An Empirical Study on Psychological Aspect of Suicidal Thoughts during the Course of Pandemic

I. Introduction

Genesis of the topic: A Roman ivory casket in the British museum shows two contrasting examples of humans who took their lives knowingly. Back then, suicide was called to be self-murder. There was statement that goes "I can kill myself" and humans were notoriously imitative which resulted in this suicidal behaviour spreading rapidly. A concept called copy cat suicide existed. And suicide was of different kinds like altruistic suicide, egoistic suicide, etc. Biologists say that these suicides are a mistake and they can be a path to extinction. Though there was an increase in the number of suicides in the US during the 1918 Spanish influenza⁴ and amongst elderly persons after SARS epidemic resulting in the breakdown of social networks, limited access to healthcare facilities, fear of spreading the infection, social disengagement, mental trauma and fear of being a burden on their families. the suicidal symptoms existed all the time of hardship as an end to hardship but actually it is not at all the right end. The study by ncrb also stated that total of 1, 39, 123 suicides were reported in India during 2019 and there is an increase of 3. 4% compared to 2018 and the suicide rate has increased by the amount of 0. 2% during 2019 over 2018⁵ as per the report. The incidence and rate of suicides during 2009-2019. However, data from NCRB significantly underestimates the number of suicides due to under-reporting of cases and does not track weekly or monthly trends or keep a record of attempted suicides. However, preparedness and impact of the lockdown varied across states. Now the third wave is said to be.

Government initiatives related to the topic: Section 309 of the Indian Penal Code states that a person attempting suicide and the person assisting suicide shall be punished. But the mental healthcare act, 2017 has restricted the application of this provision stating that the person shall not be tried and punished for an act of attempting suicide as they were already prone to severe stress thereof. The WHO's suicide prevention multisite intervention studied the suicidal behaviours to reveal the possibility of reducing suicide mortality and concluded that it isn't possible through the cheap intervention in the developing countries. By early mid-March, the Indian government had drawn up plans to deal with the worsening condition of the pandemic. The steps towards preventing the outbreak equals an initiative towards declining the suicide rates in the nation. While the virus outbroke globally, the Indian government took proactive measures to control its spread in India. It conducted heavy restrictions and strictly quarantined incoming International travellers and also suspended all the visas, except for the diplomats and employees till 15th of April. All cross-national borders were closed and sealed, and railway operations were stopped. Further, all schools, gyms, malls, clubs, hotels, motels, community halls, etc. were shut down. But due to the increased risk of the outbreak of the virus, on March 24, the Prime Minister announced a complete 21-day lockdown for the entire nation, banning people from moving out of their houses. This act severely restricted the community spread of the virus. However, the downside is that the lockdown is expected to make a huge loss of more than Rs. 10 lakh crores from the Indian economy. though things were out of control government both at central and state provided Welfare Measures to hamper the spread and impact of COVID-19 thus reducing the people impulse to end life due to financial crisis -

• State governments like Tamil Nadu govt provided Rs 5 lakh aid to children orphaned by COVID-19. A deposit of ₹5 lakh would be provided in the name of children who have lost both parents due to COVID-19 infection under the scheme. The deposit should be paid to the child with the accrued interest the child complete the age of 18. According to the guidelines of operations that are issued for the implementation of this scheme, in case a child lost one of their parents to COVID-19, a sum of ₹3 lakh would be given to the other parent considering that the case qualified other eligibility criteria. ⁶
• The government also announced the distribution of Rs 1, 000 of cash to support entitled family cardholders. Further, they were also eligible for free supply of essential commodities such as rice, dal, sugar, etc through the Public Distribution System (PDS) thus ensuring and preventing the happenings of suicide or death due to extreme hunger and starvation. Many were unemployed due to pandemic and the symptoms of starvation may also appear such as an weak immune system and poor response to infection . According to the World Health Organization, hunger is the most gravest threat to the world's public health. In many parts of the world, the pandemic has triggered brutal recessions and suspended the access to food. Even before the pandemic, the hunger was spreading resulting in lag of malnutrition. These were at peak in the nations that are affected by conflict, climate extremes or other economic downfalls and are battling higher rate of inequality, all of which the report identifies as major drivers of starvation⁷. On current trends, The State of Food Security and Nutrition in the World has estimated that the Sustainable Development Goal 2 (Zero Hunger by 2030) cannot be achieved by a margin of nearly 660 million people. Among these 660 million people, some 30 million may be suffer pandemic’s lasting effects as been stated.
• And in state like Tamilnadu in India, A child who had lost both the parents and living with his relative, guardian without being admitted in any registered child care institutions will be provided with a maintenance grant of Rs. 3000 per month till the child completes the age of 18 years. Apart from state level , The central government announced multiple measures, including pension for the dependent family members of those who lost their lives due to COVID-19, among other benefits and support provide for the families that lost their earning members to the COVID 19 pandemic.
• Besides family pensions, insurance benefits under EDLI ⁸scheme have been enhanced and inforced. Prime Minister Narendra Modi said these steps will be a helping hand in the financial difficulties faced by these families.
• The government stands in solidarity with families that lost members to COVID 19. To help these families live a dignified and good standard life, the benefit of the Employee State Insurance Corporation (ESIC)⁹ pension scheme for death related to job losses and employment has extended to those that lost life to COVID-19.
• The dependent family members of those that lost their lives to COVID-19 will be entitled to the fincial benefit of pension equivalent to 90 percent of their average daily wage as per the existing norms.

Factors affecting the topic: In India, the factors that affect the suicide are the family problems, illness which includes insanity, mental illness, unemployment, love affairs, drug abuse and addiction, failure in exams, bankruptcy and drastic downfall in economic status, poverty and dowry disputes. It was concluded that the high rates of suicide occurs due to mental illness and drug addiction. The COVID 19 pandemic savoured to more significant risk factors concerning suicidal behavior which includes the socio-demographic variables factors such as being divorced or widows or widowers or single in marital status, being residents of urban areas, belonging to higher socioeconomic class, being unemployed, bankruptcy, dowry issues and having no children and behavior and health-related variables such as lack of physical exercise, smoking, alcohol consumption, abnormalitt in sleep, high social media exposure, and suffering from the higher number of physical health problems and especially the COVID-19 pandemic-related variables such as lesser knowledge of COVID-19, lack of preventive COVID-19 measures, higher levels of COVID-19 fear and anxiety, living in highly COVID-19 infected area, higher economic loss due to the pandemic period, and experiencing relatives or acquaintances’ death during the pandemic and psychopathological variables such as depression, anxiety, stress, insomnia, and family with a history of suicide, suicidal thought history, suicide attempt history. the real heart breaking incident of famous world reputed Tirunelveli halwa owner hung himself on the fear for being tested COVID positive thus death of Hari Singh highlights yet again the urge to eradicate the virus and its fear from those infected by it¹⁰.

Current trends related to the topic: In the previous year, Suicide was declared as the 13th leading cause of death worldwide. The countries that contributed the most in this rate are China, India and Japan and they accounted to almost half of COVID 19 death cases. Sri Lankans suicide rate has aslo risen to the highest level from a modest level. World suicide prevention day with a theme of "many faces, many places" was celebrated to promote the understanding of it. In collaboration with the National Institute of Mental Health and Neuro-Sciences, Twitter is said to be launching a dedicated search prompt to serve information and updates from the authoritative sources on the topic of ‘suicide prevention’. Delhi schools won't reopen now amid third Covid wave fears said the CM Arvind Kejriwal and this can subsequently decrease the pressure on students with concern to sudden reopening of schools and examinations. But in other states, schools were said to reopen. This can lead to a whole lot of pressure on the students. COVID-19 infections are decreasing in India, with 39, 125 new infections reported on an average each day. That’s 10% of the peak which is the highest daily average reported on May 9. The decrease in the infections can subsequently lead to decrease in fear of getting affected thus preventing suicide. Another pushing factor towards suicide is loan repayment . To ease the loan repayment obligation amidst the lockdown and the economic slowdown, the RBI has increased the moratorium period further on all loan EMIs and credit card dues by another three months, i. e. , till August 31st of 2020. So, the total moratorium period will now be six months. People who are not able to clear their debts owing to the Covid-19 spread and related problems can seek for this repayment deferment without defaulting. Non-payment of EMIs during the moratorium period will not impact their CIBIL scores. Banks have informed their customers prior about the process of opting for the moratorium. Some banks are automatically passing the moratorium facility to borrowers who are unable to pay their existing loan EMIs or credit card dues whereas the others have asked their customers to opt for it manually. Thus providing relief to customers and more than 40% of the borrowers availed loan moratorium benefits.

Comparison with other Cities/States/Countries: In the countries with high-income and upper-middle-income, suicide numbers have remained largely unchanged or has reduced in the early months of the pandemic. But the case is straight opposite in countries with low income. Suicide rates range from 1 lakh across Eastern Europe, South Korea, Zimbabwe, Guyana and Suriname to less than 5 per 1 lakh across North America, Middle east, Indonesia and some Mediterranean countries. Among the top five in suicide rates are the Eastern Europe country of Lithuania, the South American country of Russia, the South American country of Guyana and the Asian country of South Korea. In regard with the pandemic outbreak, the ratio of total estimated cases and deaths to reported cases and deaths is low in several high-income countries and for some countries, it may be more or at the highest. The suicide rates are also higher in the countries that suffer high rate of covid 19 infections.

Case laws study concerning suicide: P. Rathinam v. Union Of India¹¹ The Supreme Court held that the criminal penalties for suicide violated the constitutional right to life by resulting in double punishment; specifically considering that women who attempt suicide after abuse cannot be criminally penalized for their suicide attempt. In Smt. Gian Kaur v. The State Of Punjab¹² The Supreme Court has held that the right to life includes the right to die with dignity. The Law Commission of India in its 210th Report stated that Section 309 of the IPC inhuman. It said that an attempt to commit suicide is result of 'diseased condition of the mind'. Thus, it deserves treatment and care, not punishment. Inflicting additional punishment on a person who is already suffering mental agony is not justifiable and is unfair. It can never help in preventing suicides and improving the access to medical care to those who have attempted it instead pushing them into double punishment. Vismaya death case is a recent case in which a a final year student of Bachelor of Ayurvedic Medicine and Surgery, was found dead at her in-law's house in June 22 due to constant torture and assualt seeking dowry. This led to her to commit suicide. It' said that assault of a woman by a husband or family under section 498A of the Indian Penal Code (IPC) can be charged. There are many such brutal cases regarding domestic violence, abuse and assaults happening and those push the innocents to take big decision of ending life. These issues must come into light so that no more lives are lost because of this.

The aim of the research is to bring out the psychological aspect of suicidal thoughts during the course of COVID-19 pandemic.

OBJECTIVES

• To know about the most common method of suicide during the pandemic.
• To understand who are those at high risk of committing suicide at the covid 19 outbreak.
• To analyse the warning signs of suicide at the due course of covid 19 pandemic.
• To find the reason for people to attempt suicide especially during the times like pandemic.

LITERATURE REVIEW

1) The researcher examined that the prevention of suicide especially with a higkg lethal person is matter to be addressed and it also partially alleviates the psychologists to find the reason that drives a person to commit suicide. (Schneidman CS)

2) The researcher explores the factor that raise a person's risk of suicide both psychological and biologically including substance abuse which link with childhood trauma and later suicide, the impact of the family, economic status, religion and the cultural and social conditions. (Sara K Goldsmith)

3) The author states that the mental health effects of the COVID-19 pandemic might be profound and there are thoughts that suicide rates will increase, although this is not inevitable. That suicide is becoming a more pressing concern as the pandemic spreads and has large effects on the general population, the economy, and on the vulnerable groups. Preventing suicide therefore needs urgent consideration. The response must capitalise on, but extend beyond, general mental health policies and practices. (Turecki et al. )

4) The researcher analyzed the impact of news reports of nonfictional and fictional Stories on suicide is reviewed to determine the scope and influse of the mass media on suicide. (Madalyn S Gould)

5) The COVID-19 has emerged as a new global health threat. By increasing the risk of isolation, fear, anxiety, stigma, abuse and economic downfall, COVID-19 has led to an increase in risk of psychiatric disorders, chronic trauma, mental agony and stress, which eventually increase suicidal thoughts and behavior. (Debanjan Banerjee)

6) The researcher studied that the majority of those who commit suicide have seen a physician during the last few months before committing suicide. It means a large number of those suffered from both medical and psychiatric illness. (Theodore L Dorpal)

7) The researcher examined that most individuals who consider committing suicide do not make an attempt. It's therefore hard to identify which suicide ideator is at greater risk of committing suicide. Thus the researcher tried to distinguish between those that attempt suicide and those that only consider suicide. (E. David Klonsky)

8) The researcher has stated that broad, systematic and comprehensive exploration of both historical and contemporary argumentation regarding suicide. He also dealt with the probes that underlying ethical, religious and philosophical issues which surrounds the suicides. (Margeret Pabst Batttin)

9) The researcher has examined that although various sociologists have developed and tested numerous theories about suicide whereas economonists have never analysed this phenomenon. Therefore the research has tested the implications of an economic theory in the developed countries with age group and state as variables. (Daniel S Hamermesh)

10) The researcher has dealt with suicide terrorism in its modern form. He has stated that Suicide terrorism made its first appearance in Lebanon in the early 1980's. Terrorist attacks were perpetrated by suicide bombers and it have spread across the corners of the world. It becomes a threat to both the government and citizens. (Ami Pedahzur)

11) The researcher has analysed the suicide occuring within families to help survivors. The article reviews and summarises the impact of suicide on the individuals within families, on family and social networks. (Julie Cerel et al)

12) The researcher has examined that among the many clinical skills, the psychiatrists must also have the ability to find the risk of patients killing themselves is the most demanding and important. The researcher also explores the problem in accessing suicide risk for the hospitalised patients and those who attempt suicide. (J. John Mann)

METHODS AND MATERIALS

The author has adopted empirical method and descriptive research to do this non-doctrinal study. Primary sources such as questionnaires and surveys are used for this research. Secondary sources such as books, articles and journals were referred for the study. The total sample size for the given study is 200. The independent variables chosen for the study are age, gender, educational status and occupational status. The dependent variables chosen are the reason for people attempting suicid during the pandemic, the most common method of suicide during covid 19 outbreak, those who are at high risk of committing suicide especially at the times of pandemic. The statistical tools used are correlation, chi-square.

II. Spss analysis

FIG. 1: WHAT IS THOUGHT TO BE THE REASON FOR PEOPLE ATTEMPTING SUICIDE DURING COVID 19 PANDEMIC?

RESULTS: The Highest chosen option is substance abuse.

DISCUSSION: By observing figure 6, Most of the respondents chose substance abuse(55. 7%), the next highest chosen options are peer pressure (28. 4%), depression (10. 9), mental illness respectively.

FIG. 2: WHAT DO THE RESPONDENT'S THINK IS THE MOST COMMON METHOD OF SUICIDE DURING THE COVID 19 OUTBREAK?

RESULT: The highest chosen option is hanging for the most common method of suicide.

DISCUSSION: By observing figure 7, Most of the respondents chose hanging (50. 7%), self poisoning (37. 3%) and drug overdose(11. 9%) respectively.

FIG. 3: WHO DO THE RESPONDENT'S THINK IS AT HIGH RISK OF COMMITTING SUICIDE AT TIMES LIKE PANDEMIC?

RESULT: The highest chosen option is 15 and 24 yrs of age or over age 60.

DISCUSSION: By observing the figure 8, Most of the respondents chose 15 and 24 yrs and over 60 (27. 4%), person with a prior suicide attempt (25. 4%), prone to physical or sexual abuse(23. 9%), medical illness(17. 9%), and depression and other mental illness (5. 5%) for being at high risk of committing suicide.

FIG. 4: WHAT DO THE RESPONDENT'S THINK AS THE WARNING SIGNS OF SUICIDE?

RESULT: The highest chosen option is talking about feeling empty, hopelessness or having no reason to live.

DISCUSSION: By observing figure 9, Most of the respondents chose talking about feeling empty, hopeless and not willing to live(39. 8%) , the next chosen are Using alcohol and drugs more often(26. 9%), acting anxious and agitated(25. 9%) and withdrawing from family and friends (7. 5%) respectively.

FIG. 5: WHAT WOULD THE RESPONDENT'S DO IF THEY FIND SOMEONE WITH SUICIDAL BEHAVIOUR?

RESULT: The highest chosen option is all of the above mentioned options.

DISCUSSION: By observing the figure 10, Most of the respondents chose all of the above (29. 9%), the next chosen options are be respectful and acknowledge their feelings (29. 4%), encourage the person to seek treatment (21. 4%), encourage the person to call suicide hotline (13. 9%), asking them to get help from trained professionals (5. 5%).

FIG. 6: WHAT IS THOUGHT TO BE THE REASON FOR PEOPLE ATTEMPTING SUICIDE DURING COVID 19 PANDEMIC?

RESULT: The highest chosen option is substance abuse by all the age groups.

DISCUSSION: By observing the figure 11, Depression and mental illness chosen by respondents of 41-60 age group, Substance abuse has been chosen by 20-40, 41-60 and above 60 age group, peer pressure has been chosen by below 20, 20-40, 41-60 age group for the reason for attempting suicide.

FIG. 7: WHO DO THE RESPONDENT'S THINK IS AT HIGH RISK OF COMMITTING SUICIDE AT TIMES LIKE PANDEMIC?

RESULT: The highest chosen option is 15 and 24 yrs of age or over age 60.

DISCUSSION: By observing figure 16, Urban postgraduates chose 15 and 24 yrs of age or over age 60. Rural HSC students and urban UG chose medical illness. Urban and rural undergraduates chose person with a prior suicide attempt. Urban HSC students and Undergraduates chose prone to physical or sexual abuse. Urban postgraduates chose depression and other mental illness.

FIG. 8: WHAT WOULD THE RESPONDENT'S DO IF THEY FIND SOMEONE WITH SUICIDAL BEHAVIOUR?

RESULT: The highest chosen option is all of the above mentioned options.

DISCUSSION: By observing the figure 17, Urban and Rural male and female respondents chose to encourage the person to call suicide hotline number. Femal urban respondents chose asking them to get help from trained professionals as quickly as possible. Female urban and rural respondents chose to encourage the person to seek treatment. Male and female urban respondents chose to be respectful and acknowledge the person's feelings. And Urban respondents of all the genders chose all of the above.

III. Limitations

The major limitation of my study is the sample frame The sample frames such as online surveys didn't help in interactive collection of responses. The major amount of respondents were connected through different social platforms. There were audiences who were unaware of the psychological aspects of suicide which another drawback. The restrictive area of sample size is also another drawback. The physical factors are the most impactful and a major drawback to the research. The researcher had to face time restraints in college campuses and school premises.

IV. Suggestions

The author suggests that there should be legal campaigns about suicide and its prevention to decrease the number of suicides happening everyday. During the hard times like a pandemic, the government should provide all the necessities to the citizen below poverty line. They should also provide free medical health care which includes mental health treatments as well. The author also suggests that those in the academic sector must teach the students to handle pressure in academics. As the virus continues to spread across globally, it brings with it multiple new issues, including physical and psychological health risks, economic vulnerability, unemployment, etc. Through all of that, infants and their mothers are the most vulnerable as they are the prey to domestic violence. Thus the government should help those women by giving them financial support and asking them to be more open about the abuse. The domestic abusers must be punished too.

The government can take initiatives to reduce the burden in academic institutions. Also they can find which are leading causes of this ever increasing suicide rates and take necessary actions to prevent the raise in the suicide rates during the course of pandemic.

V. Conclusion

Suicide is killing oneself, most often this happens as a result of depression or other mental illnesses at present due to COVID 19. Losing interest in the workspace, giving the bellowed possessions to others and withdrawal from friends and the lack of communication pave way for suicidal thoughts during the pandemic period. The major objective of the research is to find the most common method of suicide during the covid 19 pandemic, to find those who are at high risk of committing suicide during the course of covid 19 outbreak, the warning signs of suicide and the respondent's reaction towards a person they find to be suicidal . The findings are that substance abuse is the major reason for attempting suicide and Hanging is the most common method of committing suicide and people are ready to help out those with suicidal behaviour in all possible ways. The author suggests that there should be awareness campaigns about suicide and its prevention. Fresh data is collected using questionnaires and survey posed to common people. The secondary data has been collected using books, articles, journals, etc. This research proves to be an ultimatum to enlighten this title. The author concludes that the research was done to under the psychological perspectives behind Suicide ideators, to find the public's opinion and awareness on this inclining issue.

Footnotes

1. Author is an Assistant Professor at Saveetha School of Law, India.

2. Author is a student at Saveetha School of Law, India.

3. Author is an Advocate at Madras High Court, India.

4. Andrew Noymer, M., 2021. The 1918 Influenza Epidemic's Effects on Sex Differentials in Mortality in the United States. [online] PubMed Central (PMC). Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 2740912/> [Accessed 5 August 2021]. ↩

5. Ncrb.gov.in. 2021. [online] Available at: <https://ncrb.gov.in/sites/default/files/Chapter-2-Suicides_2019.pdf> [Accessed 5 August 2021]. ↩

6. Thehindu.com. 2021. [online] Available at: <https://www.thehindu.com/news/resources/article34798259.ece/ BINARY/TNGovtChildrenOrphanedCOVID19.pdf> [Accessed 5 August 2021]. ↩

7. Who.int. 2021. UN report: Pandemic year marked by spike in world hunger. [online] Available at: <https://www.who.int/news/item/12-07-2021-un-report-pandemic-year-marked-by-spike-in-world-hunger> [Accessed 5 August 2021]. ↩

8. Employees' Deposit-Linked InsuranceEDLI applies to all organisations registered under the Employees Provident Fund and Miscellaneous Provisions Act, 1952. All such organisations must subscribe to this scheme and offer life insurance benefits to their employees. ↩

9. Esic.in. 2021. Employees' State Insurance Corporation - Portal Application. [online] Available at: <https://w ww.esic.in/InsuranceGlobalWebV7/ESICInsurancePortal/PortalLogin.aspx> [Accessed 5 August 2021]. ↩

10. India Today. 2021. Owner of Tirunelveli's famous 'Iruttu Kadai' dies by suicide after testing positive for coronavirus. [online] Available at: <https://www.indiatoday.in/india/story/owner-of-tirunelveli-s-famous-irrutu-kadai-dies-by-suicide-after-testing-positive-for-coronavirus-1692670-2020-06-25> [Accessed 5 August 2021]. ↩

11. AIR 1844, 1994 SCC (3) 394 ↩

12. AIR 946, 1996 SCC (2) 648 ↩