Thread by @netshrink

What would National #SuicidePrevention Strategy for India look like:
1. We need to believe it is possible. With concerted effort China has dramatically reduced their suicide rates.
2. We need to implement evidence-based, low cost scalable solutions. They exist.
...contd 1/n

3. Need different strategies for sub-groups. Same solution won't work for students, young women, rural/urban, farmers etc.
4. #suicideprevention is an #intersectoral issue. All solutions do not lie in #health sector; #education #employment, #media #agriculture also imp....2/n

5. Recognise India's suicide epidemiology is different from the West. M:F ratio is 1.5:1 here while it's 4:1 in West. So more women relatively. 50% of suicides impulsive with no mental illness 🇮🇳 while 80% have mental illness in West...3/n

6. Need good quality reliable data. NCRB data on suicides grossly underestimates suicides by anywhere from 30-90%.
We don't collect attempted suicides data at all. Across the world attempted suicides r 4-10 times number of completed suicides....4/n

6. Think in terms of universal (for all), selective(high risk groups) & indicated (2ndary) prevention interventions at all levels for different groups.

Universal : Eg. 25% suicides are with pesticides. Many Impulsive. Reducing #access to pesticides can address this segment...5/n

Selective: intervention for Board exam students - eg. supplementary exam (X & XII) reduced suicides in this group

Indicated: eg. Contact & safety planning after suicide attempt can ↓ subsequent suicides.
Eg. Treating depression early can prevent suicides. ..6/n

Above all we need to believe we #suicides can be prevented. Other countries have done it.

We devote $100 million/yr to #TB with 500k deaths. We devote $0 to suicide prevention 250k deaths.

Suicides: #1 cause of death for young women (19-30 yrs) & #2 for men (19-30 yrs)...7/n

Hope this starts a discussion about #suicideprevention and mental health issues in general in India on this #WorldHealthDay ...8/n

That is also why we ask you to support #BridgeTheCareGap campaign. Sign the petition at bridgethecaregap.com to tell politicians that you the voters care about #mentalhealth and #suicideprevention ...END

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