Trigger warning: Discussions of suicide.New Delhi: In 2013, the World Health Organisation (WHO) called upon its member states to demonstrate increased commitment to its Mental Health Action Plan, of which suicide prevention was an integral component. India later also committed itself to implementing public health programmes to reduce suicides and attempted suicides. However, recent Right to Information (RTI) applications filed by a Delhi-based doctor with three premier Central government-run medical institutions have revealed that there has been no implementation of the Centres of Excellence through which this objective was to be achieved.It was following the death of a psychiatry student at All India Institute of Medical Sciences, Delhi in July this year that disability rights activist Satendra Singh decided to file the applications with the three premier institutes – AIIMS Delhi, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh and Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry – as also 13 medical institutions under the Faculty of Medical Sciences (University of Delhi) to see the status of implementation of schemes for suicide prevention.Echoing a longstanding demand, the WHO recommends India have a ‘National Suicide Prevention Strategy’. As it happens, India’s Union health minister Harsh Vardhan was elected as chair of the WHO’s executive board in May this year.“Moreover,” Singh told The Wire, “Vardhan was also president of AIIMS Delhi and yet no action had been announced, and India remains without a National Suicide Prevention Strategy.”Singh, who is also the founder of SPACE (Safe Place for Affective Counselling & Empathy) – a mental health support student group at University College of Medical Sciences, Delhi, said he filed all the RTI applications with AIIMS, JIPMER, PGIMER and Delhi University on a similar format in mid-July.The RTIs were filed with three premier medical institutions, including AIIMS Delhi. Photo: PTIThe first six queries pertained to suicide. He asked whether the institute had any dedicated helpline for suicide prevention, if it was maintaining data with regard to suicides and attempt to suicides in its premises; the details thereof, the number of suicides and suicides attempted over the last 10 years with their details; and details of programmes planned, designed and implemented to reduce suicides and attempted suicides.In response, JIPMER Puducherry responded by providing a chart of the number of suicide cases for the ten year period from 2010 to 2019.This illustrated how there had been 90 deaths by suicide of JIPMER staff and students during the period, with 27 of those taking place in 2019 alone.Besides, it said, there were six cases of staff and students dying due to non-natural causes – these included three by hanging, one of methanol poisoning and two of rat killer poisoning.To a query seeking details of programs planned, designed, and implemented to reduce suicides and attempted suicides as mandated under Section 29(2) of the Mental Health Care Act (MHCA), 2017 at JIPMER in the last 5 years, the Institute responded by saying that on September 10, 2018 (World Suicide Prevention Day), a programme related to suicide prevention was held in JIPMER where quiz and essay writing competitions were conducted to raise awareness with respect to suicide. Then last year, the second week of September was observed as suicide prevention week and an All India Radio (AIR) talk show was conducted on the subject every day for 10 minutes in Puducherry.Also Read: World Suicide Prevention Day: A Time to Reflect and Address Mental HealthSingh said while no response was received from Delhi University, the PGIMER Chandigarh in its response to the query said “there wasn’t any suicide or attempt to suicide among post graduate, senior resident, faculty and non-teaching staff categories of Department of Psychiatry, PGIMER”.On programmes planned to curb suicides or attempted suicides, the reply was silent and only stated that “no records are available from the Department of Psychiatry, PGIMER.”The most detailed response to the application came from AIIMS, where the administrative officer of the RTI Cell forwarded the application to eight different departments, some of which submitted their respective replies.The chief public information officer (CPIO) of SC/ST, OBC/Women Cell of AIIMS responded on August 19 by saying that “the sought information is not available with the CPIO, SC/ST Cell.”To another request for providing a copy of the institute’s Equal Opportunity Policy, the response was that “the sought information is available at DoPT portal”.The College for Dental Education and Research at AIIMS said, it “does not maintain such record of suicides and attempt to suicides in respect of undergraduates, postgraduates, senior residents, faculty and non-teaching staff categories”.The Department of Psychiatry and National Drug Dependence Treatment Centre of AIIMS replied saying it did have a helpline with numbers 9868397175 and 9868397176 for suicide prevention. It said it was also conducting orientation programmes, mentorship programmes, counselling and psychotherapy and referral to the psychiatry department to reduce suicides and attempted suicides.Incidentally, there are two toll-free helplines which are run by the Centre too. These are ‘KIRAN’: 24X7 Mental Health Rehabilitation Helpline by the Ministry of Social Justice and Empowerment – 18005990019 – and National Institute of Mental Health and Neuro Sciences (NIMHANS) helpline – 08046110007.The College of Nursing, while stating that “one undergraduate student died on account of suicide in the hostel in December 2014” said no such event involving faculty members or non-teaching staff occurred. It also said there was no helpline in this regard.As for the initiatives to curb suicides or their attempts, it said, “Wellness Centres set up in Hostel No 7 and 19 to provide regular counselling services for undergraduate and postgraduate students.” Also, it said, mental health services were accessible to all on the campus.The CPIO of hospital administration and the academic section also submitted their responses, but these did not have any significant information.The Centre runs two helplines for suicide prevention. Representative image. Photo: PTIMental Health Care Act too urged specific suicide reduction programmesReacting to the submissions of the institutions, Singh said, “India urgently needs a National Suicide Prevention Strategy.” He said the National Mental Health Policy of India, 2014 provides strategic direction in prevention of mental illness and reduction of suicide and attempted suicide.Among other things, it directs implementing “suicide reduction programs to reduce the likelihood of suicide and attempted suicide”. Also, it stresses addressing “alcohol abuse (and dependence), and depression as key risk factors for suicide and attempted suicide”.He said India also enacted the MHCA 2017, which provides that “the appropriate Government shall, in particular, plan, design and implement public health programmes to reduce suicides and attempted suicides in the country.”Also Read: Suicides Among Doctors Were Too Common in India. Then the Pandemic Came.Also, it laid down that the government shall “have a duty to provide care, treatment and rehabilitation to a person, having severe stress and who attempted suicide, to reduce the risk of recurrence of attempt to suicide”.But Singh said there has been “no implementation” of this in the premier institutes run by the Ministry of Health. “Suicide is a public health issue and we need inter-ministerial coordination for implementation. However, what we have seen is that the Ministry of Health and the Ministry of Social Justice and Empowerment come up with different suicide prevention helplines.”In fact, the architect of the MHCA and leading suicide prevention researcher Soumitra Pathare had also tweeted recently about the lack of coordination in setting up such helplines.Nothing happens for a long time & then two buses come together!Don’t understand why @MSJEGOI has its own #KIRAN national mental health helpline & @MoHFW_INDIA has its own national mental health helpline?Can’t they pool resources? https://t.co/f1VaGOaqlq— Dr Soumitra Pathare (@netshrink) September 8, 2020The issue, Singh said, needs urgent attention as over 1 lakh people die by suicide in India each year. As per the National Crime Records Bureau data, 1,39,123 deaths by suicide were reported in 2019, which was a 3.4% increase over 2018. Young people in the 18-30 year age group were found to be among the most vulnerable.If you know someone – friend or family member – at risk of suicide, please reach out to them. The Suicide Prevention India Foundation maintains a list of telephone numbers (www.spif.in/seek-help/) they can call to speak in confidence. You could also refer them to the nearest hospital.