June 20, 2022
In recent years, student Mental Health has been posing multiple challenges for academicians, parents and to the society in general but unfortunately, does not receive timely attention it deserves due to lack of scientific information and stigma attached to seeking help. A recent Indian Council of Medical Research (ICMR) survey revealed that 12-13% of Indian students suffer from mental health conditions. Anxiety disorders, depressive disorders, eating disorders, self-injurious behaviour and substance abuse were some of the commonly diagnosed conditions among adolescents.
Clinical depression is becoming more common among adolescents and even younger children. Most often depression is masked by symptoms like bullying, defiance, cyber addiction, overeating, lack of concentration, and anger issues which sadly results in disciplinary action instead of professional attention due to ignorance. We have to understand that depression does not always mean sadness, crying spells or lack of sleep.
The last two years have seen a steep rise in suicide rates among 11-19 year olds all over the country. The year 2020 saw a record high of 12,526 student suicides. This rapid hike in suicidal deaths among students has been ascribed to the COVID-19 pandemic and the resultant lockdown, isolation, and online education. National Crime Records Bureau (NCRB) reports that every 42 minutes a student commits suicide in India which totals 34 student deaths per day. It is true that some suicide attempts, especially among younger children could be impulsive but it is not so with teenagers. Long term feelings of pressure to excel, rejection by peers, academic stress, fear of failure, self-depreciation is often associated with teen suicides.
Risk Factors
Suicidal behaviour is one of the symptoms of depression but there are other underlying risk factors which have to be understood as well. Presence of one or more of the following factors increases the risk for suicidal behaviour in students who are already emotionally vulnerable.
• Sudden loss due to a death of a loved one- parent or even a pet; break-up of a relationship
• Easy access to means of killing oneself like pesticides, prescription medications, etc.
• Witnessing violence in the family- physical, verbal, emotional or sexual abuse
• Bullying or being bullied at school, neighbourhood
• Rejection from school, friends or family
• Behaviour challenges- temper, hyper activity, aggression, impulsivity
• Feeling inadequate, worthless or hopeless
• Neglecting personal hygiene, grooming and appearance
• Exposure to the suicidal behaviour of others- family, friends, media, etc
• Acting out- running away from home, injuring self and so on
• Taking unnecessary risks- accident proneness, rashness or otherwise self-destructive behaviour.
Warning Signs
It has been estimated that 8 out of 10 suicides can be prevented if everyone associated with teenagers is aware of the warning signs. Some of the common warning signs are listed below:
• Preoccupation with death: Talking about dying, indirect statements like “I wish I was not born at all”, “The world would be better off without me”, or direct statements such as “All problems will go away if I die” need to be paid attention to. Some engage in writing poems, art work with death themes as well.
• Bouts of sadness, crying spells, irritability, grouchiness or anger
• Giving away their possessions
• Rapid decline in studies, difficulty concentrating,
• Frequent somatic complaints- headache, stomach upsets, body pain, fatigue, etc
• Poor appetite, over eating, trouble sleeping or excessive sleep
• Withdrawal from regular activities, family and friends
Parents need to watch out
Ask your children how they are feeling, whether they are thinking about harming themselves/killing themselves. Do not be afraid to use the word ‘suicide.’ Conversations like these will give your child a chance to open up about what they are feeling deep down. It just lets them know that you truly care about their distress and want to help. Contrary to popular myth, talking about suicide does not plant ideas in their heads. When they do feel comfortable to tell you how they feel, please do not tell them to ‘get over it.’ It is a serious issue and know that they are not simply being dramatic!
If a teenager expresses suicidal thoughts or a plan, he/she should be evaluated by a qualified mental health professional right away. Threats also need to be taken seriously and it is important not to leave them alone. If a child has admitted to a suicide attempt or has made a suicide attempt, they should be taken to the nearest hospital emergency room immediately. Even if the attempt is not a serious one, medical attention is needed to prevent a repetition of the attempt. In some situations hospitalization may be warranted to ensure the safety of the child. If they are assessed to have diagnosable mental health issues like depression, anxiety, or substance abuse, they will be helped accordingly either with medication, therapy or both.
“I am sorry, I did not have any other option”; “I tried my best but I can’t take it anymore”;
“I guess I am not destined to be happy.”; “I tried to tell you but you did not understand”
These are the recurring themes in most of the suicide notes. If someone had just listened to them or responded to their agony, they did not have to communicate through a suicide note. Dear parents, please listen to your children. Suicide is the ultimate form of communication. Watch out for warning signs. Take care of their mental health needs. It is okay to seek help from a professional counsellor or to take your child to a psychiatrist.
Having an easy access to means of suicide is directly related to lethality. Although it is impossible to remove all the means of self destruction from within their reach, it is necessary to keep potent prescription medications, pesticides, insecticides, cleaning supplies, etc. locked up. Same holds good for firearms.
Economic necessities have forced both parents to work who return home physically exhausted and emotionally drained. They do not have the time nor the patience to listen to the children or even find out what is going on in their lives. Nuclear family set up has deprived the children of a grandparental safety net that was available in most extended families.
Monitor your teen’s social media use. Know what they are exposed to every day. What are their reactions to posts, messages, etc. While social media can give a lot of support to the teenager, there is a lot negativity out there which could influence your child adversely. The COVID-19 pandemic and the resultant switch to online learning has created electronic addicts who are now struggling to wean away from these gadgets. Threatening to send the child to a boarding school or a boot camp is not going to help!
Encourage a healthy lifestyle with nutritious, well-balanced diet, adequate sleep and exercise. Allow them to play, enjoy music, play an instrument, etc.
School Environment
School Administrators and Teachers have an important role to play in shaping students into mentally healthy, responsible adults. On the contrary, there seems to be a huge gap between what education should be and what it actually is. Education cannot be relegated to teaching students how to make a living. Life skills education should be the focus of academic institutions which are just hell bent on becoming mere diploma mills! There is a need to teach students how to problem-solve, how to make right decisions, how to manage their time, stress and emotions right from kindergarten. They need to be taught how to live.
There is a lot of discomfort talking about suicide and people often tend to avoid the topic. It has been a personal experience with some school administrators when we have approached the school administrators with an offer to conduct free mental health and suicide awareness programmes. A School Principal literally shooed us away saying “We don’t have that problem here; please don’t put ideas in our students’ heads.” Two weeks later, this school lost a Grade IX student to suicide. Talking about suicide is essential, talking about it does not make someone suicidal but encourages them to seek help on time.
To make matters worse, coaching centres have mushroomed everywhere promising to train your wards to score better on entrance exams of different streams. After they are done with their school-related academic work, students have to tackle assignments of the coaching centres. “I don’t have time to even take a long, deep breath” exclaims a medical college aspirant. I know students who sleep less than six hours a day, skip breakfast, have a small bite for lunch and consume a heavy dinner too late in the evening which keeps them up until 2 am. Where is our future generation heading? Some are abusing drugs to keep themselves awake and to improve their concentration. Fear of failure and excessive performance anxiety is ruining the mental health of our students. The increasing pressure is causing emotional breakdowns and suicidal tendencies.
We have to be proactive not reactive: Every time a student commits suicide we tend to engage in a blame game – Parents, teachers, students, Administrators! Blaming each other is not going to bring the dead child back to life, does it? Most school administrators seem to be in a denial mode- “Our school does not have any issues; we don’t need a counsellor.” Some say hiring a counsellor is a “waste of money.” Some schools engage in an eye wash and share a counsellor between five campuses. Each day of the week the counsellor is available on one campus. PTA needs to pressurize the schools into hiring at least one full-time counsellor in every school.
Students, if you know someone (friend/classmate/sibling) who is contemplating suicide, you can do the following:
• Listen to them
• Don’t leave them alone
• Do not tell them they are being silly. Do not ridicule them.
• Encourage them to talk to someone- school counsellor, parent, hostel warden, teacher
• If they refuse, talk to an adult about what your friend is feeling. Remember, you’re not betraying your friend’s confidence in you but you’re preventing him/her from taking a drastic step. Your action can save a life!
• Call 100 and inform the police if someone’s life is in danger.
There is a Suicide Lifeline operating in Mangalore established under the aegis of Susheg Charitable Trust. You can call (0824) 2983444 for help twenty-four hours a day, seven days a week.