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the political landscape. prime minister victor orbit, has long been an ally of vladimir putin. his opponent says that poses a security risk for hungry. so will peter mark is always policy getting up seats to when they, with al jazeera, for the latest developments. i anthony. okay, and you're watching the stream on today's episode. we are going to be focusing on the death by suicide rates in india. it's a sensitive, very difficult conversation to have. i want you to warn you, so you can decide where you want to spend the next 25 minutes, whether it's with us here at out 0, or he need to just take a break and move away from the screen. the leading cause of death in young people in india is suicide. 36 percent of all women in the wild who take

the lice are in india. this is a huge, serious problem, but he had a problem at he has solutions. we start ash old with nelson moses. i started suicide prevention india from be she because i lost my best friend to so said. so sad is the most preventable from of debt. 8 or 10 individuals are giving us warning signs. what will non verbal and written, organization trains, individuals, students, housewives crisis, helpline wall, interiors, medical students, doctors, nurses, corporate professionals to be able to pick up these, wanting science, have a conversation with them. provide emotional support post to lead them to get help and ref for them to a mental health profession, jane gatekeepers or your position to save thousands of lives. and this is critical in a country like india, when we do not have enough infrastructure investment research or a suicide prevention policy. we need to train millions to steve thousands. i want

this episode to be a very open conversation between us and our candidates, so you can talk to us about anything connected to death by suicide. the comment section is here on youtube. ask your questions, share your comments, would be delighted to hear from you. let me introduce you to your panel. we have an liter. so meter, rocky. thank you for being part of the string today. i'm rita, please introduce yourself to the stream audience. i thank you so much for having i saw i'm, i'm a former journalist and i set up something called a health collective to look at mental health. and in this from an india lens about 6 years ago. it's a happy hollow, small child. welcome to the stream. please introduce yourself. i thanks for asking me to join. i'm sorry sir, but i am a scientist by training. and i work as the director of the sender woman line policy research organization based named yeah. welcome, i'm racking get to see please introduce yourself to have you as around the world.

thank you for having me. i'm sorry, i couldn't donor professor public health advocacy foundation of india based in new jerry and professor at university of washington based in guess i 1st challenge is how do you explain in a country's largest india why there would be such a high proportion of young people who take their lives, such a high proportion of women who take their lives. why this is such a big issue for india, they're going to be certain areas of route economics and social economics that we want to delve into. and let me start amrita. you can give us one idea, one thought, and we can build as a panel. what is it? in india, an indian society where people in quite large numbers would consider that suicide is an option for them. i think, you know, one thing that we've beyond is that it's multi factorial. it's a multi dimensional issue. i also want to say it's not just limited to india. this

is the topic here, 90 percent of debt due to suicide in adolescence, globally. and the developing world, so i worked on this book with dr. godaddy, so i'm going to ask this question to him. this is what we did to investigate what's happening with the suicide crisis in india. and i would say the big learning for me, looking at this as a, you know, from a john, mr. game and to understand i'm back into interviews. was that unlike the narrative we have in the west? it's not all mental illness related doctor provided we've talked about this a lot socially dominance. there are so many socio economic issues that come to play as well. that's what the book on the screen. so we can see and then me to not, not we, we have it ready. we knew we were going to talk about it. and then switching, what would be really helpful would be to talk about it's not necessarily depression, that he's forcing people into feeling they have no option taking such drastic action. it is life life in terms of poverty. can they

afford to fall? we know about the pharmacy, so as i crisis, there are all the elements were in some parts of the world. it would be depression . but in india, we're looking at economic factors that are pushing people into extreme action. talk to us about that. well, i mean that it is true if you look at some of the data that we have from india. not that we have a normal date on the less than half of the people who die by suicide would have a medicaid problem. the remaining cop or even more than that 60 person would have a problem presumably no medical problem. now this is extremely challenging and it's very difficult to do how it is in the rest. rocky can talk to you about bad about what happened, but i'm number is that dominantly because of non mental health issues and just do something which might be interesting that in 20 brandy last year,

during the panel make your are suicide numbers went up by 10 percent in the, if you look at the restaurant in the western hemisphere in north america, we said rates did not went on. and the big difference is really, as i see it is that livelihoods and incomes will protected during the quarter been to make in the rest. whereas in india, we didn't really have that kind of protection. so, you know, there is clearly a link between economic, those other issues. and we'll talk about that patriarchy and the status of women and society. the fact that we have a lot of agenda based while it's in our society and those issues that you've been on the article hall is another big issue. i mean, these are all things that we don't really talk about as having a direct relationship to suicide. rocky, what do you think? yeah, if i could, if i could add to that, i think in terms of your question,

send me about the numbers. and i think if you look at the 2 acres how we compare the same disease across geography to the very 1st place to say global average is about paying for 100000 people. and in india that would be the rate is not very good, but population is so much that the numbers become a lot. and that's what the problem is. rate is not as much, but a numbers away more than what you would expect. given a large population intensive rate, if you compare our problem is with them, then the men died by say, twice more in india, then we will be leverage to india if you take $100000.00 women to a would die by say baby, the 6 which is global average to bed in terms of numbers, we have a rates, we have a bigger than an average. a problem is because there are

a large concrete to begin with. i agree, i think depression is less diagnosed and you know, redo no one and 7 people in india is suffering from depression. but that's still a diagnosis and there is a relationship between depression and suicide that's in india. but overall diagnosis of mental health issues is also very nice, which makes it ready for us to to, to you know, right? yeah. ok, that's a very good point because he can say, oh, it's not due to depression. but if you don't have numbers of people who have access to talk to therapist, how would we know? well that is a scene set of folks. so the multiple challenges that india is dealing with regarding death by suicide. i'm going to push on a little bit because there are to these challenges. i want to dr. palka. he spoke to a few hours ago. this is what he told us. almost all the does,

she get was produced in the country now have a dedicated se, cardeana psychology unit. and most of these units are anybody who has it. when the more than the services are always open, there is definitely a school for being minute to the roster level as well so that it becomes more accessible and the weird little dentist would be sick my days, our box and on relations. i only did it once we started accepting that we are as well level to suffering from depression, anxiety or as of right now as we are putting from $1800.00 i for diabetes on hybrid engine, then we will start to accept over to live just as we accept all of the go ahead and we'll start seeking help as well. and what i'm hearing, why is that hospitals are beginning to understand that there are mental illnesses and they have departments with mental illnesses, but from the grassroots level, eyes where most of the help needs to come from. let me start with reducing the chair when we're talking about actual practical solutions. name one.

well, i give you the one which fascinates me most, you know there was this wonderful study that came out of brazil. i don't know if you've heard of it, but they followed up a 100000000 people who. ready peter 15 years, who had received a conditional cash trans, well, you know, brazil during president last time started this program. so there are a huge amount of data. and what you find there is that the suicide rate among people who receive those unconditional cash funds was down by 61 percent. there's not a single mental dimension which brings down suicide by $61.00 person. a similar intervention in indonesia. read the cache. cons was to the board of people in the country, more 10 percent of the population brought down suicide bridge by what 24 hours. you know, these are big numbers and none of our, many of the dimensions have, have done that or are look at the policy change. and they do cation that happened

in one of the states. and again, dominant nod bridge, brought down suicide by 75 course. and or b of 10 years. so, you know, a lot of this isn't you go to actually make, you're going to make changes if you actually intervene at the broader level of pharmacy and my analog for this. because i always use, if i'm talking to lee, people is imagine if you're having a lot of accidents on a particular road on now, one thing you would always do is station a lot of ambulances out there, you know, try and save lives with quickly. but really, if you want to prevent those accident, you need to look at try what training, you need to look at the design of the road. you need to look at what is going wrong . they're blind spots on the road, is the lighting where they were on the now do the things that had create or prevent accidents happening in the 1st instance. the health care service will save lives, but it's not going to be ready the accident. and it's the same thing with suicide, she goes suicide. if you want to save them reading the broader structural issues

which we are not addressing at the woman dinner. i have a couple questions for you. did you want, if i just put them to you because i, i invited i audience to talk to you. so just give me a moment and i want to share this with you if i may. and then you come right back in. so rush up, it says the majority of suicides by women are from rural areas. one of these areas are common with domestic violence or they, they have domestic violence in those areas. and they don't have support or help for family members. rocky. i see you nodding, you want to take that question. so i mean, that's an interesting question. we really do not yet, and the data that we have, the more them and they live in india, order and, and yet, but we do understand that, you know, the indian states this as an indian state more, more than other men as compared with the not been in state have a higher rate which is quite difficult to explain or

understand because on one side we say that as you get more women, as you make them more empowered as you make them financially more empowered, the decision making is better. but that is also the thing in a higher rate of to say among the them and we do understand a little bit about the risk factors for the death in northern india. yes, alicia said a lot around family problems medication, but they do not have the details of what this means. and in the southern states, it's also about family issues. but the issue here may be the same, but the police data, the testers, all this information in india does not allow us to differentiate. if the family i'm more of the domestic violence on the northern indian side and moral other issue. there's some earlier in this i've been in, inside, i'm going to, i want to really focus on solutions that save lives and change lives. i'm going to

start with one thought from jasmine, cow ha. and then pick up of the back of jasmine because they're all real changes that happen that save people from taking their own life. he's jasmine festival by the mental health, the enjoyment education say is that dimension. everyone's just want me to acknowledge that you are prevent and therefore new evidence based interventions that are whether it is level individual community. and so therefore, we do need to focus on a national convention policy that going to check some of these issues and headphones and goals. so yeah, that's a really great point to pick up. also, when i think the idea is to look at what implementable, i'll give you 2 examples. one is we look at what she longer has done with limiting access to betty,

talk the pesticides. if you look at the work that missing and india, when it comes to the crisis of leading to pharma suicide, she was able to slash this suicide rate by taking action and others have been advocating for in get to look at something like this. okay, me, let me also talk about the media because i feel like what ends up happening sometimes in these conversations that we don't realize we all have a role to play. so you know, we are looking at what the media can do. one is to follow the guidelines that have been put in place by the w h o in india by the council of india. when on how you report about suicide, how you talk about suicide, so that you can avoid coffee, get suicide, the suicide contagion, which is called the what that effect. and we had, you know, that example in the book that might go. so i mean, i writes about actually books for the health collective this example, it should be in the mid eighty's where there was a sudden bike of suicide related to the some way. and they were able to bring this down by 75 percent by putting in responsible reporting from the media, putting in media blackout. because honestly, we don't need to sensationalize how we tell these stories. we don't need to focus

on the crisis, but i mean, what journals do best is look at the heart of the story. they put the families back in the out of the story, talk about what can be prevented, what can be done. so we do want to look at what evidence based ways of battling this crisis and each stakeholder has it all the play not really important point because all the way for the show. and as we put together this episode, i've been so careful to make sure i'm using the right vocabulary, the right tone. how are we talking about it? let's not stigmatizing. so my head right now is so focused on that. and i have a feeling that everybody know every publication, not every broadcaster is thinking that carefully that they woods, whether they're written or they're broadcast, could impact some family's life that outcomes. and i think that's really important . and we go back to you tube. i have a thought here. so raj says that it's not only farmers that have a suicide crust crisis, but also there's a high rate of student suicide in india,

particularly around exam time. and some meter, i know that there was a solution put in place that it was so simple. so genius that has saved young people's lives. tell us about that. the, the way that the exams, a stat which stop young people from feeling that they've, they've ruined their lives, that their exams are awful and they have no other options. what was the fix for that? actually do the really simply fix, you know what, what we heard normally every year is at the exam on exam times as much as the results time june, july is when the results of the board exams come out, which is the equivalent of your high school exams. or the levels at all levels, as you would know from the u. k. ah saw aside that diamond, these results come out. there's a lot of times when young people, especially students age 16 grading. my dad died by suicide, take their lives. and most of the time there's

a you and i would cry and every state government was starving counseling help line at that time. we actually don't really those counseling help lines make a difference or don't make a difference. or one of my friends and colleagues, dr. lucks me reject wires, been working in the area of suicide prevention and india for decades. now. now she got after one of the state governments in dumb and i do in the southern state of the amazon. and they did a very simple thing of which is that they said once the ward results out are if you haven't faded or if you've got 4 marks, you could thought you should have about better. and you've got 4 marks. you could actually sit for a supplemental exam within the next $1520.00 days or a month after the results. and if you bought the exam or if you've got a better sport than grade, you'd go ahead with those stores as you scores. and just the simplest thing, you know, this one simple thing, what 10 years men than suicide rates and dominant are do off the results. exam

reserves were down by 50 barson. and he was trying to remember that during that time, that number of students taking that exam rent out by 50, by about 100 course, you know, the number of certain staking the exams doubled while the suicide read half. so you can see that is like, 034 and so, and so same is the impulse identity. i love the idea. i mean, i know that he had taken exams that having more than one option and i did, do i have as we would need to have a do i have a nice rocky, i am wondering about, are there enough mental health professionals in the country for me out and then me and that's, that's a big talent and many of them who are actually in areas so and as you know, most of the population is still rudy. so we haven't begun mismatch or so the already haven't started and then we have mismatch within that chart that we do have

a national mentor has program under which i think one of the 2 that more mental health experts are now being said units. that being said, there's unit not to really mand all the time, and the quality of the mental health care that's being given is, is still questionable. so we happy her not to do to get mentioned has diagnosis, right? but then we also have an issue in terms of treatment. one is you know, having a doctor to, to treat you. but then the other is having access in terms of money in medicine to actually continue with the treatment. so if it's a larger issue to deal with in terms of addressing meant it has, especially if this is say, i mean, i just made a want to go back to work. and i think this is a very simple solution done in summer now who but what's unfortunate. ringback that

the other states are not using it that much. i think what i like for us is how the, the basin and you need to learn from each other. so if you need to learn from the way, i think i'm going to give an example of st. guy and degradation, but even women in the space need to learn to ask you to use the numbers for students. every, i'm wondering, i'm lisa, i'm just looking at the book, which is where we started. life interrupted the road with a number of colleagues, including things to nature. it's on my laptop right now. a, i'm wondering if india is missing a national suicide prevention policy programming. i know that there's there's work in progress, but when will that work be done? yeah, thank you. that looks much better than me waving this, but i appreciate you know,

i think the maintenance advocates have been clear about this. we need a national prevention policy. the walk that has been done though has been phenomenal. right? i mean, you'll find the be criminalized suicide. we've actually mind boggling the thing that, you know, attempting suicide, what the client will be decently, which is also why it's the, you know, the police and the crime, you know, that collects all the data. because due to the fact that you know, we don't have very accurate all the data collection is a problem. we do need that policy. but the other thing i would say is, it's not enough for us to look at that and see it's missing. so let's just wait for that to happen. there are fantastic examples. again, i think between, you know, professor rocky and dr. baton, they can share these kind of educate programs about getting the message out. we know that gatekeeper training is something that you know, especially for your audience as well, maybe maybe maybe open privileged and so on can can look at. because i think the,

what's clear from what our professor document to saying is you're not going to have enough dreamed export. and again, we do have to clarify, it's not just a mental in the issue, right? i mean there are so many dominance to this, but i think that for each of us to know that that is it all we can play here whether when the media where they were in public policy, where they were in academia. and so i could be met school counselors, teachers, principal year, also gatekeepers for young people. so that is a crisis that you can help. all right, i want to play one more, one more thought and this comes from kinda go y'all. he talks about it, it takes a village, takes a country, takes all of us to really appreciate the toll that death by suicide has on a society. he shifts. you said prevention is a multifaceted dusk. the bursley medical and social angles are all equally important, unless they are all taken into consideration. it will be impossible to make any change in the statistics. a so i has handbook can be very useful tool for the friends and family of someone who dies. both you said it can help the survivors

deal with their feelings of grief, guilt, and even shame. once the guilt and shame have been taken care of, it becomes easier for people to look at suicide with a sort of reverence and understanding of what happened. it is only 2 this deep understanding that we can actually prevents you sites in the future. i want to fall emily tasa mitra, iraqi for helping us understand the suicide crises in india. so much more clearly if you are currently having suicidal thoughts or you know somebody who is though always ways for people to help here. so i won't get to leave you with this video from the world health organization. thanks for watching. take care. ah.

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