Student Suicide Prevention in India: Moving Towards a Feasible Solution

To the Editor,

Suicide has been found to be the fourth leading cause of mortality in adolescent populations globally. ¹ A majority of these adolescents are students. The National Crime Records Bureau (NCRB) has also reported a higher suicide rate among students in India (8% of all suicides in 2020 were student suicides). ² In the year 2022, suicide by students constituted 7.6% of all suicides in India. ³ The academic uncertainties following the COVID-19 pandemic–related lockdown still affect the education system, though the pandemic has lost its intensity globally. Frequent postponement and uncertainties related to examination significantly contribute to suicidal behavior. ⁴ Suicide has been linked to academic stress, which appears to be a significant stressor for students. ⁵ Family issues are the main reason for suicide in India. There are many other risk factors (sexual abuse, bullying, relationship challenges, poor social support, substance abuse, significant life events, and adverse childhood experiences) that play a critical role in student suicide. ⁶ Rising incidences of suicide among students in Kota (a city in Rajasthan, India) have triggered several debates and questioned the effectiveness of existing suicide prevention measures in India. ⁷

For Teachers

Recently, the government of India has introduced the national suicide prevention strategy (NSPS),^8,9 which focuses on the prevention of suicide in students; the Dept. of School Education and Literacy, Ministry of Education, has drafted a guideline for schools for the effective prevention of student suicide. ¹⁰ The guidelines developed for schools intend to empower teachers to effectively identify suicidal behavior and the potential risk factors of this behavior among the students. This document also emphasizes life skill development (coping and resilience) among the students. However, the big challenge in this regard is the effective implementation of a suicide prevention strategy, training of the teachers on the soft skills for identifying suicidal behavior and risk factors of suicide, as well as timely referral of at-risk students with appropriate mental health facilities for the effective management of suicidal behavior. Shortage of school human resources (teachers and counselors) is also a significant challenge. NSPS 2022 focused on capacity building, training of students on life skills and stress management by the teachers, and preventing substance use among the students. ⁸ Improving peer support in educational settings has been a regularly used suicide prevention tactic for students. One potential strategy for preventing student suicide is to educate peers about the early warning symptoms of suicide. In this context, peer and teacher gatekeeper training may also be helpful. The Ministry of Health and Family Welfare, Government of India, has initiated the school health and wellness program, under which two teachers (one male and one female) are nominated as “Health and Wellness Ambassadors” to engage in strengthening positive health, including mental health. ¹¹ This can be of potential help in student suicide prevention. Additionally, sensitizing the parent–teacher association, private school associations, and government teachers’ associations in preventing suicide may be beneficial.

For Policymakers

Providing enough funding for trained mental health professionals in educational institutions is essential to improve mental health services. This will ensure that students have access to the support they need. In the 2023–2024 financial year, 1.41% of the total health budget was allocated to mental healthcare, ¹² which is very less to meet mental healthcare needs. Dedicated budget allocation may be beneficial to create a friendly school environment by conducting awareness campaigns, anti-bullying programs, and life-skill training. The health and education sectors should collaborate more closely to improve early identification and support for children who are at risk. Though various national and international guidelines for reporting suicide stories exist, there is poor adherence to these guidelines. Bringing it to the legislative framework and regulating the media reporting quality through policy and legislative control may improve the quality of media reporting about suicide. A national student mental health hotline should be provided, operated by qualified experts who can offer quick assistance and direction. Effective policies and regular training of teachers to identify suicidal behavior in students are critical to successful suicide prevention initiatives. In order to minimize student suicide, attention should also be focused on the efficient grassroots implementation of the current policies. Ensuring the application of the policy would also require stringent and regular monitoring. Furthermore, informing children about the resources and assistance offered at their school and nearby is essential.

For Medical Professionals

Medical professionals should be trained in recognizing and controlling the risk of student suicide in order to enhance mental health literacy. The mode of presentation of suicide stories by media may have a moderating effect on the suicidal behavior of the students. Several guidelines exist that recommend healthy reporting of suicide stories. ¹³ It is unfortunate to note that there is a lack of compliance with the guidelines for responsible reporting on mental health issues by the media. Raising awareness among media professionals about the importance of responsible reporting and providing expert opinions on how to tackle mental health issues among students can help promote mental health and prevent suicide. This can help students become aware of coping and stress management strategies that would help them deal with their mental health issues.

In conclusion, student suicide is a matter of concern in India; however, the efforts taken to prevent it are not enough. There is a need for collective and multipronged effort to make it more effective. It is recommended that schools conduct mental health assessments for all students to identify those who may be at risk and provide suitable interventions. Integrating mental health services into educational settings can ensure that children have easy access to therapy and treatment. The liaison with mental health facilities may be strengthened using online mental health services (telemanas and e-sanjeevani portals). Additionally, attention should also be given to the effective implementation of the existing suicide prevention initiatives/policies at the grassroots level for student suicide prevention.