27 March 13 by Liat Clark

Self harm has replaced maternal disorders as the leading cause of death among women aged between 15 and 49 in India, a study covering 187 nations has revealed.

Analysis of the University of Washington's Institute for Health Metrics and Evaluation report was published in the British Medical Journal on 26 March, and covers data recorded between 1990 and 2010. It reveals a 126 percent rise in suicides among young women across that period. The shocking statistics support a growing body of evidence that indicate it's an increasing problem in the country.

Photo: Shutterstock

Last year a Lancet study estimated there were 187,000 suicides in India among over 15s in 2010, or three percent of all deaths recorded that year. It represented a more than 50,000 increase on official National Crime Records Bureau figures, attributed to under-reporting of cause of death possibly due to social concerns over what remains a taboo subject. Compare this with the 5,608 suicides that occurred in over 15s in the UK in 2010. India's population is nearly 20 times that of the UK's, meaning equivalent figures would set Indian suicides at about 112,000 -- 75,000 less than the Lancet article's estimates. 

According to the study, 40 percent of those suicides among men and 56 percent among women occurred between the ages of 15 and 29, and rates were higher among well-educated young people in wealthier areas, suggesting economic strife is not the overriding cause behind the increase. This may instead correlate to social pressures surrounding issues of marriage at that time in life. 

According to the World Health Organisation, suicide is the seventh top cause of death globally among women aged 20-59 years. Top causes of death in the UK are attributed to circulatory and respiratory disease, and cancers. By comparison, the top causes of death among women in India are maternal disorders (child birth and pregnancy), tuberculosis, diarrhoea and, troublingly, fire. Death caused from HIV and Aids rose by 1,000 percent, and from 68th to 6th position. 

But how can the government even begin to tackle such a staggering problem? The Lancet report called on public health authorities to limit access to harmful substances such as pesticides -- half of all the suicides were by poisoning. This could combat a growing number of suicides among farmers, which has been on the rise since the 90s due to a number of socioeconomic factors squeezing the sector. 14,000 committed suicide in 2011, according to government figures, and the agriculture ministry responded by saying it would increase investment in the sector and raise minimum crop prices.

The escalating issue of sexual discrimination and the consequent violence towards women may also be a contributory factor. In response, the country's parliament has just passed a new law to offer more protection for women and harsher penalties for their attackers. A sign of the kind of social taboo surrounding the issue was made clear with an inclusion in the law to make it a crime for police to refuse to open a case based on complaints by women about sexual attacks. "The main social determinants for suicide in women are interpersonal violence (for example, marital violence) and economic difficulties," Vikram Patel, Wellcome Trust Senior Research Fellow in Clinical Science and coauthor on the Lancet study, told Wired.co.uk.

In India, as in most place across the globe, mental health remains a taboo issue. Another report published 26 March by the Royal College of Psychiatrists called for equal levels of access to treatment to become the norm for both mental and physical illness. According to the study, just 24 percent of people with mental disorders and 28 percent with post-traumatic stress disorder get treatment, compared to 91 percent of people with high blood pressure. This is despite mental health disorders shortening life expectancy by an average of 15 to 20 years. The number of deaths caused by mental or behavioural problems also increased by 10.52 percent from 2009 to 2010, according to the NHS.

The stats speak for themselves -- treating mental illness as a taboo subject, of less importance than something we can physically see or measure, is no longer an option. Providing those in need with a support network that can be easily accessed is essential, and we are seeing more of this in India. In 2011 Facebook set up a system whereby friends can alert the relevant authorities if they think a friend on the social network is contemplating suicide. By linking them up with the Aasra suicide prevention helpline, they might be helping prevent a handful of deaths. Changing the social, cultural and economic factors that contribute to the growing pressure on young people, pushing them to contemplate taking their own lives, will not be quite so simple.