Thread by @netshrink

THREAD: #SuicidePrevention
I get annoyed when ppl think the solution to India's suicide crisis is having more suicide prevention helplines. Don't get me wrong, they are absolutely necessary, but not enough! Why? Helplines are crisis intervention. Essential, but...1/n

Are we doing anything to prevent the crisis occuring in the 1st place? Ah, I hear you say - it's bcoz of depression & we need better mental health services. True, but depression is a final common pathway, not the cause of the crisis. Bcoz...2/n

~40-50% of suicides in India, there is no diagnosable mental illness (unlike West). So what's causing the crisis? Let's begin with children! If school going children are dying of suicide, shouldn't we ask what is wrong with our education system? And do something about it?... 3/n

If childhood abuse is implicated in suicides & 30% of Indian children have experienced abuse, what r v doing about that?
Let's turn to women dying of suicides...4/n

36% of women suicides in 🌍 are Indian women. 30% of women who die of suicide, domestic violence is implicated. What r v doing about DV?...5/n
indianjpsychiatry.org/article.asp?is…

How about unemployment? In Greece, suicide rates ↑ 25% after the economic crisis 2008-12 With high unemployment rates, what r v doing for this group at high risk for suicide?...6/n
google.com/amp/s/www.nyti…

I could go on - caste, alcohol use/misuse, etc are also implicated.
My point is, that unless we address the structural determinants of suicide, we will get nowhere!...7/n

Our crisis services such as helplines will get overwhelmed. Our mental health services will be overwhelmed. It's a public health crisis. And like many public health crises, the solutions (and causes) are outside the health sector!...8/n

As Snow showed long ago, the way to tackle cholera was to address the quality of drinking water (sanitation). Similarly, we need to address mental health sanitation - childhood abuse, education systems, domestic violence, financial stress!...END