James Donaldson on Mental Health – FE Mental Health Series | Every 40 seconds, someone dies by suicide—Can we prevent the next?

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Every suicide is a tragedy that affects families, communities and entire countries and it also has long-lasting effects on the people left behind.

Written by Sushmita Panda

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Trigger warning: Suicide, self-harm, depression

For the past couple of yearsSuman* has been feeling hopeless and lost. Even when surrounded by people, she can’t help but feel lonely. Life hasn’t been fair to her—multiple failed relationships, a troubled bond with her father, and the constant feeling of being unwanted have made her question whether this is even worth “fighting” for.

“For the last 1-2 years, I started feeling what exactly I am struggling for. It’s scary to admit that I can just end it all and be at peace. Why am I waking up in the morning, and putting myself through all of that, again and again. I don’t want to struggle anymore,” Suman* told Financial Express.com.

Her pain comes in waves and with that comes desire to “end it all.” However, one night when these thoughts became painfully prominent and she couldn’t take it anymore.

“I was scared as the thought of hurting myself became more and more real. I couldn’t take it anymore and I don’t know what happened I reached out to a friend and finally for the first time asked for help,” she shared.

“I am not okay. I need help.” The moment she typed those words, tears streamed down her face, uncertainty clouding her future.

“Yes, the suicidal thoughts were becoming prominent but with every ounce of will-power I tried my best that I will not give up,” she said. Currently, Suman* is undergoing therapy and working on herself.

Suicide and suicidal behavior among youth and young adults is a major public health crisis. According to the World Health Organization (WHO), every year 7,27,000 people take their own life and there are many more people who make suicide attempts. Suicide is the third leading cause of death among 15–29-year-olds. Is it possible to prevent suicide?

‘Early action is most crucial’

Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind, WHO says. Although the link between suicide and mental disorders (in particular, depression and alcohol use disorders) and a previous suicide attempt is well established in high-income countries, many suicides happen impulsively in moments of crisis, the UN health agency maintained.

This happens because of inability to deal with life stresses, such as financial problems, relationship disputes, or chronic pain and illness.

“I commonly see suicide attempts or suicidal ideation, particularly in patients struggling with depression, anxiety, or chronic disease. Mental illness occurs more often than most people recognize, and pressures at work, in relationships, or in other personal issues may drive someone over the edge. Patients do not necessarily voice what they are experiencing, so I pay close attention to hopelessness, withdrawal, or sudden mood shifts. Early action is most crucial, and open communication, therapy, and proper medical treatment can prevent tragedies and offer hope to individuals in crisis,” Dr. Rahul Chandhok, Sr. Consultant & Head Psychiatry, Artemis Lite NFC, New Delhi told Financial Express.com.

Suicide is a public health problem in India that continues to rise, with several cases reported every year. Factors leading to increased cases include mental states such as depression, anxiety, and stress coupled with financial problems, domestic conflicts, and academic pressures. Suicide cases in India differ by state, age, and gender, with middle aged people and young adults being the most affected, Dr. Chandhok said.

“Compared to global trends, Indian suicide rates are driven by certain social and cultural determinants such as mental health stigma, ignorance, and limited access to mental health care. Although suicide rates are high in specific developed nations, efficient mental health care systems prevent them. Suicide rates can be decreased through rising awareness and expert advice, and hope is brought to the tormented,” he highlighted.

According to a 2024 study published in the Mental Health & Prevention journal, India accounts for almost 25 percent of the total male suicides and 37 percent of the total female suicides worldwide, despite having approximately 18 percent of the total male and 17 percent of the total female global population.

A study published in The Lancet journal last month revealed that India has witnessed a dip of 30 percent in the suicide death rate in India from 1990 to 2021. This dip was observed on the basis of the results from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2021.

According to the study, the suicide death rate in India was 18.9 per lakh population in 1990, in 2019 it stood at 13.1 lakh per lakh population and 13 per lakh population in 2021. From 1990 to 2021, the suicide death rate in India declined to 31.5 per cent.

The researchers maintain that the data shows that intervention and prevention strategies are working.

However, Dr. Chandhok maintained that suicide rates in India are probably underestimated. “Families might conceal such incidents due to social stigma, and a few deaths are reported as accidents. Poor mental health awareness and poor reporting systems also lead to inaccurate data. These issues can be addressed through education, mental health care, and frank discussions to prevent suicides,” he said.

Which age group is most affected by suicide attempts?

Dr. Chandhok revealed that middle-aged individuals and young adults are most vulnerable to suicide attempts. “Teenagers and young adults have problems with academic stress, career confusion, relationship problems, and social pressures, which result in emotional distress. Middle-aged individuals have financial stress, job pressure, familial responsibilities, or loneliness, which exposes them to vulnerabilities,” he explained.

Old people can become depressed alone due to illness or loneliness as well. Awareness of mental illness, emotional support, and early intervention are the most crucial functions in getting the individual to confront the stress to avoid this heart-rending fate, Dr. Chandhok highlighted.

He also said that the COVID-19 pandemic also increased mental health problems, resulting in anxiety, depression, and social isolation. Social media and online lifestyles have contributed to emotional distress, particularly among youth. “While education regarding mental health is on the rise, lack of access and stigma are the challenges that remain. Emotional support is essential in averting such instances,” he added.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson’s latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

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What are the most common causes of suicide?

The most common causes of suicide include depression, anxiety, financial struggles, academic pressure, relationship issues, and chronic illnesses. “Most people are overwhelmed by feelings of loneliness, stress, or lack of support, and they get suicidal thoughts. Mental illness stigma does not allow individuals to seek assistance, and the situation gets worse,” Dr. Chandhok said.

Additionally, mental health conditions such as depression, bipolar disorder, schizophrenia, and substance abuse are frequently linked to suicide attempts. “Workplace burnout, particularly in the IT and corporate sectors, has also emerged as a growing concern,” Dr. Rituparna Ghosh – Consultant Senior Clinical Psychologist, Apollo Hospitals Navi Mumbai told Financial Express.com.

She also revealed that families often attribute suicides to “accidents” or “natural causes” to avoid societal judgment. Some estimates suggest that the actual suicide rate could be 40–50 percent higher than reported.

Is suicide is preventable?

Suicide is preventable with proper support and intervention. Dr. Ghosh highlighted that preventive measures include early mental health screenings in schools and workplaces, access to crisis helplines such as Snehi and Vandrevala Foundation, and psychological first aid training for teachers and HR teams.

“In my own practice, I have seen how a single conversation at the right time can save a life. One of my patients, who had been on the verge of attempting suicide, completely turned his life around after just four months of therapy, proving that timely support and guidance can make all the difference,” she revealed.

“Awareness of mental health, early diagnosis, and timely intervention can save lives. Individuals facing suicidal thoughts need emotional support from professionals, family, and friends. Open discussions on mental health can decrease stigma and make the individuals feel heard,” Dr. Chandhok told Financial Express.com.

Counseling, therapy, and, in a few instances, medication can alleviate depression and anxiety. Maintaining a stress-free atmosphere at home, school, and the workplace is also very important. Helplines in times of crisis, support groups, and community initiatives can provide instant assistance. Spreading awareness and accessible mental health care can considerably decrease suicide rates, he explained.

According to him, the Indian healthcare system has improved in reducing suicides, but there is always potential for improvement. Awareness campaigns, mental health initiatives, and helplines have inspired a large number of people to seek professional treatment.

“Stigma abounds, combined with limited access to low cost therapy and a scarcity of mental health experts. All of these hurdles must be overcome via knowledge, accessible care, and social support in order to promote excellent mental health and successful suicide prevention,” he said.

To combat suicide more effectively, we require improved mental health education, greater community support, and improved access to counseling services. Fostering open communication, incorporating mental health care into primary care, and increasing crisis intervention programs can be effective, enabling more individuals to receive timely help and hope.

‘India needs more robust mental health policies’

India has one of the highest suicide rates globally, with a recorded rate of 12 per 100,000 people, significantly higher than the global average of 9 per 100,000, as per WHO’s 2023 data. India also accounts for 36.6% of the world’s suicides among women and 24.3% among men, despite making up only 18% of the global population.

According to the National Crime Records Bureau (NCRB) 2023, over 1.7 lakh people died by suicide in India last year, marking a significant increase from previous years. However, due to stigma and fear of societal backlash, many cases go unreported, suggesting that the actual number is likely much higher.

“While suicide prevention strategies in Western countries focus on individual therapy and psychiatric intervention, India requires a more community-based approach to address the social and economic factors that exacerbate suicidal tendencies,” Dr. Ghosh highlighted.

Reducing suicide rates in India needs more robust mental health policies and healthcare reforms, Dr. Chandhok said. Increasing low-cost mental health services, more trained professionals, and integrating mental health care into primary health care can make it more accessible.

“Mental health awareness in schools and workplaces can help lower stigma and encourage early intervention. Improving crisis helplines, establishing community support programs, and strictly regulating harmful substances can also be beneficial. Policies of the government need to emphasize preventive care, improved insurance coverage for treatment of mental illness, and extensive education to establish a supportive environment for distressed individuals,” he explained.

What role can family and loved ones play to prevent suicide?

Family and loved ones are key players in suicide prevention through emotional support and empathy. Paying attention to emotional signals, including withdrawal, hopelessness, or changes in mood, can assist in recognizing those at risk.

“Talking openly and without judgment about feelings can make one feel heard and appreciated. Encouraging them, spending quality time with them, and encouraging them to get professional help when necessary can be lifesaving. By providing a secure and comfortable environment that is not criticized and pressurized, people can speak their hearts out, and they do not feel lonely or consider suicide,” Dr. Chandhok highlighted.

Suicide is a complex issue, but through awareness, empathy, and intervention at the right time, it can be avoided. Mental health being the top priority, open communication and easily accessible professional counseling are the solution.

“Schools, workplaces, and neighborhoods need to promote emotional well-being and stress management actively. If a person is in trouble, some basic kindness, listening, lending a helping hand, or pointing them towards seeking assistance can be helpful. Governments and healthcare systems must keep enhancing mental health services. Together, we can build a society where all people feel valued, supported, and hopeful for the future,” Dr. Chandhok told Financial Express.com.

If you or someone you know is struggling, please reach out—help is available, and no one should have to suffer in silence.

*Name changed on request

DISCLAIMER: If you or someone you know is struggling with their mental health or in distress contact the Vandrevala Foundation’s helpline (+91-9999666555) which is available in 11 languages including English and can be accessed via telephone or WhatsApp 24×7. You can also contact Fortis Hospital’s National Helpline number 91-8376804102 which is available 24×7. You can also contact the Government Mental Health Rehabilitation Helpline ‘KIRAN’ at 18005990019 which is available 24×7.

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