On September 19, Tamil Nadu woke up to the news of music composer Vijay Antony’s teenage daughter’s death by suicide. Being a film celebrity’s daughter, her death became a subject of extensive public discussion and media sensationalism. But teen suicides have been a rampant, recurring problem across India for a while now, rising alarmingly over recent years. National Crime Records Bureau (NCRB) data shows that at least 10,732 children and teens died by suicide in 2021 alone — that’s an average of about 29 suicides per day.
While there are huge gaps in India’s overall mental health care infrastructure, psychiatrists and child rights activists TNM spoke to say that children’s and adolescents’ mental health in particular continues to be tragically overlooked.
Many young people have mental health problems, even if adults don’t notice them
Dr Thara Rangasamy, a psychiatrist and co-founder of the Schizophrenia Research Foundation (SCARF), says mental health issues are very common among school and college students. She recently supervised a study involving around 15,000 high school and college students, and found that nearly 30% of them reported symptoms of depression and anxiety. “A lot more students indicated that they were ‘moderately depressed’ than ‘mildly depressed’,” she said.
Dr Dinesh Sharma, head of the psychiatry department at the Government Nursing College in Rajasthan’s Kota, recently submitted his PhD thesis on the infamous Kota suicides. The town — often called the ‘coaching capital’ of India for engineering and medical entrance exams — recorded at least between 2019 and 2022, and have already been reported in 2023 alone.
While these deaths are usually attributed to the atmosphere of intense academic pressure, Dinesh told TNM that that wasn’t the sole reason he found during his research. “Family pressure often worsens academic pressure. There are also financial problems – parents who have spent way beyond their means on coaching fees put immense pressure on their child to perform well. Then there are sudden, distressing events such as the death of a loved one, or a breakup. Psychological issues such as depression are another reason,” he said.
Dinesh said that in most of the cases he studied, the suicide victims showed symptoms of acute depression, and not chronic depression (a milder, longer-lasting form of depression). He said that most victims died within three or four months after the symptoms of depression began to manifest.
Dr Shaibya Saldanha, a gynaecologist and co-founder of Enfold Trust, a Bengaluru-based NGO that works on the prevention of child sexual abuse, finds fault with the health care system’s deeply inadequate response to rising student suicides. “During the COVID pandemic, children were isolated from friends and had to cope with online classes. Before they could deal with this properly, schools reopened and they now have to compensate for the learning loss of those two years. No one is checking in with the children to understand what is going on with them,” Shaibya says.
She adds that many children are also exposed to suicides at a very young age through media, which could worsen their mental health and lead to imitative behaviour.
How do you know when a child needs support?
But how do you figure out when a child’s mental health is suffering, and how do you offer support at the right time? Based on his research, Dinesh suggests three ways for parents to identify mental health issues.
> Verbal cues – Children saying things like ‘I am not important to you, I will go away, you will be happy without me.’
> Written cues – Many children tend to write on social media a lot about their feelings. These could be status messages, or other kinds of posts where they share prose, poetry, etc.
> Behavioural cues – Sudden withdrawal from social activities or interactions like not going to school, not eating in the mess, not talking to parents or eating with family etc.
Dr Asfia Khaleel, a psychiatrist and the director of Ummeed De-addiction and Rehab Centre, also says that children often show discernible signs of depression and stress – but they may not look different from the signs we see in adults. “Children tend to voice suicidal tendencies in different ways, perhaps by saying that they’ve lost interest in life, that they see no point in living etc. These are red flags and should be taken seriously,” she says.
Thara also says all adults responsible for a child’s well-being must undergo extensive sensitisation on mental health issues, so they can pick up on early indicators of any emotional distress and prevent self-harm. “We also need enough counsellors and peer counsellors in schools. Teachers should be observant when a student’s academic record drops, or if they start behaving differently. Their antennae must be up” she says.
On noticing any signs of distress, parents or teachers must immediately ensure mental health care is provided to the students, says Dinesh.
But to notice such signs, parents and guardians need to develop an open, intimate bond with children. They must be fully present, and take an active interest in the child’s life, say activists and mental health professionals. “Some parents merely pass directives to children, who then tend to remain isolated from their parents, often spending a lot of time on social media,” says Maya Gaitonde, a child rights activist and honorary general secretary of the Chennai-based non-profit Bala Mandir Kamaraj Trust. She stresses the importance of open communication.
What NOT to do
Trivialising children’s problems
Even when parents and teachers notice children’s problems, they often tend to minimise them or treat them with disbelief. Psychiatrists TNM spoke to said that often, adolescents' concerns are met with dismissive replies from adults – ‘What stress could you possibly have?’ ‘Why are you depressed at such a young age?’ ‘What do you have to worry about?’ They say that even well-meaning, generic advice like ‘marks don’t matter’ or ‘winning isn’t everything’ is only a band-aid solution that doesn’t address a much deeper problem.
Asfia stresses that adults must not neglect children’s problems, even if they seem trivial to them.
“Adolescents usually seek independence from family and parents and rely heavily on peers for guidance. There could be unnoticed depression or anxiety that can be triggered by any emotional stressors. There are many cases where youngsters express suicidal thoughts or ideation to family and friends, but these are brushed away as 'teenage outbursts',” Shaibya adds.
Thara too says that every expression of suicidal intent must be taken seriously and supported, without judgement, even by peers. “The person must be taken to a doctor or counsellor, or encouraged to contact helplines, etc. Preferably, one of the trusted adults or family members in their life should also be informed,” she says.
Misconceptions about psychiatric medication
Even when parents do take children’s mental health care seriously, they might consult a counsellor or a psychologist, but would hesitate to visit a psychiatrist, says Asfia. “Parents tend to resist medication for their children. There are some exceptions, where children fight with their parents to seek a psychiatrist’s help. Even then, many of them are not allowed to take medication because of prevailing misconceptions,” she says. Asfia says that psychiatric medication usually aids the recovery process significantly, and that the medicines are safe with temporary side-effects such as gastrointestinal issues.
“The end goal of medication is neurogenesis – the growth and strengthening of neurons. And it need not be continued forever, as is the common belief. In most cases, medicines are prescribed for a short time, and slowly tapered off,” Asfia explains.
(With inputs from Nidharshana Raju)