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Friday, June 2, 2023

Creating safe supportive spaces for informed conversations on suicide

Bollywood  actor Sushant Singh Rajput’s tragic  death by suicide shocked and saddened the country.  This article, the first of a two-part series, examines the toxic eco system in Bollywood that could have triggered the desperate act. It also  takes a look into the complex and complicated issues surrounding suicide and the need to view it as a serious but  preventable public health issue.

Sushant Singh Rajput. Young. Handsome. Poster boy good looks. Stylish. Successful. Well read. Tasteful. Here was a person who  apparently had everything in life. Yet on June 14, 2020,  the Bollywood actor, entrepreneur and philanthropist ended his life. The late actor received critical and popular acclaim  for his  performances in films such as MS Dhoni: The Untold Story, Chhichhore, Kai Po Che, and Detective Byomkesh Bakshy! among others. The actor was to act in Dil Bechara, a remake of The Fault in our Stars.

Sushant Singh Rajput  was reportedly struggling with depression, a risk factor in suicide. Besides, depression and suicide has no one to one correlation with achievement, success and happiness. The human mind is unfathomable, extraordinarily fragile and vulnerable. It is often difficult to predict the tipping point at which a person gives up.

Suicide. The word suicide always catches our attention, doesn’t it? However, it’s  the actions that lead up to it that are often overlooked. Following Sushant Singh Rajput’s tragic premature death, his colleagues in Bollywood flooded  social media with their RIP messages. Most of them sounded hollow, hypocritical  and politically correct. Bollywood is synonymous with nepotism and a toxic eco system. The powerful ‘lobby’ exerts a stranglehold on the industry and thus makes or breaks careers; and as with Sushant, life itself. Perhaps Sushant Singh Rajput was a Bollywood misfit, who nevertheless stormed the bastion, without the mandatory godfather, right connections to a famous film family or to the mighty and powerful in Bollywood.

However,  tweets by actor Kangana Ranaut and director Shekhar Kapur stood out for their  authenticity. Lashing out at the Bollywood cabal of the shahenshahs of Bollywood and film journalists, the firebrand Kangana Ranaut highlighted their systematic false and adverse  propaganda. According to her, they made an ‘outsider’ like Sushant Singh Rajput feel ‘left out’ and marginalised him by  restricting access to film offers and  being forced to accept ‘leftovers.’ She also said that Sushant himself had expressed his anguish and  sorrow at not being accepted wholeheartedly into the Bollywood fold. In addition, he was negatively branded as  “worthless,”  a falsehood that he,  according to Kangana Ranaut, unfortunately, believed was true.

Kangana  also exposed the nexus between tabloid film journalists and the industry bosses, According to her, they branded  Sushant Singh as “weird,” “psychotic,” “neurotic” and “addict.” However, they glorified and romanticised the  serious addiction issues of actor Sunjay Dutt. The Bollywood industry is also notorious for whitewashing  their sinister machinations. The victim is  marinated in a  toxic eco system in which “professional bullying” manifests itself in obvious and not so obvious ways. It is alleged that they often blame victims for being “weak” or “cowardly”  and push them to suicide because that is the only option to escape the intense  internalised pain and misery.

Similarly,  Shekhar Kapur who  was supposed to work with Sushant Singh Rajput on his ambitious new directorial venture Paani,  spoke about the late actor’s pain as he would openly “weep” on his shoulder because of being “let down” by certain people.

He tweeted poignantly, “I knew the pain you were going through. I knew the story of the people that let you down so bad that you would weep on my shoulder. I wish I was around the last  six months. I wish you had reached out to me. What happened to you was their karma. Not yours. There was so much more you had to offer. Perhaps the world was not up to your beliefs… you should not have gone like this…but then you were an old wise soul in a restless young body. Often the heavens cannot handle that…”

A death by suicide brings  out the worst in human behaviour. The barbaric  insensitivity and intrusiveness of the media was in full display.  We had pictures of Sushant’s dead body go viral in the Internet just minutes after the tragedy.  It  was  a gross violation of the dignity and privacy of the person who had died. With  a couple of  exceptions, most traditional and social media divulged the gory details of the manner of death, headlined the mode of death, and also included pictures of the shocked grieving family (that violated their privacy and right to grieve).

Every suicide is a tragedy with far reaching consequences.  The statistics are grim.

  • Every year, 800,000 people in the world die of suicide
  • Every 40 seconds, someone in the world dies of suicide.
  • Every 41 seconds, someone is left to make sense of it .
  • Every death by suicide impacts at least six people.
  • Bharat accounts for 17 percent of the world’s suicides.
  • This means, every year, 136,000 people in Bharat die of suicide.
  • In Bharat, one person dies of suicide every four minutes.
  • Between 2002-2012, the suicide rate in the country increased by 22.7 percent.
  • Bharat has the highest suicide rate in the world among the 15-29 age group.
  • The Bharatiya states of Maharashtra, Tamil Nadu and West Bengal account for the maximum number of suicides in the country.
  • Bharat accounts for 40 percent of the world’s suicides among women.
  • In other words, two out of every five women who die of suicide are from Bharat.
  • The Global Suicide Death Rate (SDR) for women is 7/100,000 In Bharat, the SDR is15/100,000 or  twice the global average.

Source: WHO (2017-19), Lancet Public Health 2017, and National Crime Records Bureau (NCRB).

Yet, people who die of suicide are not mere statistics or numbers. Suicide is an act of pain. According to the American Association of Suicidology, “The primary goal of suicide is not to end one’s life. It is to end one’s pain.”   Every death by suicide leaves at least six people left behind to come to terms with this profound tragedy of the death of their loved one.

Most living beings (including non humans) want to preserve and protect themselves. However, suicide or the act of intentionally killing oneself, challenges or violates this norm. It is a death like no other. Hence mainstream perspectives of suicide view it  through the lens of  sensationalism, scandal, speculation and gossip.

Suicide  is commonly perceived as a private event motivated by dysfunctional individual behaviour and not a preventable  public health issue that impacts individuals, families, friends, colleagues,  community and the nation. In addition, the 4S: Stigma, shame, secrecy and silence makes suicide a difficult topic to talk about. Mental illness  and suicide are not character flaws and that is nothing to be ashamed about. Mere moralising and virtue signalling only adds to the stigma and discourages people from seeking appropriate timely interventions.

Suicide is  an issue that humans have always grappled with. We have always viewed suicide through a morality perspective.  This is largely a legacy from  the  religious perspective  of every major religion that reserves the right to take one’s  life  as the exclusive prerogative of God. Based on  normative standards of what is right and what is wrong,  suicide is tagged as a sin, and as something morally wrong. Legal jurisprudence incorporated this moral perspective into laws that  regarded taking  one’s life as a criminal act and therefore punishable.

Currently, however, 59  countries, including Bharat,  have decriminalised attempted suicide. This includes the whole of Europe, North America, much of South America and parts of South  Asia. In North European countries such as Denmark, Norway and Sweden, the process came into effect in the early nineteenth century. Decriminalization of suicide has paved the way for a  more sensitive and humane approach to the complexities of suicide, and resulted in better reporting and better epidemiology  on suicidality. These changes all translate into greater resource allocation  into informed public health policy and practices to address this serious, but preventable public health issue.

However, in several African and Islamic countries, suicide is still viewed  as a crime. In Abrahamic faiths like  Islam,  suicide is considered haram or a cardinal sin and  deserves the worst form of punishment. Hence it is hardly surprising that when a section of celebrities in Pakistan expressed their condolence over Sushant Singh Rajput’s death, they were severely condemned for condoning the haram act of a kaafir (non believer).

Suicide is caused by a convergence of several factors. Thus, there is no single cause for suicide. Certainly, there are triggers such as stressful events and as with Sushant, depression is a risk factor, not the cause.  Also, every suicide is not associated with a mental health issue. For instance, in Bharat, non mental health issues such as  financial distress are a risk factor for suicide. However, in high income countries, mental health risk factors are higher.

The pathway to suicide is complex and complicated. It is never the result of any single cause but happens when several interrelated factors converge. There are fundamental risk factors which could be biological, psychological and environmental. Then there are proximal risk factors or triggers that include psycho-social stressors such as chronic  illness, chronic pain or physical disability, pandemic stress, death of a family member or close friend, loss of employment,  divorce, financial loss, poor performance in exams (common among students), mental health issues, previous suicide attempts, history of substance abuse,  losing a family member or close friend to suicide,  ongoing  exposure  to bullying  behaviour, and gender identity and sexual orientation issues.

Interestingly, people commonly mistake proximal risk factors as “the cause” for suicide. All these factors are “real” for the person who is suicidally ideated. Trapped in the pathway of  increasing hopelessness and helplessness, they engage with suicide as a solution to end their pain. At this stage, they begin to explore and experiment with ways to end their pain by choosing a “method.” This is the stage where a person also encounters a huge wall of  resistance—the typical Hamletian dilemma of to be or not to be. However, by now, the pain is so searing that ending one’s life, which is never pain-free, seems a preferable alternative to the pain of living with the psyche ache.

Yet, all is not gloom and doom in the field of suicide prevention. Alongside the risk factors are the protective factors that decrease the likelihood of suicide ideation progressing to suicide attempts and death. These include connectedness to parents, connections with non-parent adults in the family, academic achievement, safe neighbourhood and schools, supportive peer network, mentors  (especially teachers and wise elders), awareness of mental health issues, mental hygiene and overall resilience. The goal of any suicide prevention programme is to mitigate risk factors and maximize protective factors.

Sustained and effective suicide prevention programmes and interventions require a convergence of different stakeholders: mental health professionals, health care professionals, parents, teachers, students, media, law enforcement,  general public,  public and private sectors.

Preventing suicide is every body’s business. Every voice matters. Suicide is a difficult conversation. Yet we need to create safe supportive spaces for informed compassionate  conversations on suicide. We need to foster resilience and a strong spiritual grounding especially  in young people, which are protective factors. We must inspire them to internalise a perspective that there are life affirming alternatives to deal with pain and suffering rather than taking one’s life.

(Dr. Nandini Murali is a communications professional,  author and researcher in Indic Studies.  She is a Contributing Editor with the HinduPost.  A suicide prevention  and mental health activist, her lived experience of suicide loss inspired her to establish SPEAK, an initiative of MS Chellamuthu Trust and Research Foundation, Madurai, to change conversations on suicide and promote mental health.

She loves to wander in the forests with her camera.)

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Dr. Nandini Murali
Dr. Nandini Murali
Dr. Nandini Murali is a communications professional,  author and researcher in Indic Studies.  She is a Contributing Editor with the HinduPost. She loves to wander in the forests with her camera. 


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