1 week Ago By Umesh Isalkar
Pune: Savita (name changed to protect identity) was admitted to the YCM hospital in Pimpri about seven days ago with pesticide poisoning. She went on to require mechanical ventilation for three days and after recovering, told doctors she had consumed the liquid by accident, mistaking it for cough syrup. It was only during counselling that she told the truth to the hospital's psychiatrist.
Savita had tried to take her own life — after repeated emotional and physical abuse being meted out by her alcoholic husband. An analysis of 325 cases of 'deliberate self-harm' (DSH) reported this year at YCM Hospital has found that ingestion of a harmful liquid, as a way to take one's own life, had significant gender disparity, with more women, mainly married women, using this method, than men. Social determinants were as important as clinical factors, the study said.
The observations are supported by data. According to statistics from the National Crime Records Bureau (NCRB), marriage-related reasons accounted for 8% of suicides among women. The figure was just 0.
8% in men. Experts from YCM Hospital said most of the women they studied had attempted suicide within hours of experiencing sexual abuse, domestic violence or relationship issues so 'depression' alone doesn't explain their actions. "Most women in the study group, who attempted suicide, were those having different interpersonal conflicts at home, such as altercations with the husband or in-laws.
They provided us with a history of frequent dowry demands, domestic violence and sexual abuse," said the hospital's psychiatrist Dr Vidhu Arora. Dr Arora analysed the data with guidance from senior psychiatrists Dr Manjeet Santre and Dr Gaurav Wadgaonkar. She added: "Their psychiatric evaluation usually falls under the diagnosis of adjustment disorder.
We counsel these women on appropriate coping mechanisms, to deal with the stressor and we also treat any underlying psychiatric problems." The majority of women in the YCM Hospital's DSH study were in the 16-40 age group, belonging to middle socioeconomic status. "Also, most of the DSH attempts were impulsive in nature.
Coupled with easy access to poisonous substances or formulations, it explains the high prevalence of 'DSH' attempts through consumption of phenyl or other harmful liquids," she added, citing data from the 325 cases that were studied. Dr Arora said women were also more affected by problems in a relationship, which led to internalising of emotional distress and used self-harm as a way to escape the emotional pain. "Various studies show that women are more likely to attempt suicide by poisoning than men, although men are more likely to die from suicide due to the use of more lethal means," she said.
September 10 is observed as World Suicide Prevention Day. The year's theme is 'Changing the Narrative on Suicide – Start the Conversation' and focuses on shifting perceptions of suicide. Experts said it has always been a misconception that suicide attempts are carried out by those who are "mentally weak".
But we need to change this line of thinking and remove the social factors that are associated with suicide," Dr Arora said. The WHO's initiative for suicide prevention recommends effective evidence-based interventions such as limiting access to means of suicide; interacting with the media for responsible reporting of suicide; fostering of socio-emotional life skills in adolescents; and early identification, management and follow-ups with anyone affected by or displaying suicidal behaviour. "Sexual or domestic violence can lead to grief, and grief symptoms can overlap with depression.
It's important not to confuse the two. Suicide isn't just a mental health issue; it's also a social issue," said noted psychiatrist Dr Soumitra Pathare in his book, 'Life Interrupted: Understanding India's Suicide Crisis'..
