Suicide rates are sharply rising in India, particularly among the educated young, amid a general lack of available mental health facilities.
"Suicide kills nearly as many Indian men aged 15-29 as transportation accidents and nearly as many young women as complications from pregnancy and childbirth," said the study's lead author, Vikram Patel of London School of Hygiene and Tropical Medicine.
"Suicide is the cause of about twice as many deaths as HIV/AIDS and about the same number as maternal causes of death in young women.”
The report also noted that suicides rates are higher among well-educated youth, particularly in the affluent southern states that have undergone a dramatic technological boom in recent years.
"Young educated Indians from the richer [Southern] states are killing themselves in numbers that are almost the highest in the world," Patel told Agence France Presse.
“It has to do something with social change, the rapidity of social change and its potential impact on educated young people.”
For example, the number of annual suicides in Bihar (a poor, backward farming state in northeast India) amounted to 6.3 per 100,000 inhabitants, while the rate in Kerala (a wealthy southern state with a highly educated population) was 10 times higher.
In the West, suicides are generally more common the poor and less-educated.
Patel also noted that Indian women kill themselves at a rate three times higher than in wealthy western countries, particularly married women.
“This is consistent with other research from India that marriage is also a risk factor for depression, which is of course the commonest mental illness associated with suicide,” he said.
“One can speculate, but obviously the most plausible explanation is that for many women marriage is not out of choice and they find themselves trapped in very difficult and stressful social circumstance, and, of course, there is the huge issue of domestic violence.”
About half of suicide deaths India were committed by poisoning, principally from the ingestions of pesticides, followed by hanging.
“Public health interventions such as restrictions in access to pesticides might prevent many suicide deaths in India,” Lancet commented.
On a global basis, of the 900,000 suicides recorded in 2010, India accounted for 190,000 of them, estimated the World Health Organisation. China, at 200,000, topped that list.
The actual figures may be much higher since suicide (or trying to commit suicide) is a criminal offense in India, making the data somewhat cloudy. Such deaths may be disguised as “accidents” or even homicides.
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