preventing suicides cannot be overstated.
The health system can also play an important role in improving the quality of suicide data. Although the data from the National Crime Records Bureau is the only nationwide data available on suicides in the country, it is underreported because it is based on early information reports.
There is little reporting of suicides due to gaps in the investigation of cases of unnatural deaths in the states, the absence of a registry in health facilities, social stigma, and legal complications. In a further indication of the underreporting of suicidesan article published in the lancet titled Gender Differentials and State Variations in Suicide Deaths in India, said there were 2.5 lakh suicides in India in 2016, while the National Crime Records Bureau pegged the cases of death by suicide at 1.3 lakh on same year.
Statistics from the National Crime Records Bureau are likely to be the tip of the iceberg. There is a need to strengthen the reporting of suicide attempts and suicides in health facilities by developing a standardized registry and reporting mechanism.
Sanjida Arora is a researcher at Cehat. Sangeeta Rege is a coordinator at Cehat.
Also Read: Rural Hospitals In Gujarat Become Support Centers For Survivors Of Domestic Violence
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