At 5 pm on May 11, a 17-year-old girl was found dead in the compound of her house in the Chittar forest area of Pathanamthitta. She died by suicide when she was reportedly unable to cope with the alcoholism of her mother and step father. On the day she died — two days after an earlier suicide attempt — she had thrown away a bottle of liquor her mother was drinking from, which led to a scuffle between them. The mother asked the girl to get out of the house after which she made her second attempt at suicide and died.
Nearly two months before that, a 16-year-old girl in Thrissur died by suicide due to the distress of ending a relationship her parents had not approved of. Elsewhere in Kerala, a 13-year-old child of well-off parents reportedly died by suicide because her brother had grabbed a phone from her. And a 15-year-old boy who took his own life allegedly found it too much to bear that his mother scolded him for not studying ahead of his tenth standard board exams.
These are four case studies on a report on child suicides in Kerala from January to July this year, prepared by a committee constituted by the state government. It was headed by R Sreelekha, Director General of Police, Fire and Rescue Services.
The committee studied all 158 cases of child suicides that took place in this period and arrived at some crucial findings. Majority of the children were girls (90 cases) and in the age group of 15 to 17 years (106 cases). About one third of the children were good at studies (one had got an award from the President of India). Most of the children died by suicide within their home premises (137 cases). Some had mental health issues (24), others heavily relied on their mobile phones, and in one case, a girl was pregnant and the parents were unaware of it.
For 19 of the children, scolding by parents had allegedly resulted in taking their own lives. For 14 kids, it was related to relationships, and 13 of these were girls. Domestic violence and family problems have caused 12 suicides. Mobile phone addiction took away the lives of 11 others.
But most worryingly, in 40 of the cases the reason for suicide is 'unknown'. Another cause of concern is that 91% of the children belonged to lower and middle class families, suggesting that financial stress might have been a problem.
It was in his press conference on July 9 that Kerala Chief Minister Pinarayi Vijayan revealed there were 66 child suicides during the lockdown to contain COVID-19 began in the last week of March. He had then announced the formation of the committee that would study the issue.
However, the committee concluded that the lockdown and the online classes following it had not caused undue stress to children. They based it on the statistics of the previous year, when for the same period, the number of child suicides were 83. Only two children in Malappuram are known to have died by suicide reportedly due to lack of educational facilities. Most of the suicides are from Malappuram (22), double the number it reported last year. Thiruvananthapuram follows with 21 suicides, Thrissur with 18 and Palakkad, 15.
It is of concern that so many children died by suicide while they were mostly at home, under parental care.
The study shook rejected notions that children of single parents are more prone to suicide. In the 158 cases, 116 of the children were with biological parents when they took their lives. Fourteen of them were with a single parent and only one was adopted. It was also gauged that loneliness without a sibling cannot be a compelling factor since only 10 were single children and the others had one or more siblings.
Another important finding is that only 4% of the children were alone at home when they died by suicide. "This number clearly shows that parents could not identify/address the problems faced by children," the study says.
It adds: “Majority of the children under consideration stayed with their families, at their own homes which indicate a possible gap in communication between parents and children.”
“Parenting skills and communication problems can be one of the major reasons for inducing stress in children. There is a lot of pressure on doing well in academics especially in students attending entrance oriented programmes,” says Dr Kiran PS, state nodal officer of mental health programme.
Kerala's Health Department had started a project called Ottakkalla Oppam Undu to offer psychological support to people during the lockdown, and it was later extended to address children's issues.
As many as 1,373 mental health professionals have been making support calls to people in quarantine since February. They have made 41,56,049 calls until October 24, and this includes the calls made to schoolchildren.
In the report, 24 of the 158 children who died by suicide, had mental health issues. This could also be because there were issues in other children that went unnoticed. There were also 26 children in the list who had a family history of suicide.
"Awareness creation is much needed. Providing helpline numbers need not be enough since many children may not call themselves. We decided to be proactive and make calls to them, approach them first to ask after their issues. Many times it could be the impulsive component in children, taking the extreme step for trivial reasons as a remote snatched off from them,” Kiran says.
The report also details preventive mechanisms and solutions to deal with the issues that children face at home and school, including monitoring, interventions, the roles played by various departments like health, education, police and media.
Dr Anil Kumar, professor in charge of child and adolescent psychiatry at the Thiruvananthapuram Medical College, who was part of the team preparing the recommendations, said that there is a need to study the issues on a higher level. “The reasons in the report were arrived at by trained counselors who spoke with the families. But there could be deeper reasons – impulsive behaviour, lesser tolerance, lack of support or social skills. Life skills -- to resolve a conflict, to solve a problem -- are seldom taught to children. They are only told to study and score marks. They wouldn’t know how to tell parents if there is a failure. Parents and children should be able to discuss the problems – including that of relationship issues. The children should feel that there is someone with them when there is a crisis,” says Dr Anil.
What an outsider may think as trivial would perhaps be a crisis for the child. “It may take as long as they are 25 years old for the brain to mature. So schools and families should work with the kids like a team, find their skills, set a goal for them and train them accordingly,” Dr Anil says.
Schools should become wellness centres, he says. Not just for physical health but mental health too. “Children should be able to learn with joy. Friends can be peer mentors – such a system is already followed in some schools where able students from the NSS, Student Police Cadet, are trained. Teachers should act as counselors and professional help need be sought only when they can’t resolve issues,” the doctor says.
A traffic model has been suggested to check the mental health of children. It should ideally be green, indicating positive mental health and active wellbeing. When the positivity reduces, it is orange, for children who need additional support and counseling from teachers. The remaining – usually 5% - will be red, which are children with deeper issues, and for them professional help would be needed.
At home, this role should be taken up by parents. A child who doesn’t score well is sometimes beaten or scolded. But the child could have mental health issues that brought down the score. Warning signs should not go unnoticed, Dr Anil cautions.
The report showed that four suicides have been reported from a single school. That’s a phenomenon called copycat suicide, Dr Anil says, one child trying to behave like another.
“Not just parents and teachers, there is a role that can be played by members of the society. Like we say in the old days, a child is raised by a village, it is a society’s responsibility,” Dr Anil says.