Embed Size (px)
Citation preview
83
CHAPTER – 4
PSYCHOLOGY OF SUICIDES IN KERALA STATE
In Chapter – 3 the problem of suicides in Kerala has been
analyzed at some length, and in Chapter – 5 the empirical study
conducted in three districts of Kerala, has been discussed. In this
Chapter, it is considered worthwhile to dwell briefly on some
special features of the problem (of suicides) in Kerala State, which
have been revealed during this study, as well as remarks and
opinions of psycho-analysts who studied the life experiences of
dozens of suicide –prone persons. The result of studies conducted
based on experience at "Suicide Prevention Clinics" at
Thiruvananthapuram and Kottayam as well as interviewing some
victims of attempted suicide by the researcher are being discussed
in the succeeding paragraphs.
4.1 Family Suicides in Kerala
4.1.1. In Chapter 3, paragraph 3.4.1 to 3.4.9 the peculiarities
of ‘family suicides’ in Kerala has been mentioned, and some
notable incidents which occurred recently, have been recounted. In
fact, Kerala reported the maximum number of such incidents, with
161 deaths in 2001. At the all – India level, such incidents
contributed 499 deaths; Kerala accounted for 32 % of the total.
84
Rajasthan had 46 such incidents, resulting in 88 deaths, Madhya
Pradesh had 27 incidents, contributing 63 deaths, and Tamil Nadu
had 23 incidents, leading to 65 deaths. One important feature of
such ‘family suicides’ is that the normal male: female ratio in
suicide cases is reversed in these type of incidents – as against the
National average Male: Female ratio of 61:39, it was 40:60 in
‘family suicides’. It was 201 males and 298 females in the year
2001.1 The table 4.1 below gives the data on family suicides for
the country as a whole (data for some States like Andhra Pradesh
and Bihar are not available). In the year 2003, the total number of
victims in the incidents of 'family suicide' rose up to 793 (465
males and 328 females) of whom 152 are minor children - 19.17
percent of the total.2
1 'Accidental Deaths & Suicides in India' 2001, N.C.R.B. 2004, p.180. 2 'Accidental Deaths & Suicides in India' 2003, N.C.R.B., 2005, p.176.
85
Table 4.1
Distribution of Family Suicides During 2001 Adults Minor Total Sl.
No. State/UT Co. of
Cases Male Female Male Female
States 1 Andhra Pradesh - - - - - -
2 Arunachal Pradesh 0 0 0 0 0 0
3 Assam 1 1 1 0 2 4
4 Bihar - - - - - -
5 Chattisgarh - - - - - -
6 Goa 0 0 0 0 0 0
7 Gujarat 3 4 3 2 2 11
8 Haryana 0 0 0 0 0 0
9 Himachal Pradesh 1 - 1 1 - 2
10 Jammu & Kashmir 0 0 0 0 0 0
11 Jharkhand
12 Karnataka 13 12 17 5 9 43
13 Kerala - 47 73 17 24 161
14 Madhya Pradesh 27 22 19 7 15 63
15 Maharashtra 11 9 7 5 5 26
16 Manipur 0 0 0 0 0 0
17 Meghalaya 0 0 0 0 0 0
18 Mizoram - - - - - -
19 Nagaland 0 0 0 0 0 0
20 Orissa 2 2 1 2 2 7
21 Punjab 0 0 0 0 0 0
22 Rajasthan 46 19 36 14 19 88
23 Sikkim - - - - - -
24 Tamil Nadu 23 13 30 6 16 65
25 Tripura 0 0 0 0 0 0
26 Uttar Pradesh - - - - - -
86
27 Uttaranchal 1 1 1 0 0 2
28 West Bengal - 3 3 - - 6
Total (States) 128 133 192 59 94 478
Union Territories 29 A & N Islands 0 0 0 0 0 0
30 Chandigarh 0 0 0 0 0 0
31 D & N Haveli - - - - - -
32 Daman & Diu - - - - - -
33 Delhi(UT) 5 5 7 4 5 21
34 Lakshadweep 0 0 0 0 0 0
35 Pondicherry 0 0 0 0 0 0
Total (UTs) 5 5 7 4 5 21
Total (All India) 133 138 199 63 99 499
Source :- Accidental deaths and suicides in India – 2001 (NCRB)
4.1.2. According to Dr. C.J.John, M.D., D.P.M., MNAMS,
Chief Psychiatrist, Medical Trust Hospital, Cochin, Kerala, with
more than 20 years experience in psychiatry, “this phenomenon of
murder followed by suicide appears to take two forms. In the first,
the husband becomes suicidal and convinces his wife to enter into
a suicide pact, killing their children before killing themselves. In
the second, the adult female becomes suicidal, does not share her
feelings with her husband, but again kills her children before
killing herself.” 3
3 'Family Murder Suicides In Kerala', in Crisis : the Journal of Intervention and
Suicide Prevention, published by Huber & Hogrefe Publishers, Vol. 21(3) 2000]. p.105-106
87
4.1.3. Dr. C.J.John analyses that the suicidal adult appears
to take the morbid decision as a result of depression brought on by
several factors such as sudden fall in financial status, bankruptcy,
and consequent lowering or expected lowering of living standards.
A sense of hopelessness, leads often to alcoholism, and depression.
The decision to kill the children is apparently taken out of ‘love and
compassion’ to prevent the sufferings of the children after the
death of parents. The children therefore become the passive victims
of the ‘suicide pact’ entered into by the parents. In case when, only
the female adult is taking the decision regarding suicide, there is
no such ‘pact’ but, out of frustration brought on by the harassment
and stress from the husband or his close relatives, she may kill her
children, and then put an end to her own life.
4.1.4. It is significant that in the survey conducted (details
given in Chapter - 5); two incidents of family suicide have been
reported, out of the 105 incidents subjected to study. The first of
them is an incident which occurred in the night of 13th July 2004,
in ‘Hari Bhavan’, Thachottukavu, in Malayinkeezhu police station
limits, Trivandrum district. Harikumar, aged 34, a plumber by
profession was staying with wife Maya, aged 26, his father
Janardhanan Nair, mother Saraswathy, and their two children,
Arya aged 4 years and Aathira aged 1 year. On the day of
occurrence, Maya was helping the child Arya with her lessons. The
88
attention of the child was distracted by something and she was not
following the lessons being given by her mother. Enraged by this,
Maya thrashed the child and she started crying in pain.
Saraswathy then interfered and chided her daughter in law, not to
take it out on the child. Maya then shouted at the mother - in -
law, and the exchange of words flew between them. Maya then
came out with what might have been nagging her, ‘it is so
expensive to look after old parents, what with so many other things
to worry about ’. The mother - in - law started her own tale of woes,
and the situation was becoming bitter. This led to cold feelings,
and after three days, Maya left home with her children. Harikumar
and friends searched in the city and found them near the beach.
That night probably the husband and wife took stock of their
situation and found life unbearable. They killed both children and
both committed suicide by hanging (details taken from case diary
file in crime 297/04 of Malayinkeezhu P.S.) It is notable that the
wife appears to have taken the initiative in this ‘suicide pact’
(according to relatives, she was a dominating person) and it is also
worth mentioning that one of her brothers had committed suicide
some time back.
4.1.5. In the second incident, which occurred in the night of
23rd January 2004, one Deepu @ Kuttan aged 21 years, and his
young wife Shyni aged 18 years, belonging to Vithura village,
89
Trivandrum district, had got married about 7 months back. She
was pretty but from a poor family. She had a love affair with a boy
who was now working abroad (Gulf countries). Deepu who
belonged to a rich family of agriculturists, of the locality, married
her for her good looks. When the lover came on leave he came to
know about the matter and was desperate and inconsolable. In the
meanwhile, Shyni conceived, but there was a miscarriage and she
was depressed. On the day of occurrence she visited her parents,
and apparently, the condition of the ex-lover was discussed. Her
parents had financial dealings with him, which were still
outstanding. Shyni returned home, and that night, husband and
wife decided to die together, and committed suicide by hanging.
(details taken from case diary file of crime 22/04 of Vithura P.S.)
In this incident also the wife appears to have taken the initiative,
and the husband did not have any cogent reasons to suffer from
depression so severe as to put an end to his life. He appears to
have joined the decision of his wife to put an end to her life, by
repeating the same act.
4.1.6. While on the topic of ‘family suicides’ an incident
which occurred in the recent past, in the month of July 2006 in
Wayanad district of north Kerala is worth reporting here. In
Padinjarathara panchayath, one Ramachandran aged 46 years,
his wife Leelamma aged 38, and their two children, Sumisha aged
90
16 and Akhil Raj aged 13 committed suicide, by consuming poison,
in the night of 5th July. Ramachandran, who was a farmer, had
one acre of land which he was cultivating himself. Since the prices
of farm products had hit the floor, he had taken some more land
on lease and started cultivation of plantains. He had taken loan of
Rs. one and half lakhs from South Malabar Grameen Bank,
Canara Bank, and also from ‘Kudumbasree’ project (self-help
groups), but the failure of crops due to rain storms spoiled any
chance of a financial recovery. This had apparently driven the
family to take such a desperate step. It is pathetic to know that the
girl had scored 586 marks out of 740 in the S.S.L.C. examination
in May 2006 which is nearly 80% and was hoping to go in for
higher study.4
4.2 Expert Opinion of Psycho-analysts
4.2.1. While discussing the circumstances under which
people commit suicide, David H. Malan has remarked, that it is not
always abnormal or problematic persons who commit suicide. He
has identified as one common feature, “one of the most dangerous
situations, namely, loss of all hope. This can result in suicide in an
essentially ‘normal’ person…”5 The author goes on to reveal the life
story of a 56 year old woman of Hungarian- Jewish origin, who 4 'Mathrubhoomi' news paper, 6th July 2006 5 'Anorexia, Murder & Suicide' Reed Educational and Professional Publishing
Ltd. 1997, p.155.
91
came for consultation in psycho analysis clinic, one week after her
only son committed suicide by throwing himself under a train. Her
husband had died after a long illness a few months previously.
“She felt there was no point in going on”. After several sessions
with the psychotherapist, she had somewhat come to grips with
her desperate situation. She even planned to stay with a friend
during the Easter holidays, and hoped that this friend would
eventually come and live with her permanently. However, all the
plans were upset when the friend was suddenly taken ill and had
to be admitted to hospital so that the patient was now alone. This
was just enough to tip the balance, and she took a fatal overdose of
sleeping pills as she had told in the first session with the psycho
therapist.
4.2.2. Family history is also very important in certain cases.
The same author has revealed the incident of one lady receptionist
aged 28 years, who was depressed because she had to break off
her engagement with her fiancé. A few months later he had become
alcoholic and died of coronary disease. At this point she became
depressed. “Her depression was of an ‘ordinary neurotic’ kind but
not her family history. Her father appeared to be demented, her
mother was alcoholic, one brother appeared to be schizophrenic,
and another brother was withdrawn and seemingly schizoid”
92
(meaning, ‘introvert with a tendency to phantasy, but without
definite mental disorder’). In spite of psychotherapic assistance
she “took an overdose of anti-depressants after the 9th session and
died two days later”.6
4.2.3. Regarding motives and mechanisms in suicide, the
same author says, “ since suicide is by its very nature, a self-
destructive act, it is usually said to represent a defensive
mechanism by which aggression, originally directed against
someone else, is turned against the self ”7 It is also sometimes “
unexpressed anger combined with cry for help ”8.
4.2.4. A convergence of traumatic events may induce a
person to take the extreme step of suicide. The same author has
given the life experiences of a University student, in whose case “
there were no fewer than four – or arguably five – independent
strands, which by a series of extra-ordinary coincidences led to
the final desperate situation ” [ibid, page 171] Finally he took an
overdose of chloral hydrate but was taken to a hospital, survived
and went on to live “a highly creative and productive life ever
since” and at the final follow-up more than fifty years after his
suicidal attempt, “he said that his underlying and ever present
6 ibid, p.160. 7 ibid, p.163. 8 ibid, p.164.
93
longing to be released from the burden of life had completely
disappeared ” [ibid, page177].
4.2.5. According to social scientist P.O. George, formerly
Director, Centre for Health Care Research & Education, Rajagiri
College of Social Sciences, Kalamassery, Cochin, “Death by suicide
may be seen as a major health problem in Kerala. In the year 2003,
total deaths by suicide, was 9438. Many more sustained injuries in
unsuccessful attempts to take their own lives. The situation,
indisputably, calls for immediate attention of all people.” He adds,
“It is paradoxical that Kerala, which is considered one of the more
advanced States in the country, has a suicide rate three times the
national average”.9 He further adds, “Kerala has been one of the
economically backward States in the Indian Union for a long time
now…The State also has a heavy load of unemployment. About 4.5
million unemployed youth are said to be on the live registers of the
Kerala State unemployment exchanges. In addition the agricultural
sector is in crisis with the price of almost every cash crop like
coconut, rubber, coffee, paddy etc. crashing and the crops wilting
under severe pest conditions”.10
9 Suicide a Major Health Problem of Kerala, Rajagiri Journal of Social
Development, Volume - I, Golden Jubilee Issue – 2005, p.30 10 ibid, p.30.
94
4.2.6. The author also identifies the social changes taking
place in the State. “The joint family, which afforded a great deal of
support, care and protection, has almost disappeared, and in its
place, the nuclear families or smaller extended families have
emerged. The number of single parent families is also steadily
rising”.11 The changing role of modern women is also noted by the
author as significant. Kerala is a State noted for high literacy of
women (89.81 %) comparable with the Western world, and
increasing number of women seeking employment outside home.
The women who work outside home are straddled with the double
burden of the career woman and that of homemaker. Being forced
to attend to household chores such as cooking, washing, cleaning,
attending to children’s education and nursing the aged, sick and
disabled members of the family, puts a lot of strain on them. In
addition if the husband is prone to alcoholism, extra-marital
affairs, criminal behaviour etc. life could become unbearable for
the women. P.O. George concludes by pointing out, “Suicide is to
be seen as a phenomenon of multi-dimensional causation. It is
normally not easy to attribute one specific cause to any incident of
suicide…It is indeed naïve to believe that one takes the decision to
kill oneself out of frustration caused by an isolated event.”12
11 ibid, p.31. 12 ibid, p.43-44.
95
4.3. Feedback from Suicide Prevention Clinic – Trivandrum
4.3.1. Dr. A. Ashraf Ali, M.D., D.P.M., Assistant Professor of
Psychiatry, Medical College Trivandrum, Kerala, who has been in
charge of the ‘Suicide Prevention Clinic’ of Medical College,
Trivandrum revealed that the clinic was started in the year 1993,
and ever since then, the patients who are admitted in the Medical
College hospital for attempted suicide, have been under psychiatric
care in the ‘clinic’ being held every Tuesday in the psychiatric wing.
So far, total number of cases handled by them is 2977. During the
year 2005, they have handled 362 new cases, and also 100
patients of previous years for follow-up.
Out of the 362 persons, 204 (56.3 %) were females and 158
(43.6 %) were males. This is comparable with the percentages of
completed suicides, which is 70.1 % males (1995) and 72.9 %
males (2004) as against 29.9 % females (1995) and 27.1 % females
(2004) [data from State Crime Records Bureau of Kerala Police] It
would appear that in the case of unsuccessful attempts, females
have a larger share while the converse is true in the case of
completed or irrevocable incidents.
The educational status of the 362 persons was that 318, or
87.8 % had only school level education, 32 or 8.8 % had college
level education, and the percentage of illiterate persons was only
3.3 (12 persons). This is comparable with the survey data in table
96
5.12 of chapter – 5, which revealed an illiteracy level of 10.5 %
while the persons with school level education were 81 %. Regarding
marital status, 212 or 58.6 % were married, 124 or 34.3 % were
single, 21or 5.8 % were divorced / separated and 5 or 1.4 % were
widows. This is comparable with the survey data in Chapter - 5
table 5.10, which shows married persons as 71.4 % and single
persons as 21 %. This may mean that suicide attempters are more
often single persons as against married persons. Age classification
of the 362 persons, propensity to consume alcohol, and financial
status, would have been an interesting study, but unfortunately it
is not available. Mode of attempt of the 362 persons is given in the
table 4.2 below.
Table 4.2
Means Adopted for Suicide Attempt Type of method Number of
Persons Organophosphorus poison 181 Drug over dose 30 Oleander poison 26 Rodenticide 30 Formic acid 12 Lotion 7 Kerosene Oil 15 Attempted hanging 20 Cut throat wound 3 Railway track 5 Other type of poisons 16 Unknown causes 17
Total 362
Source:- Unpublished article by Dr. Ashraf Ali, M.D.
97
4.3.2.Dr. Ashraf Ali considers suicide as an the end result of
an ‘adjustment disorder’ emanating from stressful events such as
marital problems, financial problems, catastrophic events in life
(such as death of a love object) and substance abuse. Severity of
the ‘stressor’ depends on degree, quantity, duration, reversibility,
personal context, and cultural norms. The stressor can be single
dimensional such as divorce, loss of job etc. or multi-dimensional
such as death of a loved one + loss of job + recurrent physical
illness. It can also be a continuing one such as chronic illness or
poverty. Same stressor can cause different response in different
individuals, depending on family and genetic factors. He has
prepared an outline of how the stressors are working on a person
and culminating in the final act. It is given in figure 4.1 below.
98
Figure 4.1
FLEETING SUICIDAL
THOUGHTS
ABANDON PLAN
SUICIDAL
IDEAS
SUICIDE
PLAN
SUICIDAL COMMUNICATION
STAGE OF COGNITIVE REHEARSAL
FINAL SUICIDAL ACT SUICIDAL
ATTEMPT
He has concluded that in the management of the persons
with such ‘adjustment disorder’ drugs have only minimal role.
Supportive psychotherapy, group therapy in which patients with
similar stressors take part and crisis intervention by Suggestion,
99
Reassurance, Environmental modification, and Hospitalization (in
severe cases), are the methods suggested by Dr. Ashraf Ali.
4.4. Feedback from Suicide Prevention Clinic , Kottayam
4.4.1. The staff of Department of Psychiatry, Medical College
Kottayam, have also done some extremely useful work for the
community, by organizing ‘suicide prevention clinic’ for suicide
attempters, and also arranging awareness classes both for medical
staff and for the people of the affected villages. This was started on
2nd Oct., 2002. Dr.V.Satheesh, Assistant Professor, Department of
Psychiatry has been in charge. It is held each Friday. So far 956
persons have attended the ‘clinic’. They are also organizing
awareness programs for health professionals such as junior
doctors, house surgeons, nurses, nursing students, etc. on
subjects such as ‘causes and prevention of suicide’, ‘alcoholism
and suicide’ etc. Apart from health professionals, such study
classes are held also for non-governmental organizations, youth
organizations, pensioners, police officials, leaders of ‘Kudumbasree’
project, and so on, in various parts of Idukki and Kottayam
districts. So far, 14 such ‘awareness programmes’ have been
conducted. The department of Psychiatry, Medical College
Kottayam have formed an action group named ‘KRISIS’ (Kerala
Integrated Scheme for Intervention in Suicide) with the purpose of
100
sensitization of health professionals and general public regarding
the ‘growing evil of suicide’. They are also sending ‘psychiatric
social workers’ from the Medical College to visit the houses of
alcoholics and other high risk categories in suicide- hit areas for
interaction and socialization with the family.
4.4.2. Analysis of the first 500 cases statistically, revealed
that suicide tendency is seen more in married persons, more in
persons less than 35 years in age (both sexes) and more than 50%
of the affected persons had consumed alcohol. Psychiatric analysis
of the trends revealed, adjustment disorder, depression and acute
stress reaction as the common diagnosis.
Details of classification as per sex revealed that 52.2% were
males and 47.8% were females. Details are given in table 4.3.
Table 4.3 Distribution of Victims as per Sex
Sex Number of Victims Percentage
Male 261 52.2
Female 239 47.8
Total 500 100 [Source : unpublished data from suicide
prevention clinic, Kottayam.]
101
4.4.3. Details of classification as per age revealed that 283
out of the total 500, i.e. 56.6 % are from the age group 18 - 35
years, and 117 persons, i.e. 23.4% are from the age group 36 - 50
years, in short, 80 % are from the productive age groups in the
community. Details of the age groups are given in table 4.4.
Table 4.4
SOCIO ECONOMIC PROFILE
CLASSIFICATION OF AGE - GROUPS
Age Group Male Female Total Percentage
< 12 years 1 2 3 0.60
12 to 17 years 17 44 61 12.20
18 to 35 years 135 148 283 56.60
36 to 50 years 84 33 117 23.40
51 to 65 years 16 10 26 5.20
> 65 years 8 2 10 2.00
Total 261 239 500 100.00 [Source: unpublished data from suicide prevention
clinic, Kottayam.]
4.4.4. Details of education of the victims revealed that 80% of
them had school level education, and 11.8% had completed + 2
level, whereas 5.2% were graduates/post graduates, and only 3.0%
were illiterate. Details are given in table 4.5.
102
Table 4.5
Classification as per Education
Education Level Male Female Total Percentage
Illiterate 8 7 15 3.00
L.P./U.P. School 104 59 163 32.00
High School 119 118 237 47.40
Plus Two 27 32 59 11.80 Graduate / Post Graduate 3 23 26 5.20
Total 261 239 500 100.00 [Source : unpublished data from suicide prevention clinic,
Kottayam.]
Of the 500 persons under study, 63.2% were married
persons, while 36.8% were unmarried. Details are given in table
4.6.
Table 4.6
Distribution as per Marital Status
Category Male Female Total Percentage Married 148 136 284 56.80 Separated / Widow 17 15 32 6.40 Unmarried 96 88 184 36.80
Total 261 239 500 100.00 [Source : unpublished data from suicide prevention clinic,
Kottayam.]
4.4.5. Considering the profession of these persons, it is
significant that163 or 32.6% were unskilled workers, majority of
them males, while 141 or 28.2% were unemployed. This reveals a
strong correlation to the economic condition as motive for the act
103
of attempted suicide. Students formed a segment which cannot be
ignored - 13.2%. Details are given in table 4.7.
Table 4.7
Classification as per Profession
Nature of Profession Male Female Total Percentage
Farmer 15 1 16 3.20 Unskilled labour 138 25 163 32.60 Business 9 3 12 2.40 Skilled worker 54 17 71 14.20 Student 20 46 66 13.20 Unemployed 13 128 141 28.20 Others 12 19 31 6.20
Total 261 239 500 100.00 [Source : unpublished data from suicide prevention clinic,
Kottayam.]
4.4.6. There is wide disparity in the representation of people
belonging to different religions among the attempted cases. Hindus
formed 66.4%, and Christians formed 30.6% of those brought to
the Kottayam Medical College, whereas Muslims were only 3.0%.
When analyzing this data it is to be kept in mind that
demographically, the percentage of Hindus in Kottayam and Idukki
districts of Kerala State is less than 51%, that of Christians is 40 -
45 %, while that of Muslims is 6 – 9%. Therefore the percentage of
Hindus is certainly more, while the same cannot be said regarding
Christians, and the percentage of Muslims is definitely less than
proportionate. Details are given in table 4.8.
104
Table 4.8
Classification as per Religious Faith
Religion Male Female Total Percentage
Hindu 173 159 332 66.40
Muslim 9 6 15 3.00
Christian 79 74 153 30.60
Total 261 239 500 100.00 [Source : unpublished data from suicide prevention
clinic, Kottayam.]
4.4.7.The breakup of urban-rural background as among the
attempted cases revealed that 87.4% were from the rural areas,
and only 2.2% were from the urban areas. This again has to be
seen against the location of Kottayam Medical College away from
the urban centres, and with the ‘feeder Districts’ of Kottayam and
Idukki which are basically having a rural /agrarian background.
Details are given in table 4.9.
Table 4.9
Classification as per domicile
Category Male Female Total Percentage
Urban 4 7 11 2.20
Semi-urban 26 26 52 10.40
Rural 231 206 437 87.40
Total 261 239 500 100.00 [Source: unpublished data from suicide prevention
clinic, Kottayam.]
105
4.4.8. A very significant and useful data revealed in the
analysis of cases which came to the ‘suicide prevention clinic’ at
Kottayam, is, regarding consumption of alcohol. As per the data
collected from 500 patients 50.9% of the male victims had
consumed alcohol at the time of the attempted suicide, and it zero
percent for the female patients. Details are given in table 4.10.
Table 4.10
Consumption of Alcohol by Victims
Category Male Female Total Percentage
Consumed alcohol 133 - 133 26.60
Not consumed alcohol 128 239 367 73.40
Total 261 239 500 100.00 [Source: unpublished data from suicide prevention clinic,
Kottayam.]
4.4.9. It may be mentioned here, that similar trends have
been revealed in the analysis of data in the Survey and also in the
data collected from the attempted suicide cases of Medical College,
Trivandrum.
4.5 WORK DONE by ‘MAITHRI ’ at COCHIN
4.5.1. The organization called ‘Maithri’ described by
themselves as a ‘Link with Life’ started functioning at Kalamassery,
on the outskirts of Cochin city on the 17th June 1995. The Rajagiri
College of Social Sciences gave the initial leadership and support.
106
The service ‘Maithri’ offers is ‘befriending’ – empathetic listening to
the distressed in an atmosphere of respect, trust and confidence.
The principle being strictly followed here is ‘befriending rather than
counseling’. According to the present Director of ‘Maithri’ who has
been associated with its activities right from the beginning, the
persons contemplating suicide are ‘depressed, lonely, desperate
and helpless’ They need someone to talk to, whom they can trust,
and who would keep their problems strictly confidential. At
‘Maithri’ they do not offer any financial help, nor visit to the family
or workplace to ‘solve’ the problems. On the other hand, they listen
to the potential suicide victim, for perhaps several hours, and the
visits may be repeated, and help the person to identify his / her
problems, examine various solutions, analyze pros and cons, and
make their own decisions. The organization do not accept any
grant from Government, there are no paid officials or social
workers, professional counselors, etc. and depend on purely
honorary work put in by selected ‘volunteers’, who are working in
banks, govt. offices, some are teachers, housewives, retired
persons etc. They put in 4 to 6 hours of work at ‘Maithri’ each day
as per a planned work chart, so that round the clock there is
someone to attend to a ‘caller’ who may contact over telephone, or
personal visit. Dr. Lakshmi Vijayakumar, founder Director of
‘Sneha,’ an organization at Chennai doing similar work for the last
107
two decades, selected and trained the first batch of 22 volunteers.
During the last 10 years, as many as 14589 distress calls were
received at ‘Maithri’ .Of these, 9881 calls were received over the
telephone, 2980 by personal visits, and 1728 through letters.
Details of calls attended are given in table 4.11.
Table 4.11
Year Telephone Visit Letter Total
1996 208 145 118 471
1997 1115 145 226 1486
1998 1420 289 377 2086
1999 1015 416 420 1851
2000 1057 486 139 1682
2001 1241 364 198 1803
2002 1117 387 81 1585
2003 1364 356 89 1809
2004 1344 392 80 1816
Total 9881 2980 1728 14589
Source - Decennial Celebrations of 'Maithri' Souvenir - 2005
4.5.2. It is also very significant that on analyzing the data
available with ‘Maithri’ the percentage of persons who visited the
institution reveals that stress and tensions are maximum in the
age groups between 20 and 50 both for male and female. The data
is incomplete, naturally since ‘volunteers’ on duty at ‘Maithri’ who
belong to various professions have collected it from the ‘callers’
108
without any programme of storing and analyzing the data in
future. It is also true that sometimes details such as age may not
have been asked and collected at all. Still, whatever is available is
strongly corroborative of the conclusions thrown up by this study.
The details for the years 2003 and 2004 are given below as table
4.12.
Table 4.12
Age Group of Persons who visited 'Maithri'
Year 15-19 Yrs 20-30 Yrs 31-50 Yrs 51-65 Yrs
Over
65 Yrs
M F M F M F M F M F
2003 1 - 37 46 57 37 7 6 1 -
2004 2 1 53 54 94 49 35 12 - -
Total 3 1 90 100 151 86 42 18 1 0
Grand Total 492
Between 20 - 30 Years (M+F) - 38.6 %
Between 31 - 50 Years (M+F) - 48.2 %
Between 51 - 65 Years (M+F) - 12.2 %
Total males - 58.3%
Total females - 41.7%
Source - Unpublished data from 'Maithri'
4.5.3. It is seen from the table that out of the total number of
492 persons who contacted ‘Maithri’ in the two years, 86.8 % were
109
from the age groups between 20 and 50 years. Of them, 58.3 %
were males and 41.7 % were females. It is also significant that in
the age group 31-50 years, which accounts for the largest group of
237 persons (48.2 % of the total 492) males are 63.7 % and
females are only 36.3 %. This is comparable with the data collected
in the survey, at Chapter – 5, table 5.8, which revealed 68.6 % of
the victims as males and 31.4 % as females.
4.6 STUDY OF ‘ATTEMPTED SUICIDE’ VICTIMS OF
TRIVANDRUM
4.6.1. As a part of this research study, interview was held
with 27 victims of attempted suicide cases in the Medical College
hospital Trivandrum. The interview was held on the dates given
below.
18th April 2006 – 6 persons
25th April 2006 – 7 persons
2nd May 2006 – 6 persons
9th May 2006 – 5 persons
16th May 2006 – 3 persons
The persons interviewed were patients who attended the
‘suicide prevention clinic’ being held in the department of
Psychiatry, of the Medical College, under the guidance of Dr.
Ashraf Ali, Assistant Professor of Psychiatry. Those who were
admitted to the Medical College hospital surgical ward from various
110
parts of Trivandrum and Kollam districts (southern part of Kerala
State) were being referred to the ‘suicide prevention clinic’ each
Tuesday from 11 a.m. onwards, depending on their physical
condition. Most of the persons interviewed were freshly admitted
cases, but there were two cases that deserve a more detailed
discussion.
4.6.2. The first one in which the victim aged 30-35 years, had
made one attempt to commit suicide three years back, the
‘stressor’ being neglect and indifference from husband. She
survived, but made a second attempt on 30th April, 2006, the
relationship with husband being still very strained. When
interviewed, she expressed a mood of hopelessness and despair,
faced with a situation in which neither family, friends nor the legal
system could intervene to bring relief to her. The second one was
that of another lady aged 25-30 years, who had made an attempt
to commit suicide by consuming poison nearly 4 years back. She
frankly admitted that she had suspected her husband to be having
extra marital love affairs. She was under medical (psychiatric)
treatment ever since the ‘attempt’ and regularly visited the ‘suicide
prevention clinic’ for the last 3 years. She said she was now having
a satisfactory marital life, another child was born to them in-
between and ‘domestic quarrels’ which had been the stressor had
111
more or less disappeared. A living witness to the success of the
‘clinic’ run by the department of psychiatry.
4.6.3. Out of the 27 persons interviewed, there were 15 males
and 12 females. Table 4.13 gives details and percentage of sex of
the victims.
Table 4.13
Attempted Suicide - Sex of Victim Sex Numbers Percentage
Male 15 56% Female 12 44% Total 27 100%
Source:- Interview of victims.
It is seen that 56 % were males and 44 % were females.
4.6.4. Details of classification of age of the victim is given in
table 4.14.
Table 4.14 Attempted Suicide - Age of Victim Age Group Numbers Percentage
Less than 15 years 0 0%
15 to 30 years 16 59%
30 to 45 years 8 30%
45 to 60 years 3 11%
More than 60 years 0 0%
Total 27 100% Source: Interview of Victims.
It is significant that 89 % of victims were aged between 15
and 45 years. Due to prompt medical attention so many valuable
lives could be saved.
112
4.6.5. Details of the marital status of the victims is given in
table 4.15.
Table 4.15
Attempted Suicide - Marital Status
Category Numbers Percentage
Married 18 70% Divorced / Separated 0 0
Singled 9 30% Widow / Widower 0 0
Total 27 100%
Source: Interview of Victims.
Suicidal tendencies would appear to be more in the case of
married persons, but such a conclusion need not be true, because,
out of the major group of victims who are in the age group 15 to 45
years, vast majority of them would be married, especially in Indian
conditions.
4.6.6.Educational status of the victims, is given in table 4.16.
Table 4.16
Attempted Suicide - Education
Category Numbers Percentage
School level 24 88% Graduate 1 4% Technical 1 4% Illiterate 1 4%
Total 27 100%
Source: Interview of Victims.
113
The data now brought out is comparable with the details in
Table 5.12 (Chapter- 5) in which the survey revealed that 81 % of
the victims had school – level education and 4.8 % were
graduates.
4.6.7.Data regarding the professions of the 27 victims, is
given in table 4.17.
Table 4.17
Attempted Suicide - Profession
Category Numbers Percentage
Coolie work 11 41%
Business 3 11%
Salaried 8 30%
House wife 3 11%
Unemployed 2 7%
Total 27 100%
Source: Interview of Victims
The data revealed is that 41 % were engaged in coolie work,
whereas 11 % were doing some kind of business. House wives
constituted 11 %. This is comparable with the survey data in
Table 5.11 (Chapter -5), according to which, coolie workers were
43.8 %, those engaged in business were 7.6 % and housewives
constituted 17.1 % of the victims in completed suicides.
114
4.6.8. The religious faith of the victims interviewed, is given
in table 4.18.
Table 4.18
Attempted Suicide - Religious Faith
Religion Numbers Percentage
Hindu 21 78%
Muslim 1 4%
Christian 5 19%
Total 27 100% Source: Interview of Victims.
The data on religious faith is comparable with the details in
Table 5.14 (Chapter -5) according to which the percentage of
Hindus was almost the same – 77.1 and that of Muslims and
Christians was 8.6 and 14.3, respectively.
4.6.9.The income level of those interviewed is given in table
4.19.
Table 4.19
Attempted Suicide - Income level
Category Numbers Percentage
Below Rs.18,000 per annum 24 89%
Between Rs.18,000 to Rs.One
lakh per annum 3 11%
Total 27 100%
Source: Interview of Victims.
115
Most of the victims were from the poor sections of society,
being 89 %. The data revealed in the ‘survey’ is markedly different
in this aspect – as revealed in Table 5.16, according to which, only
50.5 % of the victims were in the income bracket ‘below Rs.18000 /
per annum’ which is nothing but the ‘below poverty line’ group.
Here that group accounted for 89 % of the victims. This is
explained by Dr. Ashraf Ali, M.D. who is in charge of the ‘suicide
prevention clinic’ as due to the reason that, the patients who are
admitted to the Medical College hospital are, almost all, or at least
vast majority of them, from the poor sections of the people. Those
who can afford private hospitals would prefer to be admitted there,
especially in cases of attempted suicide for reasons of privacy.
Hence, those who attend the ‘suicide prevention clinic’ are mostly
from the ‘below poverty line’ sections of the population.
4.6.10.The interview revealed the alcohol consumption habits
of the victims as given in table 4.20.
Table 4.20 Attempted Suicide - Consumption of Alcohol
Category Numbers Percentage
Daily 1 4%
Often 4 15%
Sometimes 6 22%
Never 16 59%
Total 27 100%
Source: Interview of Victims.
116
This is comparable with the survey data given in Table 5.23
(Chapter- 5). According to which, those who used to drink daily
were 31.4 %, while in the case of attempted suicide it is only 4 %.
The percentage of those who used to drink ‘often’ and ‘sometimes’,
added was 26.6 % in the case of completed suicides, while it was
37 % in the case of ‘attempted’ suicides. This may mean that the
hard drinkers went to ‘the point of no return’, while in the case of
less acute alcoholism, the body could recover and life was saved.
4.6.11.Details of financial position revealed by those who
were interviewed, is given in Table 4.21.
Table 4.21
Attempted Suicide - Financial Position
Category Numbers Percentage Good 11 41%
Unable to repay loans 6 22%
In difficulty 10 37%
Total 27 100%
Source: Interview of Victims.
Financial problem is cited as the stressor in the case of 59 %
of the victims, while to 41 % that was not the causative factor, and
financial position was ‘good’. This is comparable with the survey
data in Table 5.32 (Chapter- 5) according to which, 43.8 % of the
victims were in financial difficulty, and 38.1 % reported finance as
‘good’.
117
4.6.12.Coming to the analysis of causes, data collected in the
interview, is given in Table 4.22.
Table 4.22
Attempted Suicide - Causes
Category Numbers Percentage Economic Problems 8 30%
Domestic quarrels 14 52%
Scolding by relatives 2 7%
Unable to repay loan 1 4%
Neurotic 1 4%
No specific cause 1 4%
Total 27 100%
Source: Interview of Victims
Domestic quarrels dominated the causative factors, with 52
%, followed by economic factors, 34% (‘economic problems’ +
‘unable to repay loans’). Comparing with the survey data, (Figure
5.6) it is seen that, economic factors caused 33.3 % of the
incidents, while domestic quarrels contributed 24.5 %. But as we
have seen already, rather than any single cause, it is often a
combination of multiple causes that lead to the fatal decision.
4.7. A Note on SUICIDE CASES of WAYANAD District
4.7.1.Incidents of suicide cases of Wayanad district have
been sensationally reported in the local as as well as National
media in recent times. According to some reports, it is a glaring
example of the evil effects of globalization, destroying the
118
agriculture based economies of third world countries. Having
considered that a study on suicide cases of Kerala will not be
complete without at least a glimpse on the Wayanad situation, this
researcher has collected some data on the incidents of suicide
reported in Wayanad district during the year 2004. Total number
of incidents of suicide in the year is 302, and the rate per lakh
population is 38.37. The rate for Kerala State is 28.43 for the same
year. Hence it is clear that the rate of suicides in Wayanad district
is much above the State average. Some other important aspects of
the problem in Wayanad are given below in table 4.23 to 4.25
Table 4.23
Year 2004 – Distribution of suicide cases by Profession
Type of Profession Number of victims of
suicide
Percentage of Victims
Daily Wage Worker 129 42.72%
Salaries Persons 4 1.32%
Agriculture 65 21.52%
Unemployed 43 14.23%
Housewife 47 15.57%
Student 12 3.98%
Others 2 0.66%
Total 302 100%
Source: District Crime Records Bureau, Wayanad
119
4.7.2.It is revealed from the data that 42.72 percent of the
victims were daily wage earning persons, and 21.52 percent
dependent on agriculture. Industrial development in the district
being very little, both these groups are agriculture -based classes.
Hence total 64.24 percent of the victims were from the primary or
agriculture sector. Unemployed persons formed 14.23 percent.
This situation is even more lucidly brought out in table 4.24
Table 4.24
Year 2004 – Distribution of Suicides by Annual Income of Victim
Income Bracket Number
of Victims
Percentage of Victims
Below Rs.18000/- per Annum 242 80.13%
Rs.18000/- to Rs.One Lakh per annum 60 19.87%
Above Rs.One Lakh per Annum - -
Total 302 100%
Source: District Crime Records Bureau, Wayanad
4.7.3.From the above data it is clear that 80.13 percent of the
victims belonged to the economically lowest category of ‘below
poverty line’. Perhaps in no other district of Kerala such a situation
may be seen.
Analysis of causes of suicide is revealed in table 4.25
120
Table 4.25
Year 2004 – Distribution of Suicides by Causes
Type of Cause Number of
Incidents of Suicide
Percentage of Victims
Prolonged illness 29 9.68% Domestic quarrel 116 38.42% Financial difficulties 40 13.25%
Insanity/Mental Illness 28 9.27% Bankruptey or sudden change in economic status
33 10.93%
Other causes 56 18.54% Total 302 100%
Source: District Crime Records Bureau, Wayanad
4.7.4.‘Domestic quarrels’ is the single largest cause of suicide
in this district, followed by ‘financial difficulties’. Adding together
‘bankruptcy or sudden change in economic status’ to ‘financial
difficulties’ the total percentage is 24.18. The total picture that
emerges from the above analysis is one of a grave situation. In the
succeeding year of 2005 also, the number of suicides in the district
has only gone up to 320 from 302, pointing a finger at the lack of
corrective steps from the government as well as voluntary agencies.
4.8. A Note on the ‘KUDUMBASREE’ Project
4.8.1.The Government of Kerala launched the ‘Kudumbasree’
Project on 17th May 1998, with the motto – “Reaching out the
families through women and reaching out the community through
121
families”. The avowed aim of the project is to eradicate absolute
poverty within a period of ten years. This is to be achieved through
concerted community action under the leadership of local self-
governments. Empowerment of women is a major concern and
prime priority activity for this mission. As part of its poverty
eradication mission it has established ‘Neighbourhood Groups’ and
‘Self Help Groups’ for women all over Kerala State.13
4.8.2.The Neighbourhood Group consists of 20-40 women
members selected from poor families who live in a nearby location.
They conduct weekly meetings, discussions, and participate in
planning and implementation of socio-cultural and developmental
activities. Thrift and credit operations and micro enterprises
enhance the economic status of members inside the family and in
the community at large, and build up their confidence. Income
generation activities are executed by one ‘volunteer’ by collecting
small but regular savings from members, which is then pooled
together. Another ‘volunteer’ convenes various programmes
undertaken by the Health and Family Welfare and Social Welfare
Department of the State government. Training to the ‘volunteers’ is
imparted by the NABARD for increasing their capability. Ten to
fifteen Neighbour hood Groups have a federation called an Area
13 'Women Empowerment – A Conceptual Analysis', Dr. Kochurani Joseph,
Vimala Books and Publications, Kanjirappally. Kerala, 2005. p.59.
122
Development Society. At present there are 8667 Thrift and Credit
Societies operating in 58 towns and 143983 such societies in the
rural areas – 991 Gram Panchayaths.14
4.8.3.‘Self Help Groups’ are voluntary groups which are
formed for working as micro finance units through mobilization of
savings and providing loans to met the urgent credit needs of its
members. The idea of SHG originated in Bangladesh by Prof.
Muhammod Yanus of Chittagong University. They are formed by
patient and painstaking community work by non-governmental
organizations. The Neighbourhood Groups are also SHGs, but
termed as NHGs when they are formed under the ‘Kudumbasree’
Projects.15
Having discussed various aspects of the psychological factors
that contribute to suicides, and analysis of the causative factors by
experts in psychiatry and social work, now it is time to examine the
findings and conclusions of this study.
**** **** **** ****
14 ibid, p.63. 15 ibid, p.74.
