March 2020: A man in Karnataka died by suicide after suspecting that he had contracted coronavirus.
April 2020: A farmer too took his life after realising that his crops would go to waste as he had no labourers to harvest them. A few days later, an Assamese migrant labourer who had been working as a daily wager in Maharashtra also ended his life.
The battle against the deadly Covid-19 pandemic is long, arduous and exasperating as there seems to be no easy end to it. At least, not anytime soon. But the battle is not the same for everyone. While social distancing and nationwide lockdowns may come across as viable measures to curb the contagion, it has also led to increased risk of suicide.
A report by WHO published in 2016 showed that India had the highest rate of suicide in South Asia and no robust strategy to prevent it. India's rate was 16.5 suicides per 100,000 people while globally, the rate was 10.5. And this was before the pandemic struck. Now, the threat of a deadly virus ravaging through the country has aggravated the suicide rate in India.
A study published in the Jama Psychiatry journal shows that efforts to reduce human contact to a minimum to spread the infection from spreading may eventually flatten the curve and slow down the virus, but it may pose another issue which might be a little more complicated to deal with - a surge in suicides.
The study lists a few factors which could be causing people to feel suicidal during the pandemic.
Economic stress. Job losses. Businesses shutting down. Industries coming to a standstill. Public events getting cancelled. A few days ago, reports suggested that the economic crisis brought on by the Covid-19 pandemic might be worse than the recession of 2009. UN's labour organisation estimates the equivalent of 195 million full-time jobs could be lost in the second quarter alone from the COVID-19 outbreak, with businesses and plants shuttered worldwide.
Most of us are leading isolated lives right now and psychologists fear that may be causing irreparable damage to our mental health. Panic, depression, anxiety and paranoia have become more common among people who already battle mental health issues.
Dr. Jawahar Singh, a psychiatrist at All India Institute of Medical Sciences (AIIMS) in Delhi, opined that that lack of awareness is one of the primary reasons why suicide rates are increasing in the light of the coronavirus outbreak in India. "People don't really understand how the virus is spreading or what they should do if they begin showing symptoms. They do not know where to go or whom to approach if they need help and there is no way to educate them about it," Dr. Singh said.
At present, the number of confirmed cases of Covid-19 has crossed 18,000 in India with over 600 deaths. Yet, awareness about this disease is alarmingly low. India has at least 14% of its population living below the poverty line, and many of them might not even know about the deadly virus. As Dr. Singh explained, if an individual develops symptoms and has no clue about how to get tested or even approach the authorities, he or she would be left feeling helpless and desolate.
Fear of the unknown is another factor here. With no proper understanding of how the virus spreads, people don't really know how they could pass it on to their family members and loved ones.
"People are getting scared without even getting tested. They don't even know what's happening. There has to be some awareness drive by the government, some sort of counselling to help the underprivileged people understand," said Dr. Singh.
Dr. Singh also believes that the stigma associated with the disease may be crucial in increasing death rate caused by suicide in India.
The coronavirus is also bringing out another, darker side of some people: Fear, anger, resentment and shaming. Research has shown that human beings tend to castigate those who are ill in order to protect themselves from a deadly disease. "Fear of being ostracized from mainstream society and the shame which comes along with it may further push people to take their own lives," he added.
"In Kerala, mental health is being treated with equal importance as physical health. People must realise that medical and mental health go hand in hand. Physicians treating Covid-19 patients must also assess if they require therapy and do the needful," he said.
The lockdown poses another problem for people who haven't been able to step out of their homes for therapy or meet their therapists face-to-face to discuss how they've been feeling in times of coronavirus. Dr. Singh said that at AIIMS, telepsychiatry has been adopted as a temporary measure. From April 20, psychiatrists at AIIMS have begun taking appointments virtually and are connecting with their patients through phone calls.
The aforementioned study also examines how healthcare workers, who are fighting Covid-19 from the front lines, are also at an increased risk of suicide. From constant exposure to the virus to the risk of exposing family members, sick colleagues to the incessant feeling of death hovering around them - the pressure and stress that healthcare workers are experiencing right now are insurmountable.
"We recognize the fact that doctors and nurses may also experience burnout during this stressful time and we've opened up student wellness centres as well. I hope other hospitals can do the same," said Dr. Singh.
According to the World Health Organisation, at least 7.5 percent of India's population, which amounts to approximately 90 million people, suffer from mental health problems. However, since the topic of mental health or therapy is still considered a taboo in the country, only a few end up seeking help.
As a consequence of the lockdown which has now been extended to May 3, people have been compelled to stay at home (in many cases, alone) with no idea of when it'll be safe to step out again. The burden of the disease, along with the uncertainty and chaos that it brings along, has been difficult to cope with.
Tannistha Vaidya, a counsellor, has been working with the Sahai Helpline for Suicide Prevention and Emotional Distress for a while now. Sahai, based in Bengaluru, has a number of volunteers who work in shifts to tend to callers to save lives.
Vaidya agrees that the number of distressed people calling for help has gone up after the lockdown was imposed. "People are anxious and worried, they don't know what's ahead of them, they have no certainty for the future. A lot of people are worried they might be able to restart their lives once all of this is over," she said.
Vaidya also said that helping callers at risk has been challenging due to the lockdown. During this period, all counsellors have been working from home. On other days, they might have referred the callers to therapists and psychiatrists for medical help after assessing the levels of risk. But that hasn't really been easy during the pandemic.
"What I instead try to do now is give the callers some ray of hope. I try to explore other options and divert their mind. For instance, if someone calls me worried about their jobs, I try to help them sort their thought processes by helping them build their resume, list their qualifications and show them that losing their current job might not be the end," Vaidya said.
Vaidya also recommends having a definite routine, monitoring sleep patterns and diets and exercise to improve mental health.
The pandemic has claimed millions of lives globally. Reports suggest that that the world may not be completely rid of the pandemic till 2022. As the death toll from the Covid-19 crisis rises with each passing day, there's a looming fear of a mental health crisis in the near future.
For suicide prevention helplines, contact: AASRA Suicide Prevention at 022 2754 6669 or contact Sahai by dialling 08025497777.