Rising student suicides: Why Gujarat is failing to hear the cries of help

In June this year, Devangi Patel’s friends at the girl’s hostel of Gujarat Adani Institute of Medical Science (GAIMS) in Bhuj region of Gujarat knocked at her room’s door early morning as Devangi had stayed in beyond what was usual for her. When they did not receive a response they thought Devangi must be asleep after studying till late in the night. Turn by turn, hostel inmates kept checking if Devangi had opened the door. The restlessness among them grew as the hours went by.

By the time it was 11.30, there was a commotion as Devangi had not responded to even loud bangs and thuds on the door. Authorities were alerted and when the door was broken open, the second-year MBBS student, who was barely 26, was found hanging from the ceiling fan of her room. “Devangi, a student from middle-class family from another district was suffering from anxiety disorder,” her professors and batch-mates said.

In April 2023, a student of CEPT Ahmedabad, died by suicide after jumping off the terrace of a multi-storey building in the city where he lived as a paying guest. As per the statement of Shiv Mistry’s friends, the final year student was under a lot of study-related stress.

While student suicides beyond Kota, the Indian hub of coaching centres in Rajasthan, mostly fail to make it to national headlines, as per the National Crime Records Bureau (NCRB) data of 2021-2022, Gujarat ranks 6th in the country in the number of student suicides. In India, 35 students die by suicide every day, meaning 1-2 student die every hour. In the last five years, as many as 3,002 students have died by suicide in Gujarat, which comes to an estimated 1-2 students per day.

The fact that mental health of the young population of Gujarat is screaming for attention is also seen in the fact that the sale of antidepressants has gone up by 32 per cent since Covid, primarily within the age group of 20 to 45, a large section of whom are students.

In overall suicide figures, at 5.4%, Gujarat ranks fourth on the list led by Chhattisgarh at 4.8%, Uttar Pradesh at 3.6%, Andhra Pradesh at 4.9% and Gujarat at 5.4%.

What makes the situation worse is that the worsening mental health situation hasn’t been met with a commensurate administrative attention.

“Attempting suicide is a matter of impulse and if somehow, that is not possible in the spur of the moment, it causes people to rethink their decision. In many cases it has never been attempted again. Building barriers on bridge are very effective in this regard. However, it is not the only mode of suicide. The situation can be actually handled when more people have access to mental health counselling,” said Doctor Minakshi Parekh, head of psychiatry at Ahmedabad Civil Hospital.

Gujarat severely lacks in the number of mental health professionals with just 511 registered psychiatrists in the whole state. Out of the 511 doctors, only 363 have an MD in Psychiatry, while 148 hold a Diploma in the field. Of the total 511 psychiatrists, 90 work in government institutions and among the 130 psychologists, only 48 are employed by the state government.

“If look at the ratio, Gujarat has just one psychiatrist per 1,27,000 people considering that the state’s population has exceeded 6.5 crore,” said Dr Nitin Vora, president of Gujarat Medical Council.

“There are just about 130 psychologists registered under the norms of Mental Healthcare Act making the psychologist to patient ratio to 1:5,00,000. This apart, the number of qualified Mental Health Nurses is also low with just 80 trained nurses in the entire state, of which 50 work in the public sector. This means there is one nurse for every 8,12,500 people in the state,” added Vora.

Gujarat is found wanting not just in terms of mental health experts but also awareness and advocacy. Students barely know who to turn to for help when parents, coaching centres, teachers or professional institutes increase the pressure for improved academic performance.

“Being medical students, our schedules are always hectic and erratic. We are always being evaluated, one mistake and our grades go down. The pressure to do well is more for me as my parents expect me to do so as my parents got me admitted to a private medical institute. I am from a small town in Porbandar district. Sending a girl child for higher education is a big deal. It took me a lot of effort to convince my father. I have to get good grades to pursue a speciality of my choice,” second-year MBBS student of GAIMS, Bhuj, Hetal Darshan Raval, told The Federal.

“I want to be a cardiologist. At times it feels like it’s too hard and living away from home doesn’t help either. In this college we do not have any counselling facility for mental health of students. Being medical students, we do know that various state helplines exist but I have never sought help. I don’t know the helpline numbers. I doubt anybody here would know. Our professors always say that medical students have to be tough. We are often told by seniors that the relentless hours of studies are just the norm and we better get used to the pressure,” Hetal added.

The college has not created any counselling facility despite the death of Devangi.

The pressure is being felt by students across streams and not just those pursuing medical or engineering.

“My daily routine is quite packed. To keep up with the syllabus, I spend almost every minute studying. I get up at 6 am to reach college for my first class. After hours of college, I come back to my PG to grab a quick bite and change before I rush for coaching classes. I am preparing to sit for the Chartered Accountant entrance exam. My family expects me to become a CA. My elder brother is a CA too but he did not clear the entrance exam at one go. I hope to get through the first time. It’s frustrating otherwise to prepare for another year,” said third-year Bcom student Umesh Solanki who studies at Gujarat University, Ahmedabad.

“We don’t know much about mental health. It is not exactly a subject of discussion at home or in my social circle. I remember last year, one of my classmates failed, he was frustrated and one of our professors suggested that he should seek help. Everyone made fun of him for quite some time. It is still a taboo from where I come. Besides, if we work hard now, we will be more successful later in life,” Umesh added.

To make matters worse, even as the state has been grappling with the increasing number of suicides and mental health issues, there are vacancies of doctors in government hospitals. As of December 2021, there were eight posts of psychiatrists vacant in the eight Gujarat Medical and Education Research Society (GMERS) state-run medical colleges across. Five posts are still vacant in the six government medical colleges.

Tele counselling programme

Presenting the Union Budget for the Fiscal Year 2022-23, the government announced a Tele-mental health programme will soon be launched to provide mental healthcare. The government said that the introduction of this programme will take mental healthcare services and counselling to underserved regions in the country, especially rural areas which lag behind in mental healthcare infrastructure.

Since then, the number of calls to seek help for mental health related issues and suicide have considerably increased. For Gujarat, that was already reeling from a lack of doctors across the state, the aid from the Central government came as a blessing.

The dismal number of doctors in government sector in Gujarat has made community volunteering and tele-counselling not just supplementary to physical counselling, but the primary mode to reach out to people across the state.

“We get the highest number of calls from the bridges across the rivers, especially Sabarmati river in Ahmedabad. This is owing to the posters of the helpline facility put up across the river banks. While some mental illnesses are well-known, people often do not seek help for depression and anxiety. The problem of access to mental health counselling for women or young adults is especially dismal because family members do not see the need for medical help as long as they continue to do their routine work,” a volunteer, who is a trained tele counsellor, said requesting anonymity.

“While the posters across the bridges have helped a few to change their mind, over the years, we have observed that it also pushes people to other ways of taking their lives. Most people wouldn’t know which number to call in the situation as the awareness campaigns have not been aggressive so far. In a state where talking about mental health is still a taboo, a few posters along rivers in cities is not enough. There should be more awareness programmes,” he said.

From mid-2020 to December 2021, the toll free helpline of Gujarat government – 1100 had received more than 5,000 calls seeking counselling against thoughts of attempting suicide.

Guided by NIMHANS, Bengaluru, the Gujarat Digital Academy of Mental Health in Ahmedabad, established in August 2019, is one of the 23 Centres of Excellence for mental health announced by Finance Minister Nirmala Sitharaman in the Union Budget 2022-23.

There is an urgent need for government to work on multiples levels, including creating awareness, providing dedicated helplines and making counselling available for those on the verge of taking the extreme step.

Suicide helpline numbers:

(Suicides can be prevented. For help please call Suicide Prevention Helplines: Neha Suicide Prevention Centre – 044-24640050; Aasara helpline for suicide prevention, emotional support & trauma help — +91-9820466726; Kiran, Mental health rehabilitation — 1800-599-0019, Disha 0471- 2552056, Maithri 0484 2540530, and Sneha’s suicide prevention helpline 044-24640050.)