(This story is from The Quint's archives. It was republished in the context of a 16-year-old girl dying by suicide in Kerala.)
Suicide unfortunately has become a common endpoint for many adolescents and young adults today; and the trends indicate that the problem is consistently rising with every passing year. India is considered to be the ‘global capital for suicide’ with the maximum suicide rates anywhere in the world (nearly 17%). Way back in 2013, suicide was already identified as the leading cause of death among 15-24 years old in India.
There has been a global increase in the suicide rates among teenagers, with a US report in 2020 showing a 57.4% rise from 2007 to 2018. In India, the NCRB data has been showing a consistent increase in annual suicide rates among the youth, such that 10,159 students died by suicide in 2018.
Roughly every hour one student commits suicide in India.
These numbers coincide closely with the increasing availability and access to digital media and internet use among teenagers and youth. More than half the teenagers above 15 years now own a smartphone device.
With the advent of COVID and unprecedented lockdown, most children have transitioned online for classes as well as recreation in the ‘new normal’. This has led to a surge in sanctioned access to gadgets among children as young as 3 years. Hence, an indirect correlation does exist between excessive technology use, ‘digitalization of lives’ and suicide rates.
The statistics mentioned here are not to spread fear but to portray the stark reality of how the productive workforce of Indian population is vulnerable to the social evil of suicide and what we can do about it.
Pros and Cons of Life in the Digital Lane
Research indicates that there are two sides of the coin and we need to have a balanced view about the impact of the internet and social media on the mental health of adolescents. Pew Research explored the opinions of teens on their use of social media and found that 31% adolescents find social media a great tool for communication, expressing sexuality and identity, accessing information, and exploring interests. It is an important source of fostering a sense of community among teenagers, which is particularly relevant in the current times.
It is important to note that these effects change when you examine how a child is using social media, and how often.
As psychiatrists, we find a strong association between increased screen-time and poor mental health, especially in children who access social media for two or more hours daily for non-academic purposes.
The most common causes for emotional distress and mental health issues arise as a result of disruption of routine life, sleep disturbances, cyberbullying and victimisation. Adolescents are more vulnerable to an impact on their self-esteem due to a constant pressure to tailor content for popularity, boost physical appearances, and project parts of their life which are socially acceptable or superior to others. These influences can create unrealistic expectations of their looks, body image, comparing social status and life position, which in turn leads to indulgence in high risk and impulsive behaviours including self-harm and suicide.
Individual personality traits which can increase the risk include poor ability to handle rejection and failure, need for instant gratification, and craving for a sense of achieving or exceeding at an activity.
Digital exposure provides freedom of expression and anonymity but has the risk of a never-ending vicious cycle of “need to please” and “need to be informed”. What can be the best example but COVID to teach us that misinformation snowballed through social media is as dangerous as the virus itself!
This is one of the reasons we often hear about a cluster of suicides in children and adolescents, secondary to seemingly trivial triggers such as an online game challenge or a negative comment on a social media post. It directly hurts the self-esteem and sense of belonging, which are easily hijacked by the virtual world in absence of a real time social circle.
Is Social Media Use Leading to Mental Health Issues or the Other Way Round?
We need to acknowledge that simply the use of social media is not sufficient to increase the risk of suicide. It is usually true that children who tend to spend more time with gadgets are also more likely to be experiencing conflict at home or at school, bullying, may be socially isolated and be suffering from anxiety or depression. These children often face difficulties with unmet emotional needs of connectedness. The perceived ‘void’ of friendships and care in daily lives tend to get overcompensated by a ‘virtual’ world, where connections and contacts are just at the fingertips.
Adolescents who engaged in suicidal behaviour have been found to have spent more time searching the internet for suicide related topics or methods in previous weeks. They were also more likely to be posting more negative content online. Adolescents tend to get influenced by internet posts which cover stories on high-profile suicides and deaths. There have been examples of the same even last year after the alleged suicide of a Bollywood celebrity.
Protective factors against suicide include getting support and encouragement from social media; feeling connected to friends; social engagement or encouragement to participate in social interaction; and personal expression or ability to speak freely. Many times, in introverted persons, social media can boost identity, confidence and abilities in more ways than one.
How Do We Change the Youth Suicide Graph for Better?
Attempts at suicide are often the culmination of an interplay of various factors including mental health of the adolescent, social influences and support. An automatic linkage of all suicides to “mental health issues” neglecting the social and environmental triggers is reductionistic and harmful, at its best.
Even though no study so far has been conclusively able to state the role of social media in suicides, it definitely seems to be an important factor which influences the thoughts and opinions of youngsters today. Digital platforms have helped bridge gaps and made people more accessible to the other. Each of us shares a responsibility about what opinions we put out and how it may influence another person.
It is vital to create a supportive environment which encourages two-way communication with adolescents. Reprimanding adults are less likely to earn the trust of teenagers. Parents and teens should be open about their amount and type of media they're using, so that they can look out for warning signs, talk about worsening mood and reach out for help.
Setting time-limits is very useful- limiting use to less than two hours per day, not using electronic media after a certain time at night and not using it during specific activities (such as mealtimes, during family activities etc.). Educating adolescents about internet etiquettes- the ‘do’s and don’ts’ of the internet world is an important part of communication. Also, senseless forwards need to be avoided with the help of authentic sources of information. This fights misinformation-induced panic.
Certain children may be at higher risk and need closer supervision. Adolescents who tend to be heavy users of gadgets are also more likely to be emotionally sensitive, withdrawn, or may experience bullying or abuse at home or school. Simple gestures such as a pat on the back, a warm hug, a handshake, a huddle or a smile (with social distancing) can reinforce a sense of belonging which is otherwise lacking.
The pandemic with the “new normal” has been an eye-opener. This World Suicide Prevention Day let us count on the lives of the youth by advocating ‘digital balance’ as a public health measure besides social distancing.
Every life is worth saving!
(Dr Vandana Shetty is a Consultant Psychiatrist with Mind Body Clinic, Bengaluru, Dr Debanjan Banerjee is a Consultant Geriatric Psychiatrist in Kolkata)
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