Stress Among the Medical Students

In Context

• A recent Right to Information (RTI) response from the National Medical Commission (NMC) said that 64 MBBS and 55 postgraduate medicos died by suicide in the last five years.

About

• According to a study, 358 suicide deaths among medical students (125), residents (105) and physicians (128) were reported between 2010 and 2019. 
• Concerned over the incidents of suicide and suicidal ideation among medical students, the NMC, India’s apex medical education regulatory authority, late in 2022 asked all medical colleges in the country to compile data on suicides.
• The risk of suicide among doctors is almost 2.5 times more than the general population.
• Suicide and self-harm are a major health and societal issue worldwide, with the greatest burden occurring in low-income and middle-income countries.

Reasons for Suicide among Medicals

• Suicide is a complex, multifactorial issue. The gruelling 24×7 shifts, untimely working hours, distance from family, hostile work environment and unsupportive administration, sleep deprivation, financial hardships, examination stress, inhumane ragging sometimes, confounded by caste-based discrimination and regionalism are some of the hardships that student doctors face.
• Lack of implementations of rules, safeguards, and support systems  in almost all medical colleges.
  • For instance, the NMC has an anti-ragging committee that monitors complaints, still lack of effective implementation is a concern.
• The transition to university coincides with a critical developmental period characterised by individuation and separation from family, development of new social connections, and increased autonomy and responsibility. At the same time, the brain is undergoing accelerated development and is at heightened sensitivity to risk exposures commonly encountered by university students including psychosocial stressors, recreational drugs, alcohol binging, and sleep disruption.

What is Suicide?

• Suicide is when people harm themselves with the goal of ending their life, and they die as a result.
• A suicide attempt is when people harm themselves with the goal of ending their life, but they do not die.

Data on suicide deaths in India

• In India, more than one lakh lives are lost every year to suicide, and it is the top killer in the 15-29 years category. 
• In the past three years, the suicide rate has increased from 10.2 to 11.3 per 1,00,000 population, the document records. 
• The most common reasons for suicide include family problems and illnesses, which account for 34% and 18% of all suicide-related deaths.

Rise in Suicide cases

• The rate of suicide attempts in India has been increased in this pandemic situation, people lost their jobs, many are stuck somewhere alone for months and the emotional and psychological factors of a pandemic leads to the risk of suicide by feelings of hopelessness.

Reasons for Suicide

• Family Problems (other than marriage related problems)
• Marriage Related Problems
• Illness

Legal status of Suicide in India

• Section 309 IPC:  Section 309 of Indian penal code states that the “Whoever attempts to commit suicide and does any act towards the commission of such offence shall be punished with simple imprisonment for a period which may extend to one year”.
  • Attempt to commit suicide is no more a crime under section 309 of IPC in India. Article 21 of the constitution states that to quote “No person shall be deprived of his life or personal liberty except according to procedure established by law”. Article 21 does talk about the right to life but no article talks about “Right to die”.
• The Law Commission has twice, in 1971 and 2008, recommended the repeal of IPC Section 309.

Government of India Initiatives 

• Mental Healthcare Act, 2017: It was passed in 2017, came into effect in May 2018 and replaced the Mental Health Act of 1987. The act decriminalised suicide attempts in India.  It also included WHO guidelines in the categorisation of mental illnesses.  It also restricted the use of electroconvulsive therapy (ECT), and banned its use on minors, finally introducing measures to tackle stigma in Indian society.
• Manodarpan Initiative: It is an initiative under Atmanirbhar Bharat Abhiyan. It aims to provide psyho-social support to students for their mental health and well-being.
• National Suicide Prevention Strategy: Recently the Ministry of Health and Family Welfare announced a National Suicide Prevention Strategy. The suicide prevention policy comes with time-bound action plans and multi-sectoral collaborations to achieve reduction in suicide mortality by 10% 2030.

Way Ahead 

• Given that suicide is a complex issue, tackling it will necessarily require inter-sectoral collaboration. Intervention from students and parents also need to be considered. 
• The universities should take a lead role in developing an “integrated system of student mental health care”.

Source: TH