Coverage of SSR death, Covid, unemployment spark suicidal thoughts

Declared on March 24, 2020, the lockdown ensured that hundreds of millions of people were confined at home, except when they ventured out, armed with a self-attested affidavit, to stock up on essentials. While this may have been effective in curbing the spread of the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) in India, it has not, perhaps, been conducive to the emotional and mental health of many.

Psychiatrists are getting more patients with suicidal tendencies during this period. The reasons vary from loss of employment and livelihood, break-ups to incidents of violence at home. However, in the last two months, the situation has exacerbated monumentally.

Aakash Healthcare, a super speciality hospital in New Delhi, noted 33 per cent of patients battling mental health issues exhibit suicidal thoughts. One of the biggest instigators has been the extensive coverage of Sushant Singh Rajput's death, who allegedly died by suicide. Meanwhile, the Indian Spinal Injury Centre (ISIC) say they see at least 10 patients every day who complain of suicidal thoughts due to various reasons.

"One of the biggest triggers can be the talking about suicide, and since the death of Sushant Singh Rajput and the constant media discussion on it, many people are coming to us who feel intrigued by suicide and are curious about it. About 150 people approached us with clinical mental health issues in the past two months, and 50 had serious suicidal thoughts. Children as young as 15 are showing suicidal thoughts. One of the patients was a man in his 30s who tried to commit suicide through medicine overdose. Those who have anxiety or bipolar disorder may also be prone to committing suicide," says Dr Loveleen Malhotra, Psychologist, Aakash Healthcare & Super Speciality Hospital, Dwarka.

Apollo Telehealth, a telemedicine service by pharmaceutical and healthcare giant Apollo, say they have given as many as 2000 consultations to people suffering from mental health issues. Dr Tabassum Sheikh, Psychologist at Apollo Telehealth, noted that many among them exhibited suicidal tendencies.

"A variety of issues and underlying situations were observed in the patients, which led up to suicidal thoughts. But the majority faced the fear of catching an infection, social isolation,loss of loved ones often exacerbated by the distress caused due to unemployment and loss of income," Sheikh said. Sheikh also classified her patients based on the issues they faced, which led to the onset of suicidal thoughts in them. Emotional: Grief, anxiety due to prevalence of COVID-19, loneliness, depression.

Employment issues: Unemployment, lack of job security and satisfaction, distress and demotivation leading to lack of focus and concentration. Inadequate sleep due to work pressure.

Interpersonal Relationship Issues: Marital issues, including lack of compatibility, trust, commitment, and compassion towards each other. Lack of communication and break-ups.

Problems with Parenting: Difficulty in making a fair decision among two kids or more kids and issues in understanding the psychology of a kid with separated parents

Personality and Habits: Increase in aggressiveness of obsessive-compulsive disorders, overthinking, and anger.

Physical: Lack of sleep and concentration, lethargy, loss of energy, and issues due to chronic illness and recent surgery.

Dr Shanu Shrivastava, a senior psychologist at ISIC, said that in patients exhibiting suicidal thoughts, she had observed issues such as domestic violence, substance abuse, and alcoholism. "The workload has increased a lot for psychologists due to several stressors in the lives of people such as a change in lifestyle, change at work, lack of balance between work and personal life, no social interactions, meetings and hanging out. Many problems are between spouses as husband and wife are not getting proper space due to prolonged work-from-home, resulting in fights. We can say fear of COVID is a major factor, but non-acceptance of changing scenarios is also an important factor," she explained.

Meanwhile, Dr Malhotra advised that to mitigate suicidal thoughts, it is imperative to provide the affected persons with an environment in which they can talk. Most cases occur due to lack of communication between the affected person and the people around them. "We should work towards providing comprehensive, integrated, and responsive mental health and social care services in community-based settings while implementing strategies that promote mental well-being and prevent mental health deterioration. We also must strengthen leadership and governance for mental health through robust information systems, evidence- and-research-based treatment modalities," he said.

Dr Malhotra adds that there is a need to re-evaluate categorising suicide as a crime. "Suicides should be considered a socio-medical problem, not a crime," he said.

Vikram Thaploo, CEO of Apollo Telehealth, also said mental health should be treated as a core element in our response to the pandemic. "There is already considerable social stigma attached to seeking psychiatric assistance and a number of people who need help right now but are not getting it. The bottled up cases are surely going to cause a surge in mental health cases going forward. Unless mental health is treated as one of the core elements in our response to the pandemic, the long-term social and economic costs will be severe. Lack of access to mental health care and shortage of qualified mental health professionals is already a big problem in India," he added.