COVID-19: Alleged Suicides and the Pandemic of Fear

COVID-19: Alleged Suicides and the Pandemic of Fear

The uncertainty about the lockdown and panic over COVID-19 is taking its toll on people.

(If you feel suicidal or know someone in distress, please reach out to them with kindness and call these numbers of local emergency services, helplines, and mental health NGOs)

Suicide almost never has only one cause - and in India, they often relate to financial fears.

On Thursday, 2 April, ANI broke the news of two alleged coronavirus related suicides from Uttar Pradesh. Earlier, Kerala saw seven alleged suicides, reportedly linked to alcohol addiction and the lack thereof in the lockdown.

On March 18, a young man allegedly committed suicide shortly after being taken to the quarantine facility at Delhi's Safdarjung hospital.

FIT spoke to Dr Soumitra Pathare, a consultant psychiatrist and Director of Centre for Mental Health, Law and Policy at ILS, who spoke to us about COVID-19, anxiety of an uncertain lockdown and the toll it is taking on the lives of people.

Dr Soumitra Pathare“Many people are on the edge, this is a time of uncertainty. One has to understand that suicide is a complex psychosocial phenomenon with many drivers.”

Of suicides, Dr Pathare said that so far we are seeing “fear-related suicides.”

Fears over the virus yes, but also of the anticipated side-effects from financial insecurity to unemployment and food scarcity.

Suicide is (Often) a Financial Issue

Dr Soumitra Pathare“The issue for many people is not just the lockdown - especially for the working classes it is about anxiety over the financial insecurity. Practical issues like where will you get food from? So there is already that stress.”

He reiterated that there is not always a clear link between suicide and mental illness. Especially in India, people who die from suicide often don’t have diagnosable mental illnesses - the issues is largely about other factors, primarily economic or societal ones.

“A knee-jerk reaction should not be taken right now. So we may not necessarily need more counselling to address the rising suicide rate. The government instead needs to address and mitigate the economic impact of the crisis. This will play a large role in reducing fear and worries.”

He warns that this is a growing crisis and we need to understand the complexity of suicide and implement targeted policies.

As the COVID-19 cases grow, so will the fears, but also after we ride that wave comes another - an economic one.

The economic driver of suicide is not new or unique to India. In 2008, during the heights of the financial crisis and even after, Greece - one of the worst-hit - saw a drastic rise in suicide rates. “The data shows it went up by almost 25%,” says Dr Pathare.

Addiction and Suicide

It has been speculated that the suicides in Kerala were brought upon by addiction to alcohol and the severe withdrawal symptoms from the lack of supply in the lockdown.

To address this, Chief Minister Pinarayi Vijayan announced that the government is planning to provide some liquor to alcoholics with withdrawal symptoms. The patient would need to get a certified slip from the doctor denoting that they are in the stages of withdrawal and would only then be allowed to purchase liquor.

Dr Pathare says it is too early to discuss the trends of any of the suicide but adds that the response in Kerala was "pragmatic, given the circumstances.”

“See, patients with withdrawal symptoms would need to be hospitalised and in a situation like this, where governments are trying to avoid over-crowding hospitals, this move is pragmatic.”

Addiction is a mental illness with many treatment models, the two most common being total abstinence or harm minimisation.

“In Kerala, the latter has been employed, They are trying to reduce the harm caused to society as a strategy in this emergency.”

Dr Pathare says that there is no correct answer to strategies used in unprecedented, extraordinary times like these.

What About the Women Who Die by Suicide?

However, alcoholism and lockdown ring alarm bells for a different reason as well - gendered violence. Cases of domestic violence have increased, and this is especially worrisome as one of the drivers of suicide for women is some form of gender violence.

Dr Soumitra Pathare“One third of women die by suicide when they experience domestic violence. These are associations and not causations though.”

For now, devastatingly, there has already been an increase in domestic violence cases around the world and in India too, as reported by The Quint.

For now, it is difficult to draw gendered conclusions of the suicides during the lockdown, he said but added that the victims of suicide in India are largely women and the youth.

“Besides, alcohol and domestic abuse are linked and these need to be addressed structurally.”

‘Suicide Intervention Needs to Be Multi-Pronged’

Dr Soumitra Pathare“The suicide rate will not change unless we address the issue of suicide structurally. It needs a multi-pronged, multi-sectoral approach.”

Since suicide is so complex and India is a large country with people of different motivations - it is also important to tailor interventions for specific groups.

For example, for women only-groups, maybe the policy focus could address gender violence. For men, there would be interventions on alcohol, dependency and addiction.