More than 4,00,000 people commit suicide all around the world every year. It is amongst the top ten causes of death for all ages in most countries of the world. In some, it is amongst the top three causes of death in the younger age group (15-34 years). Moreover, it is the second most important cause of death in the age-group 15-19 yrs., second only to vehicular accidents. Which just goes to show how young and prospectively brilliant lives are sniffed out in this tragically premature manner.

If this were not enough, we must note that suicide is under reported by 20-100%. If we take the 1994 figure reported above as the base, this figure in 2000 was projected as 5,00,000 plus. Even if we take 60% underreporting (average of 20-100%), we are talking of around 8,00,000 lives all around the globe getting exterminated in this manner every year. And the figure is rising. If this does not qualify for it to be called a public health issue, what does ?

Moreover, this is the figure of successful suicides. Attempted suicides are around ten times the figure i.e. 8,000,000 people attempt suicide, out of which 8,00,000 succeed in ending their lives. Attempted suicides involve a great effort on the part of medical and paramedical professionals and health care delivery systems, the immediate caregivers, the NGOs, and society at large to manage this colossal burden of morbidity and mortality. Moreover, research studies have found that 1- 2% attempted suicides become successful suicides every year. This means 10-20% attempted suicides will end their lives in a decade.Therefore, prevention and treatment of both potential and attempted suicides and identifying the population at risk has to become a major public health priority area.

 A number of risk factors of suicide have indeed been identified. Factors that predispose to successful suicide are male sex (males outnumber females 2.5:1; while in attempted suicides, females outnumber males 10:1); widowed, single or divorced marital status; addiction to alcohol or drugs; concomitant chronic physical or mental illness; people staying in lodging homes or living alone and in areas with a changing population. The key factor probably is social isolation, for the widowed and single consistently have higher suicide rates than the married , and widows with children have lower rates than those without. Such at risk population, in other words, is in greater need of psychosocial measures involving crisis intervention and rehabilitation.

 Consider the Indian scenario, which is equally pertinent to us, probably moreso. As elsewhere, suicide is amongst the top ten causes of death here, and amongst the top three between the ages 16-35 years. While in 1984 around 50,000 people committed suicide (50,571, i.e. 6.8 per lakh), in 1994 this figure rose to 90,000 (89,195 i.e. 9.9 per lakh). At present we have nearly a lakh Indians dying of suicide every year, which is 20% of the world suicide population: another dubious distinction for this country, beside the population explosion. And suicide attempters are ten times the suicide completers. This means around ten lakh Indians attempt suicide every year, out of which one lakh succeed*. What an ironic success rate indeed ! In other words, 2740 people attempt suicide and 275 Indians kill themselves every day by suicide. Even the greatest supporter of eugenics or population control would not even remotely recommend such a method.

We just discussed that suicide is under-reported. There are various reasons for this, common amongst these being the competence in medicine and law of those who issue Death Certificates, the mechanism used for collecting vital statistics, and the social and cultural attitudes of the community. For, we must know that, unlike most other causes, suicide stigmatizes the survivors as well.

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*And if we consider 60% under-reporting, the figure is 16 lakhs attempters and 1.6 lakh suicide deaths.(-eds.)