Suicide by hanging is a priority for suicide prevention: method specific suicide in India (2001–2014)

• Published in: Journal of affective disorders 2019-10, Vol.257, p.1-9
• Main Authors: Arya, Vikas, Page, Andrew, Gunnell, David, Dandona, Rakhi, Mannan, Haider, Eddleston, Michael, Armstrong, Gregory
• Format: Article
• Language: English
• Subjects: Hanging; India; Insecticide poisoning; Pesticide poisoning; Suicide
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2019.07.005

•Suicide by hanging has increased while suicide by pesticide poisoning has decreased in India.•States with higher levels of agricultural pesticide use have higher rates of pesticide poisoning suicides.•The increase in suicide by hanging has occurred with a contemporaneous decline in pesticide poisoning suicide. India accounts for over a quarter of the global burden of suicide. One of the most effective population level suicide prevention strategies has been restricting access to suicide means. Trends in method specific suicide rates (2001–14) were calculated using National Crime Records Bureau data stratified by sex, age-group, and geographical region. Multilevel negative binomial regression models stratified by sex and suicide method were specified to investigate associations between state-level indicators of economic development, education, agricultural pesticide use and religious factors. Suicide by hanging increased by 56% (from 3.9 to 6.1 per 100,000) among males and by 24% (from 2.1 to 2.6 per 100,000) among females over the study period while incidence of insecticide poisoning decreased by 44% (from 2.7 to 1.5 per 100,000) among males and by 52% (from 1.7 to 0.8 per 100,000) among females. In general, states with higher levels of development, higher agricultural employment and higher literacy had higher rates of suicide for each suicide method. States with higher levels of agricultural pesticide use had higher rates of insecticide poisoning suicides. Reported rates might be an underestimation of the true rates as the official data used for the analysis likely underestimates the actual number of suicide deaths in India. Responsible reporting of suicide by hanging in the media, and limiting fictional portrayals of this method may be useful areas for prevention. Further restrictions on production and sales of highly hazardous pesticides may also help with further reductions in suicide by pesticide poisoning.