Symposia
Global Mental Health
Vaishali V. Raval, Ph.D.
Professor
Miami University
Oxford, Ohio
Vaishali V. Raval, Ph.D.
Professor
Miami University
Oxford, Ohio
Bency Joy, PhD
Instructor
Andaman Nicobar High schools
Port Blair, Andaman and Nicobar Islands, India
Baiju Gopal, PhD
Associate professor
Christ University
Bengaluru, Karnataka, India
Christopher Sutter, PhD
Associate Professor
Miami University
Oxford, Ohio
Nikhil Singh, PhD
Graduate student
Miami University
Oxford, OH
Cameron Hay, PhD
Professor
Miami University
Oxford, Ohio
In India, the Andaman and Nicobar (A&N) Islands, one of the seven union territories of India located 1200 kilometers away from the mainland, have among the highest rates of suicide nationally and lack of available health care services to prevent them. Specifically, 28.9 individuals per 100,000 die by suicide on these islands in comparison to the national rate of 10.6 and the global rate of 11.4 individuals per 100,000 (WHO, 2014). These islands provide a unique context to explore trajectories of suicide and the feasibility of possible solutions to prevent suicide in a resource-limited setting. In this study, we aimed to explore factors that trigger suicide and which potential solutions for suicide prevention may be feasible in the local context. To address this aim, we interviewed 10 key stakeholders from Port Blair, the capital of A&N Islands (youth who attempted suicide, peers, medical providers, educators, and religious leaders).
Qualitative thematic analysis of interview data indicated that suicide on the islands needs to be understood within historic, as well as current sociopolitical, economic, and geographic contexts. The historic context of oppression, cruelty, and displacement during the British rule in India and the use of the islands to imprison Indian freedom fighters provides a backdrop for the current sociopolitical climate. Because migrants on the islands come from different states of India, there is low community cohesiveness with poor systems for social support. Employment prospects seem limited for young adults as many small businesses are owned by “outsiders” and a finite number of salaried positions. Within this social and economic context, many young adults struggle with a lack of purpose in life, difficulty coping with perceived rejections or failure in romantic relationships, family conflict, academic failures, and uncertainty about future occupation. These difficulties contribute to mental health problems more generally and suicidal behaviors specifically. Within the healthcare system on the islands, infrastructure for mental health is lacking, such that a suicide crisis hotline could not be sustained. Stakeholders shared that traditional mental health approaches (e.g., a counseling center or a clinic) may be less helpful compared to approaches that raise community awareness (e.g., street theatre), or train teachers and peers in suicide prevention. Overall, our findings have implications to inform suicide prevention efforts in resource-limited settings around the world.