NEW DELHI — The ban on highly hazardous pesticides (HHPs) currently being debated in India will not only protect the environment and improve the public health but will also achieve another rarely acknowledged goal: a rapid and major reduction in the number of Indians dying from suicide.
The Supreme Court, which is currently deliberating the case challenging the government's delay in banning HHPs identified by the Anupam Verma Committee, has a major role to play. The case emerged following a public interest litigation by Kavitha Kuruganti and others filed in 2017.
Statistics on suicide are notoriously unreliable due to stigma and the family's fear of negative consequences. Official data estimate 131,623 people committed suicide in 2015 — that is 15 suicides every hour. A nationally representative survey estimated that 92,000 (49.2%) of 187,000 Indian suicides in 2010 resulted from poisoning, with the great majority following pesticide ingestion. Pesticide poisoning was the leading method of suicide among both men and women. It is also the method that is easiest to prevent.
Indian small farmers use high strength pesticides and fertilizers to increase farm productivity. This wide availability makes HHPs an easy option for those attempting suicide. In comparison with developed countries, where agricultural strength pesticides are only available to licensed workers, and where a relatively smaller number of people now work in agriculture, HHPs are freely sold in shops and dangerously stored in many homes in rural Indian communities. Unlike relatively low toxicity medicines commonly used for self-poisoning in the West, HHPs are almost always deadly if ingested. This means that the number of people who die after self-poisoning is much higher in Indian agricultural communities than in industrialized countries, producing high rates of suicide.
Many pesticide suicides are highly impulsive, with a person contemplating suicide for just a few minutes. Most who engage in suicidal behavior do not want to die, with suicide serving as a response to psychosocial stressors. If a person is prevented from using a dangerous method, they may use a method with lower lethality, with an increased chance of survival, or the suicidal impulse may pass.
Farmer suicides are just one aspect of pesticide suicides in India. In comparison to the 15,000 farmer suicides that occur each year, many by hanging, more than 80,000 pesticide suicides occur among non-farmers, according to national statistics. Many more women and non-farmers than farmers die from pesticide poisoning each year — simply due to their wide availability in their rural communities.
It's like barriers to prevent jumping from bridges and high buildings.
The World Health Organisation estimates that at least 20% of all suicides could be prevented by restricting access to poisons. Such restrictions have proven to be highly effective in the reduction of suicide in the UK after the domestic gas supply was made less toxic. Barrier installation on bridges, high buildings and railway platforms to prevent jumping has also been shown to be effective in many countries.
Restricting access to the means of pesticide suicides in India — banning and removing HHPs from agricultural practice through legislation and importation limitations — will be the most effective way to prevent suicides. Removal of HHPs rapidly and comprehensively reduced the total number of suicides in Sri Lanka, Bangladesh and South Korea.
Importantly, in these countries equally effective, but less toxic, alternative pesticides and agricultural practices — in particular, integrated pest management — have been found. As a result, no reduction in agricultural productivity has been noted following the bans.
This approach is not meant to minimize the importance of a comprehensive effort directed at improving mental health and health systems. However, legislative restrictions on HHPs is a cost-effective approach to rapidly reducing the number of suicides. In Sri Lanka, this approach saved an estimated 93,000 lives at the remarkable direct cost to the government of less than $50 per life saved.
Reducing the suicide rate should be a government priority for a number of reasons: it will save lives, help the government to comply with international human rights obligations, reduce healthcare costs and productivity loss, and help the government to achieve its commitments to the United Nations Sustainable Development Goals.
If you know someone — friend or family member — at risk of suicide, please reach out to them. The Suicide Prevention India Foundation maintains a list of telephone numbers they can call to speak in confidence. You could also accompany them to the nearest hospital.
*Leah Utyasheva is policy director and Michael Eddleston is director, Centre for Pesticide Suicide Prevention.
The confinement experience could turn brutal for those forced to live with relatives who would not tolerate a member of the family living their sexual orientation openly as a young adult. Here are stories from urban and rural India.
Abhijith had been working as a radio jockey in the southern Indian city of Thiruvananthapuram when the COVID-19 pandemic hit in March, 2020. When the government imposed a nationwide lockdown, Abhijith returned to the rural Pathanamthitta district , where his parents live with an extended family, including uncles, cousins and grandparents.
Eighteen months later, he recalled that the experience was "unbearable" because he had to live with homophobic relatives. "Apart from the frequent reference to my sexual 'abnormality', they took me to a guruji to 'cure' me," Abhijith recalled. "He gave me something to eat, which made me throw up. The guru assured me that I was throwing up whatever 'demon' was possessing me and 'making' me gay."
Early in 2021, Abhijith travelled back to Thiruvananthapuram, where he found support from the members of the queer collective.
Inspired by their work, he also decided to work towards uplifting the queer community. "I wish no one else goes through the mental trauma I have endured," said Abhijit.
Abhijith's story of mental distress arising from family abuse turns out to be all too common among members of India's LGBTQ+ community, many of whom were trapped in their homes and removed from peer support groups during the pandemic.
Oppressive home situations
As India continues to reel from a pandemic that has claimed more lives (235,524) in three months of the second wave (April-June 2021) than in the one year before that (162,960 deaths in March 2020-March 2021), the LGBTQ community has faced myriad problems. Sexual minorities have historically suffered from mainstream prejudice and the pandemic has aggravated socio-economic inequalities, instigated family and institutionalized abuse, apart from limiting access to essential care. This has resulted in acute mental distress which has overwhelmed queer support infrastructure across the country.
Speaking to queer collective representatives across India, I learned that the heightened levels of distress in the community was due to longstanding factors that were triggered under lockdown conditions. Family members who are intolerant of marginalized sexual identities, often tagging their orientation as a "disorder" or "just a phase", have always featured among the main perpetrators of subtle and overt forms of violence towards queer, trans and homosexual people.
Calls from lesbians and trans men to prevent forced marriages during lockdowns.
Sappho For Equality, a Kolkata-based feminist organization that works for the rights of sexually marginalized women and trans men, recorded a similar trend. Early in the first wave, the organization realized that the existing helpline number was getting overwhelmed with distress calls. It added a second helpline number. The comparative figures indicate a 13-fold jump in numbers: from 290 calls in April 2019-March 20 to 3,940 calls in April 2020-May 2021.
"Most of the calls we have been getting from lesbians and trans men are urgent appeals to prevent forced marriages during lockdowns," said Shreosi, a Sappho member and peer support provider. "If they happen to resist, they are either evicted or forced to flee home. But where to house them? There aren't so many shelters, and ours is at full capacity."
Shreosi says that the nature of distress calls has also changed. "Earlier people would call in for long-term help, such as professional mental health support. But during the pandemic, it has changed to immediate requests to rescue from oppressive home situations. Often, they will speak in whispers so that the parents can't hear."
Lack of spaces
Like many of his fellow queer community members, life for Sumit P., a 30-year-old gay man from Mumbai, has taken a turn for the worse. The lockdown has led to the loss of safe spaces and prolonged residence at home.
"It has been a really difficult time since the beginning of the lockdown. I am suffering from a lot of mental stress since I cannot freely express myself at home. Even while making a call, I have to check my surroundings to see if anybody is there. If I try to go out, my family demands an explanation. I feel suffocated," he said.
The pandemic has forced some queer people to come out
Sumit is also dealing with a risk that has hit the community harder than others – unemployment and income shortage. He's opened a cafe with two other queer friends, which is now running into losses. For others, pandemic-induced job losses have forced queer persons from all over the country to return to their home states and move in with their families who've turned abusive during this long period of confinement.
Lockdowns force coming out
According to Kolkata-based physician, filmmaker and gay rights activist Tirthankar Guha Thakurata, the pandemic has forced some queer people to come out, succumbing to rising discomfort and pressure exerted by homophobic families.
"In most cases, family relations sour when a person reveals their identity. But many do not flee home. They find a breathing space or 'space out' in their workspaces. In the absence of these spaces, mental problems rose significantly," he said.
Not being able to express themselves freely in front of parents who are hostile, intolerant and often address transgender persons by their deadname or misgender them has created situations of severe distress, suicidal thoughts and self-harm.
Psychiatrist and queer feminist activist Ranjita Biswas (she/they) cites an incident. A gender-nonconforming person died under suspicious circumstances just days after leaving their peer group and going home to their birth parents. The final rites were performed with them dressed in bangles and a saree.
"When a member of our community asked their mother why she chose a saree for someone who had worn androgynous clothes all their life, she plainly said it was natural because after all, the deceased 'was her daughter,'" Biswas recalls.
The Indian queer mental health support infrastructure, already compromised with historical prejudice, is now struggling
In India, queer people's access to professional mental healthcare has been "very limited," according to community members such as Ankan Biswas, India's first transgender lawyer who has been working with the Human Rights Law Network in West Bengal.
"A large majority of the psychiatrists still consider homosexuality as a disorder and practice 'correctional therapy'. It's only around the big cities that some queer-friendly psychiatrists can be found," Biswas said. "The pandemic has further widened the inequalities in access to mental health support for India's LGBTQ community."
Biswas is spending anxious days fielding an overwhelming amount of calls and rescue requests from queer members trapped in their homes, undergoing mental, verbal and even physical torture. "We don't have the space, I just tell them to wait and bear it a little longer," he said.
Medical care is dismal
Anuradha Krishnan's story, though not involving birth family, outlines how the lack of physical support spaces have affected India's queer population. Abandoned by her birth family when she came out to them as a trans woman in 2017, Anuradha Krishnan (she/they), founder of Queerythm in Kerala who is studying dentistry, had to move into an accommodation with four other persons.
Isolation triggered my depression
"I am used to talking and hanging around with friends. Isolation triggered my depression and I had to seek psychiatric help." Living in cramped quarters did not help with quarantine requirements and all of them tested positive during the first wave.
What is deeply worrying is that the Indian queer mental health support infrastructure, already compromised with historical prejudice, is now struggling, placing more and more pressure on queer collectives and peer support groups whose resources are wearing thin.
During the 10 months of the first wave of the pandemic in India in 2020, Y'all, a queer collective based in Manipur, received about 1,000 distress calls on their helpline number from LGBTQ+ individuals. In May 2021 alone, they received 450 such calls (including texts and WhatsApp messages) indicating a telling escalation in the number of queer people seeking help during the second wave.
As India's queer-friendly mental health support infrastructure continues to be tested, Y'all founder, Sadam Hanjabam, a gay man, says, "Honestly, we are struggling to handle such a large number of calls, it is so overwhelming. We are also dealing with our own anxieties. We are burning out."
Sreemanti Sengupta is a freelance writer, poet, and media studies lecturer based in Kolkata.
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