India & Suicides: Can New Policy Address Mental Health Pandemic Among Youth?

As an educator and counselor, it's alarming to learn of two student suicide cases in K'taka in less than a fortnight

The intellectual, vocational, social, psychological, and emotional foundations of teenagers' futures are laid by the abilities they acquire in school. There is only little the teachers can do apart from teaching and planning lessons. For the larger good, there have to be strategies that are endorsed by the educational sector and health system altogether.

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Trigger warning: The following story contains details of personal harm. We urge the readers to use their own discretion before proceeding further.

On 8 November, 16-year-old Moin Khan—a Class 10 student at a private school was caught copying in an exam as a result of which he was sent out of the classroom by the teacher. That same evening, he jumped to death from his apartment’s 14th-floor terrace.

In a second such incident in Karnataka on 13 November, Amrutha was allegedly reprimanded by her teacher at school after she was found referring to a chit during the examination. Additionally, her parents were called to the school and told about the incident. She hanged herself at her house days later.

As an educator and a counselor based out of Bangalore, it is alarming to learn of two cases of suicide by students in the state in less than a fortnight.

Students’ Suicide Spree Asks Some Pertinent Questions

The state government of Karnataka adopted the Samagra Shikshana module for value-based education beginning with the current academic year for children from grades 1 to 10. It uses activities and tales to teach lessons based on moral principles and values. There are no textbooks for it as of now. To create the module, the department is collaborating with two NGOs and 25 instructors from all grade levels.

Some states have moral values and some have a curriculum that helps children learn coping mechanisms like mindfulness, emotional regulation, and so on. The Delhi government has introduced ‘The Happiness Curriculum’, which consists of mindfulness activities, self-expression, reflections, and exercises through stories and activities. Goa has moral science taught once a week. However, there are no common textbooks, and schools devise their activities. Telangana and Jharkhand too have moral science classes.

The steps look promising but they do raise some serious questions about how trained and equipped the teachers are to deliver the content. Do they have any time on their sleeve to connect with students via these programs or this seems like yet another duty added to their list by management which seems like a chore?

If there are no textbooks or a guided structure, how are they planning and structuring the sessions, Why no therapeutic strategies are initiated on teaching students about healthy coping mechanisms, emotional regulation, interpersonal skills, and art therapy? Who is driving and monitoring the success and failure of these moral value classes?

Counselling & Coping Strategies Over Moral Lessons

All of these initiatives are for government schools, is there any appointed body or organisation that checks for these initiatives in a private school? I might sound like a non-virtuous person against the teaching of moral values which is not so, my significant question is, are moral values enough and all that children need today? We do need moral values to be taught but definitely need coping strategies to be taught too.

In a meta-analysis research study, by synthesising timely evidence, it was found that for children and teenagers, anxiety and depressive symptoms dramatically worsened after COVID-19. The current challenge is how to counteract this trend, especially in the senior school and college years. According to World Health Statistics (World Health Organization), a 2022 study shows India has a suicide rate of 12.7 per 1,00,000 people which is alarming.

Knowing that we are in a do or die situation we need to start acting now by bringing in more robust ways of preventing suicides and promoting mental health in youth and children. Studying the youth who cope via self-harm and suicidal behaviors suggest that the great majority of psychopathological alterations have their onset in childhood and adolescence (Werner-Seidler, Perry, Calear, Newby & Christensen, 2017).

Senior professionals in trauma care frequently remark that suicides are typically indicative of an individual crossing a critical threshold and that there is a significant likelihood that they had undiagnosed depression and melancholia and that the trigger that caused suicide can never be considered in isolation and as a standalone event.

Is Mental Health the New Pandemic?

Similar to many other nations, India has seen an increase in psychological distress among children and adolescents in the recent years. Covid has had a huge impact in making things worse. “Children these days are emotionally brittle, many children confess feeling lonely, anxious, and depressed. Already, the mental health situation was bleak, Covid has made things worse," says Shaista Basheer, a psychologist based out of Bangalore.

"New research shows that Covid has caused physiological changes in the brain that are perhaps making people more vulnerable and susceptible to depression, anxiety, and thoughts of suicide. Children have remained holed in their homes and locked out of social worlds for long, thus, leading to a major disconnect and resulting in maladaptive practices and adjustments. They have missed out on what colleges and schools had to offer them holistically. They have lost out on a lot of skills like keeping up with time and deadlines, and are unable to cope with the pressures. Mental health crisis in the new pandemic," she adds.

My mentor Dr Kapur— a consultant Psychiatrist at Columbia Asia Hospital in Bangalore who brings 45 years of experience to the field, on being quizzed about the possible rise in cases post covid, and the challenges faced by the Psychiatry fraternity, responded saying, “We are seeing a huge rise in anxiety neurosis, panic disorder, and depression has become very common, especially in families that lost their loved ones. People who suffered from Covid, are showcasing an impact on the nervous system including anxiety, insomnia, depression, restlessness, lack of concentration, loss of memory etc. This has resulted in social anxiety and depression leading to suicide ideation, particularly in children and young adults, leading to a quantum rise in cases.”

How a Support Ecosystem Can Mitigate Suicide Risks

To improve awareness towards the prevention of suicidal behavior, mental health, and wellness, as well as to foster resilience, it is widely known that early intervention and the promotion of positive mental health in schools and colleges are essential.

The intellectual, vocational, social, psychological, and emotional foundations of teenagers' futures are laid by the abilities they acquire in school. There is only little the teachers can do apart from teaching and planning lessons. For the larger good, there have to be strategies that are endorsed by the educational sector and health system altogether.

Children with identified needs—those who are at risk or have serious psychological issues should be identified based on assessments, observations, one on one counseling and receive support from family, friends, and the entire community. The whole fraternity and eco-space that a child is surrounded with have to be sensitised to the child’s developmental stages and emotional and psychological needs.

There are multiple examples of programmes that aim to educate children on these fronts internationally such as Mind Matters in Australia, Friends for Life (7-16years) in multiple countries (e.g. New Zealand, Canada, Finland), and the Social and Emotional Aspects of Learning (SEAL) program in the United Kingdom(Library & Research Service, 2012) that help children go through a journey of understanding themselves better rather than focusing only on the cardinal virtues and morals.

Delhi Government’s Wellness Recipe for Young Minds

Another brilliant initiative came in 2018 in the form of ‘The Happiness Curriculum' in Delhi which was soon adopted by Chhattisgarh and Uttar Pradesh, witnessing great results. The curriculum was implemented to improve students' mindfulness and constructive output along with allowing children to develop securely in the face of complicated social issues and dangers.

With the practice to feel better as their mantra, the curriculum is integrated into the educational setting to address mental health issues starting in childhood. The Deputy Chief Minister of Delhi Manish Sisodia proposed the notion of such a curriculum for children to learn how to care for mental health in 2017. Chief Minister Arvind Kejriwal and the 14th Dalai Lama officially unveiled this curriculum in July 2018.

What else could be done besides introducing a practical holistic curriculum that helps children? Unscientific age-old methods will not work with new-age children. One of the constant concerns we counselors share, is how to appropriately respond to malpractice. You will always have a question or two on how to balance between bringing discipline in children and positive behavior engineering and modification

Some of the recommendations could be:

1. Children need a holistic training ground where they are not just taught resilience and grit but also to practice and embody it in their day-to-day life. Resilience can be defined as a process of successfully adapting to challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands.

2. Every school should have a School counselor, at least one counselor, and a special educator on a consulting basis. This is so that each child has an unbiased safe space to share, open up, and get counseled for their emotional needs individually. According to research by the Associated Chambers of Commerce and Industry of India (ASSOCHAM), just 3% of private schools have real appointment records of having a counselor, despite the Central Board of Secondary Education rule mandating that schools must have counselors on staff. The predicament in government schools is far worse.

There is always this cliché about teachers displacing their emotions and anger on children but what we could be missing is perhaps they aren’t trained and equipped to handle situations and deal with them the old-school way. For instance, out of the many interventions, one could be trained and taught to use the 'Wise Mind'.

How Can Academia Create a Safe Space for Students?

3. In Dialectical Behaviour Therapy under the Emotion Regulation module, we train clients to build a wise mind. (the three mind states of DBT) Reasonable Mind, Emotion.

4. Mind, and Wise Mind. The reasonable mind is motivated by reasoning and logic, the emotional mind is motivated by feelings and emotions, and the wise mind occupies a space in the center of the two. Psycho-education of teachers is important, for instance, a teacher learns that if she is caught in a situation like this where she finds a child cheating in exams, her rational mind would want her to turn the child in as the child is clearly guilty.

The emotional mind would want to let it go and the wise mind finds a balance, perhaps waiting for the exam to get over, talking to the child in private asking for a reason for the behavior, and listening to his/her side empathically. Perhaps he has been finding this subject extremely tough and is scared of failing due to the pressures at home. Perhaps the child has ADD (attention deficit disorder) which is making him lose focus and blank during exams. The teacher uses her wise mind to help the child understand it is not right and yet give him a chance to change, reflect and make amends for his/her behavior without breaking the morale of the child.

The child could also be asked to take the exam in private again as a consequence but without shaming him in person or in front of other teachers, students and parents. Teachers' training needs to include counseling strategies and loads of case studies on handling deviance and malpractice in a wise way rather than being impulsive. Also to support them with, a safe space for academic catharsis and emotional catharsis. Practical workshops and training in building on teachers’ coping skills and mechanisms need to be brought about.

Roles & Responsibilities of A School Counselor

Source : Link For Counselors (https://www.linkforcounselors.com/)

5. Education leaders can support teachers in managing their stress. Teachers can escape the pessimism and emotional exhaustion that frequently result in burnout with the correct support and direction. Teachers can be guided by school administrators to change how they react to the difficulties they face. Teachers frequently begin their careers full of optimism and anticipation. They may quickly give up when faced with some of the hard realities of teaching. However, educators can change the reactions that feed undesirable emotions by using the appropriate coping strategies.

Workshops, counseling, and training sessions can steer teachers in the direction of adopting strategies that can let them internalize problems and reframe them. Avoiding teacher burnout can be significantly improved with these strategies. Age-old practices need to be challenged. Although the B. ED program has a paper on child psychology, there is a significant gap between theoretical understanding and actual on-ground issues faced by teachers. We saw an alleged commonality in both the above cases of the teacher reprimanding the students in front of the class. Teachers should be trained and sensitised to abandon their long-standing traditions of shaming students and adopt positive reformative methods and ways of bringing change and reforms to a child.

Awareness Is the Key

Finally, we need to understand that mental health and well-being are not the sole responsibility of the school and parents. The educational sector including health services has a role to play in supporting youth mental health and wellbeing. The education department needs to organise talks in different cities, towns, taluks, and villages, on the developmental stages of the child and the characteristics of each age group. Also on the learning, and behavioral disorders, and how to positively parent and support children while building their resilience and grit.

Data on Age-standardised Suicide rates, 2019

Source: World Health Organization

According to WHO, more than 700 000 people die due to suicide every year in the world. For every suicide, there are many more people who attempt suicide. Another report says there are many that go unreported in the statistics. Suicide is the fourth leading cause of death among 15-29 year-olds. Let’s not wait to act until it becomes the first.

(Suicide helplines -- Maithri, Cochin: [phone]; Sumaitri, New Delhi: 2338 9090, Sneha, Chennai: 91-44-2464 0050, 91-44-2464 0060, Aasra, Mumbai: 9820466726, Fortis MentalHealth: 8376804102)

( Zulekha Shakoor Rajani is a Bangalore-based educator, counselor and therapist who advocates for mental health well-being. This is an opinion article and the views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)