Recognising signs of suicidal distress before it’s too late

It was sometime after the New Year in 2010. Along with two of my college friends M and P (names abbreviated owing to privacy), I had come out from the theatre after watching the movie '3 Idiots'. As we went into an animated discussion on the differences between the movie and the book from which it was partially inspired, P sighed, "Sometimes, I want to just quit like Joy Lobo! Maybe, someday I will!" M and I got alarmed and tried to handle the sudden somberness by cracking some bad jokes. However, we both struck a plan of informing P's parents if we ever again heard say her something on similar lines. One year after this event, all three of us were scattered in different places in our lives, trying to pursue a future. One day I got a call from P that our dear friend M had passed away owing to suicide. To say it was a shock is an understatement; as those who knew M had never imagined that such a warm, funny, happy-go-lucky, friendly person with no known mental health issues could contemplate suicide. Till now, we friends question ourselves about why we didn't notice that something was wrong with M, why we didn't pay more attention.

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Unfortunately, these are the primary questions that assail us once we lose someone to suicide. That someone could be a family member, a loved one, a friend, a neighbour, a classmate, a workmate, an acquaintance, or just a familiar face in our milieu. But every time we are faced with such tragic news, we as a society grapple with the familiar questions of why we didn't notice something was wrong, why we didn't pay closer attention.

Shouldn't we as a community familiarise ourselves with the signs of cries for help and possible suicidal ideations? Shouldn't educational institutions, that are entrusted with teaching and nurturing young minds, take better initiatives in taking care of their mental health, apart from academics? Shouldn't government educational policies ensure that proper measures are implemented to blunt this increasing trend of suicide among students? Are we doing enough?

It is not that nothing is being done. The Supreme Court recently decided on forming a National Task Force to prevent incidents of suicide in educational institutions. The government released its first national suicide prevention strategy in November, 2022. The Department of School Education and Literacy, Ministry of Education, has long provided a guideline called 'Umeed' for schools towards effective prevention of suicide. In 2023, the Ministry of Health and Family Welfare launched Tele-MANAS, a 24x7 toll-free mental health helpline.

It is mandatory for CBSE schools to have a full-time counsellor and wellness teacher, the ICSE board encourages its schools to provide similar counselling services. The IITs, IIMs and other premier institutions for higher studies often provide inhouse counselling services.

So, what are we missing? The first step towards any preventive strategy should be to acquire knowledge of the factors behind suicidal ideas and acts. Usually, they occur due to an interplay of personal and environmental factors. As children transition from pre-school to primary school to high school and graduate to college, they go through different challenges, both personal and impersonal. These transitional stages also bring forth the possibilities of interaction with different stressors.

At times, the child may be able to cope with the stressors, and at other times, it might become too distressing for him/her. However, it is when the stress, whether acute or chronic, feels like it cannot be successfully solved, along with the perception of isolation and helplessness, that it starts to feel unbearable.

Usually, the cycle that precipitates suicidal thoughts is formed by an amalgamation of different factors — a persistent sense of failure in being able to change one's circumstances, a perception that no help is available, self-depreciation turning into self-loathing and a bleak outlook. In other words, ideas of worthlessness, helplessness and hopelessness are the usual precursors to suicidal thoughts. These are the warning signs that we need to recognise in order to provide timely intervention.

If we look keenly, we can observe how, on a deeper level, our 'concept of self' plays the role of a major catalyst in all risk factors, protective factors and warning signs related to suicide.

Hence, it is imperative to focus on our definition of 'self', by promoting our physical and emotional well-being, personal growth and values, including such life skills as adaptive coping, communication and problem-solving, emotional regulation and resilience.

One major change should also be related to our attitude towards life. Though achievements give us joy, that joy is temporary and unpredictable in nature. Rather than determining self-worth solely on measures like grades, awards, pay package, number of social media followers, if people are taught to focus on developing positive characteristics and behaviour, they will learn to measure themselves on the basis of the kind of person they are and their authentic inner journey rather than just their achievements.

Additionally, de-emphasising our focus from achievements not only reduces the pressure to constantly strive for external validation but also helps us develop a more process-oriented approach towards life rather than being result-oriented.

Similarly, while focussing on suicide prevention, our aim should not only be at understanding and addressing the complexities of suicide but also at expanding conversations about mental health and well-being at a community level. Any effective preventive measure has to be comprehensive, requiring a collaboration of various efforts addressing different aspects of the problem.

We should also be careful about missing the forests for the trees. And mostly, we should not make 'suicide' or 'mental health' a taboo subject; rather have open conversations on it.

We cannot just have this conversation whenever a life gets tragically lost and then forget about it. ‘Lest we forget’ — maybe, that should be our motto. Maybe, that is how we can be fair to the memories of the ones we have lost.