PYQ Relevance:

[UPSC 2023] Explain why suicide among young women is increasing in Indian Society.

Linkage: Mental distress is deeply intertwined with societal issues like increasing suicide rates among young women, poverty, marginalization, and the impact of modernization and urbanization.

Introduction:

The National Crime Records Bureau’s Accidental Deaths and Suicides in India (ADSI) 2023 report recorded 1,71,418 suicides, a marginal 0.3% rise from 2022. While the suicide rate per lakh population declined slightly, absolute numbers remain high, underscoring a deep social, economic, and psychological crisis.

National Data and Trends as per ADSI, 2023:

Demographics: Men constituted 72.8% of suicides in 2023.
Leading Causes: Family problems: 31.9%; Illness: 19%; Substance abuse: 7%; Relationship and marriage-related issues: around 10% combined.
Regional Variation: The Andaman and Nicobar Islands, Sikkim, and Kerala had the highest suicide rates, while Maharashtra, Tamil Nadu, Madhya Pradesh, Karnataka, and West Bengal together accounted for over 40% of all cases.
Urban vs Rural: Cities reported consistently higher suicide rates than rural areas, reflecting the psychological stress of urbanisation and competition.

Farmer Suicides and Rural Distress:

Farmer deaths: 10,786 suicides (6.3% of total) in 2023, concentrated mainly in Maharashtra and Karnataka.
Long-term pattern: Over 1,00,000 farmers have taken their lives since 2014. Between 1995 and 2015, nearly 2,96,000 deaths were linked to debt, market volatility, and institutional neglect.
Underlying causes: Debt, crop failure, inadequate price support, and the absence of reliable social safety nets.
Invisible victims: Homemakers and caregivers, particularly women, face rising rates of depression and domestic stress but remain underrepresented in official data.

Magnitude of Mental Illness in India:

Estimated burden: Nearly 230 million Indians live with mental disorders ranging from depression and anxiety to bipolar disorder and substance use.
Treatment gap: 70–92% of individuals with severe illness receive no formal care.
Lifetime prevalence: 10.6%, according to national health data.
Global comparison: WHO estimates India’s suicide rate at 16.3 per 1,00,000, significantly higher than the global average.

Value Addition: India’s Mental Health Governance and Legal Framework:

Mental Healthcare Act, 2017:
1. Guarantees the right to affordable, quality mental health care.
2. Decriminalises suicide and mandates insurance coverage for psychiatric illnesses.
3. Upholds patient dignity and autonomy under Article 21 of the Constitution.
Judicial reinforcement: In Sukdeb Saha vs State of Andhra Pradesh (2025), the Supreme Court reaffirmed mental health as a fundamental right, compelling state accountability.
District Mental Health Programme (DMHP): Covers 767 districts, expanding access to outpatient services, suicide prevention, and counselling.
Tele MANAS Helpline: A 24×7 service offering over 20 lakh tele-counselling sessions, particularly beneficial in underserved regions.

Systemic Gaps and Institutional Failures:

Workforce shortage: Only 0.75 psychiatrists and 0.12 psychologists per 1,00,000 population, below WHO’s minimum of 1.7 psychiatrists and far from the ideal of 3.
Underfunding: Mental health receives only 1.05% of India’s health budget, compared to 8–10% in countries like Australia, Canada, and the UK.
Policy–practice gap:
- The Mental Healthcare Act (2017) decriminalised suicide and guaranteed the right to care.
- The National Suicide Prevention Strategy (2022) targeted a 10% reduction in suicides.
- However, implementation remains weak, and suicides continue to rise.
Non-functional initiatives:
- The Manodarpan school-based support scheme remains largely inactive.
- ₹270 crore allocated for mental health is largely unspent.

Persistent Challenges:

Treatment Gaps: 70–92% of individuals with common disorders like depression and anxiety remain untreated.
Infrastructure Deficits: Inadequate availability of psychotropic medicines and rehabilitation services, which meet less than 15% of actual demand.
Stigma and Awareness: Over 50% of Indians still attribute mental illness to personal weakness or shame, limiting early intervention.
Workforce Urban Bias: Mental health professionals remain concentrated in cities, leaving rural areas, where 70% of India’s population lives, largely unserved.

Steps to Strengthen India’s Mental Health System: Way Forward

Budget Expansion: Raise mental health allocation to at least 5% of total health spending, ensuring resources for workforce, infrastructure, and medicine.
Workforce Development: Train and deploy mid-level mental health providers to fill rural gaps and meet WHO’s minimum density.
Integration: Embed mental health into primary health care and universal insurance coverage.
Monitoring: Create a cascade-based national monitoring system to track outcomes, ensure accountability, and guide funding.
Anti-Stigma Campaigns: Institutionalise mental health education in schools and workplaces, aiming for 60% literacy coverage by 2027.
Cross-Ministerial Coordination: Establish a unified framework linking health, education, social justice, and labour for cohesive policy execution.

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