Suicide
 

 

Suicide is a self directed act of fatal outcome. Attempted suicide (Deliberate Self Harm) is injury with varying degree of lethal intent. In Kerala 0.4 to 0.9 % of all deaths in the hospitals and 0.3 to 1 % all casualty admissions are following suicidal attempt. Suicide rate increases all over the world. In kerala also it increases but the rate of increase is disproportionately high. In Kerala it is an index of the disturbed society. Available reports are based on the National Crime Record Bureau (NCRB) andState Crime Record Bureau (SCRB).

As per the available data the following are some important observation. Among other states Kerala has highest suicidal rate, highest rate of literacy, highest per capita alcoholic consumption and highest rate of unemployment. Though Kerala is providing a model for Health Care Delivery System the mental health care system have to improve a lot.

Population of India ( 2001 ) and Kerala as per census 2001 is 102.53 Crore and 3.18 Crore respectively. Though the population in Kerala is only3.1% of the national population the nearly 10% of the total suicide in India is taking place in Kerala.

Statistics

There is no sufficient clinical data to give a clear picture of suicide in our state. Available information is based on the data of National Crime Record Bureau (NCRB) and State Crime Record Bureau (SCRB). In these police records all cases of suicide are not reported and it is an under representation of the real picture. The possible causes for this under reporting of suicides are.

  • Social Stigma
  • Legal Actions
  • Scandals

In addition DSH cases are not usually reported here.

Suicide rate is decreasing

The following is a Chart showing the rate of suicide from 1991 to 2008 in Kerala


Perusal of the chart make it clear that Suicide rate is gradually decreasing in Kerala. The rate have reduced from 30.8/lakh to 25.2/lakh during the period from 2002 to 2008.

The National Average is only10/Lakh in 2008.

Suicide rate among youngsters and family Suicide are also on the higher side in Kerala.


District wise suicidal data per one lakh population
District / Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Idukki  48.6 41.1 43.3 43.0 43.0 41.5 49.2 49.7 51.0 42.4 40.3
Kollam  32.0 33.5 32.1 31.2 33.4 33.2 33.9 43.6 43.1 41.0 42.4
Wyanad 44.4 39.1 38.6 39.4 51.7 48.4 39.8 40.6 45.0 36.5 38.0
Thiruvananthapuram 17.2 33.2 40.6 41.3 39.8 41.4 41.4 38.5 32.7 35.5 37.0
Pathanamthitta  23.5 19.8 21.1 27.4 29.4 22.6 32.3 38.2 32.6 32.9 31.4
Thrissur 37.5 33.1 35.1 35.3 37.1 34.0 34.3 34.5 33.7 31.0 31.6
Palakkad 32.3 32.7 33.4 33.2 34.1 34.4 33.1 32.9 33.1 33.0 35.8
Kannur 27.7 29.3 29.2 30.1 27.5 26.7 32.3 32.2 29.5 27.1 25.2
Ernakulam 26.0 23.0 27.5 26.4 26.4 24.7 25.9 27.8 24.0 23.0 23.0
Ksaragode 24.8 22.0 24.1 22.5 24.0 19.0 22.1 26.1 23.5 22.8 21.0
Kottayam 23.5 20.8 23.1 25.1 24.4 21.8 24.6 25.4 26.0 22.5 23.0
Alappuzha 19.9 19.3 20.4 23.6 33.2 22.9 22.9 25.3 25.1 22.5 23.4
Kozhikode 22.0 21.4 24.5 24.6 24.8 23.7 25.5 24.3 22.7 21.4 22.3
Malappuram 12.0 10.1 14.6 14.2 13.5 14.7 11.7 11.8 12.9 12.8 12.0
District / Year 2006 2007 2008
Idukki  38.6 39.5 34.6
Kollam  41.3 42.0 36.4
Wyanad 40.1 36.5 38.2
Thiruvananthapuram 37.8 37.0 34.6
Pathanamthitta  26.6 30.7 24.9
Thrissur 30.3 27.7 27.1
Palakkad 34.5 32.0 29.2
Kannur 23.4 23.0 23.8
Ernakulam 23.2 23.0 24.6
Ksaragode 18.7 20.5 18.9
Kottayam 22.2 21.3 22.5
Alappuzha 21.7 22.3 21.0
Kozhikode 22.0 22.0 19.7
Malappuram 11.3 10.6 10.6
Data from State Crime Record Bureau
Some important observations are

  • Suicide is maximum in Waynad, Kollam and Idukki districts.
  • Suicide rate is high in Thiruvananthapuram, Palakkad & Trissur districts
  • Rate is more less steady in Kannur, Eranakulam, Kasaragode, Kottayam, Alleppy & Kozhikkod districts.
  • Rate of increase in suicide is highest in Thiruvananthapuram district where it has gone up from 17.2/l in 1995 to 34.6/l in 2008.
  • Suicide rate is consistently low in Malappuram district. (Effect of religion ?).
Age and Suicide in Kerala

Age/ Year 2005 2008
Below 14 yrs 1 % 1 %
15-29 21 % 20 %
30-44 30 % 32 %
45-59 30 % 31 %
Above 60 18 % 16 %

Suicide is maximum in the age group 30 to 59 Years (63%) Suicide is increasing in the age group 30 – 44 (32%)
27% of female suicides are in young female in the age group of 15 –29 years. More cases of suicides and attempted suicides are now reported among school children.
 
Sex distribution

Sex distribution of the suicide victims are l so significant. Suicide is maximum among males(72%)The Male female ratio is 2.6 : 1(In the Western countries M : F ratio is 4 :1) But attempted suicide is more among female (60%) compared to male.

Marital Status

In Kerala 78% of the suicide are among married persons. But in the Western countries suicide is more among unmarried & separated

Marital Status and suicide in Kerala (2008)
Status/ Year 2005 2008
Married 76 78
Unmarried 19 18
Widow/Widower 5 4
Education & Suicide in Kerala (2008)
Education/ Year 2008
Illiterate 3.5 %
Primary & Middle 51.5 %
SSLC/PDC/+2 40.6 %
Graduate/ Diploma 3.7 %
Postgraduate& above 0.7 %
Suicide is Maximum among those with Primary & Middle school education and is least among postgraduates. Majority of the population are having Primary and middle class education.

Method adopted

Hanging is the most common method adopted in Kerala (60%).

Causes of Suicide

As per SCRB data, family problems are the most common cause of suicide (44%) followed by physical illness (17%) and mental illness (15%).

Causes of Suicide as per SCRB data (%)
Causes/Year 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Family problems 24.2 21.5 18.7 23.4 21.5 22.4 28.7 37.9 42.2 43.6
Physical illness 14.5 16.2 15.7 15.3 14.7 15.7 14.7 15 16 16.6
Mental illness 8.8 8.7 10.8 12.2 10.8 16.1 15.1 16.7 15.4 15.3
Financial problems 13 14.2 15.2 11.6 16 9.9 0.1 8.2 8.4 6.3
Unemployment 3.1 1.9 2 1 1.4 2.4 1.5 1.1 0.6 0.4
Failure in examination 0.6 0.8 0.9 0.9 0.3 0.78 0.8 0.7 0.5 0.5
Love failure 1.5 1.4 1.6 0.9 0.9 1 0.9 0.78 0.9 1.4
Job related problem 1.8 1.8 2.1 0.7 1.1 0.2 0.4 0.2 0.2 0.4
Drug abuse/addiction 2.7
Others 32.4 33.4 33 33.9 33.2 31.3 24.4 19.4 15.8 12.8
Mental illness is the cause of suicide in 5% of cases according to NCRB. Police report and clinical experience varies in terms of causes of suicide. In clinical practice mental illness is an important cause of suicide. According to western literature 90%suicide are due to underlying mental illness. Adjustment problems family problems, social problems, personal loss, love failure , failure in examinations, emotional disturbance (depression), feeling of hopelessness ,financial crisis, low frustration tolerance, alcoholism and drug abuse, physical illness in the terminal stages, employment problems, ruthless and competitive life style, influence of consumerism, changing value system, changing economic policy etc are other important causes in clinical experience. Influence of media is also important where sensational reporting of suicide may lead to ’copy cat’ suicide.

Family Suicide is also increasing in Kerala. Some important causes are Financial crisis, despair related to family life, over concern for children, effect of consumerism,mental illness or alcoholism in the dominant family member.