R. P. was 46 years old when he tragically took his own life, hanging himself from a tree using a bed sheet he had taken from home. Hailing from Katami, a village deeply nestled within the forests of Lormi District in the state of Chhattisgarh, he belonged to the adivasis, the indigenous population. His education was limited to the sole school in the village, where he rarely had the opportunity to learn due to the scarcity of teachers.
As he reached adulthood, R P found employment in a nearby farm, as he had not inherited any land of his own. His family arranged his marriage to a woman from a neighbouring village, and over time, they were blessed with four children – three daughters and a son. Recognizing that the income from agricultural labour, already dependent on unpredictable crop and weather conditions, would not suffice to provide for his children, especially to cover the expenses of his daughters’ marriages and dowries, he left his job in the fields.
He transitioned to work as an ambulance driver, eventually saving enough to secure credit for the purchase of a tractor. With the tractor, he could provide his services to local farmers and enhance his earnings. Despite his hard work and efforts to train his son in the same line of work, R P soon realized that the income he made was insufficient to sustain his family and cover the instalment payments.
Encouraging his son to take charge of the tractor, R. P. ventured to the city to secure additional earnings. Yet, he likely underestimated the strain of living apart from his family, juggling long hours of work, and constantly fretting over the family and his tractor business back home. Gradually, exhaustion set in, accompanied by frequent nocturnal awakenings and persistent rumination.
During one of his visits to his family, a local health worker noticed the shift and suspected depression, but persuading him to seek medication proved futile, given the absence of psychotherapeutic support in the village. The ensuing couple of years proved challenging as R. P. helplessly witnessed his son succumb to alcohol, a prevalent issue among the Adivasis in Chhattisgarh. Family dynamics grew strained, and in a fit of despair after a confrontation with his wife, he attempted to hang himself.
Fortunately, vigilant neighbours intervened, dissuading him from following through, yet no further support was sought. Several months later, upon his return from the city, he found the tractor untouched for days, sparking another heated altercation. It was that very night when he seemingly reached a breaking point. Though the exact nature of his thoughts remains a mystery, it was akin to losing a battle and feeling utterly incapable of carrying on. He left his house and, this time disappeared into the forest for the final act. The family did not report the suicide to the authorities to avoid bureaucratic procedures.
Every suicide is a tragedy, often resulting from a complex interplay of factors. While some suicides occur impulsively without warning signs, particularly in adolescents and younger adults, many involve a prolonged period of suffering and psychiatric morbidity marked by the disclosure of suicidal thoughts and even suicide attempts.
In states like Chhattisgarh, where under-reporting of suicides doesn’t seem to be a major concern, the suicide rate stands at 26.4 per 100,000 population, approximately double the national average. Considering the economic aspect, it’s distressing to note that in 2021, over 65% of the victims in Chhattisgarh had an annual income of less than 1000 pounds, with a staggering 95% earning less than 5000 pounds. Many of these suicides might be closely linked to poverty and the pervasive fear of losing even the most basic means of survival. Approximately 64% used hanging as the method, where it is indeed very challenging to control the means, in contrast to poisoning with pesticides.
In the planning of suicide prevention efforts, it is crucial to move beyond just reducing the statistics and to delve into the individual tragedies behind these numbers as is to provide support to the families burdened emotionally and psychologically. Psychiatric disorders tend to be frequent in families. The need for trained health workers and clinicians in rural areas, equipped with knowledge about mental health, is critical as is the involvement of the community through self-help groups in order to encourage expertise at the village level and reduce the stigma attached to seeking help for mental health issues. This effort should also encompass understanding, recognition, and management of common mental disorders, documenting each suicide with a basic psychological “autopsy” and extending care to every individual who has attempted suicide.
– Prashant Gogia, Yogesh Jain, Manju Thakur