Sikkim unveils inclusive mental health strategy amid alarming suicide rates

Sikkim has prepared a new strategy to address mental health issues through a fresh study and a bottom-up approach under the Sikkim Integrated Service Provision and Innovation for Reviving Economic Program (Sikkim-INSPIRES) action plan, in technical collaboration with the Centre for Mental Health Law and Policy (CMHLP), Indian Law Society, Pune.

Programme Director Sikkim INSPIRES Planning & Development Department, Rohini Pradhan, opened the briefing by revisiting the launch of the state’s first localised mental health strategy on May 16 she said Government of Sikkim under the aegis of Sikkim-INSPIRES has come up with the action plan after one year of study and research.

Earlier, it was handled by the health mainly sees as health issue and only health department was taking action but now after our study we have found this is social problem it needs to be handle societal level so we have now action plan which will be the bottom up approach instead of top down approach and now all the stakeholders were also discussed and we have come up with the inclusive action plan which will roll on in phase wise.

She emphasised that the briefing was intended to convey the process behind the development of the strategy and shed light on the pressing need for evidence-based and economically grounded interventions. She expressed concern over the alarming suicide rates in the state, especially among the youth, and pointed out the absence of a robust economic safety net for citizens.

A pan-state baseline survey had been undertaken in technical collaboration with the Centre for Mental Health Law and Policy (CMHLP), Indian Law Society, Pune, she noted, adding that the strategy now seeks to translate these insights into actionable and sustainable programmes.

She further reiterated the State Government’s commitment and reaffirmed the prioritisation of mental health through evidence-based and inclusive policymaking under the able leadership of Chief Minister Mr Prem Singh Tamang.
 
District Collector Namchi, Ms Anupa Tamling, shared that Namchi district would initiate community-level interventions on a pilot basis immediately as the entire project is now under action.

She informed that preliminary workshops had already been conducted with district-level stakeholders, and the community was prepared to engage openly in conversations around mental health, seek help, and break the stigma associated with it.

She further stated that key stakeholders are ensuring the inclusion of rural areas in the initiative. The intervention is expected to roll out in the first week of June, she added.

Programme Director CMHLP Pune, Mr Arjun Kapoor, described the strategy as a landmark document, built on consultations with diverse stakeholders. He said its vision is to promote the mental well-being and prosperity of the people of Sikkim through an integrated, multi-sectoral approach.

He highlighted the six strategic priority areas the document focuses on—ranging from service delivery and suicide prevention to research and employment.

The strategy has six area of action which was developed with consultation with various stakeholders both government and non government including civil society and based on their insight and suggestion and first action will be strengthening leadership in government sectors and coordination between different department and their roles and the idea behind this is mental health is not just a health issue it is development  issue it is a right issue and if we have to tackle this it need to address jointly together and second area is community based mental health awareness like panchayats, teachers police and so many other stakeholders third is to promote mental health issue in society for the awareness reason through various means fourth suicide prevention interventions and last Sikkim is different state geographically also and more data is needed to understand  further planning special action after understanding the scenarios or setting. He also shared reliable data on suicide is still a concern but we are working on this too and we will further research for the interventions. 

Must tell, in 2022, the National Crime Records Bureau (NCRB) reported a total of 1,70,924 deaths by suicide (nationally) with Sikkim having the highest rate of suicide of 43.1 (number of suicides per 1,00,000 population) in comparison to the national suicide rate of 12.4 per 1,00,000 populations. This was the highest rate recorded in India in over 56 years.

Since 2008, Sikkim has consistently reported the highest suicide rates among all states in India. However, this high rate may also be attributable to Sikkim's small popu-lation, among other factors. NCRB reports attribute nearly 75% of suicides to singular causes. However, suicides do not occur in isolation and are often a result of extreme distress caused by an inter-play of various factors in a person's life such as unemployment, substance use, financial issues, relationship problems,physical/emotional/sexual abuse etc

In 2022, Sikkim's unemployment rate for youth (aged 15-29) was at 13% in comparison to the national average of 29%. However, 27% of youth suicides (aged 21-30) were due to unemployment. Sikkim also has high prevalence rates of opioid use (more than 10%), and cannabis use (2.9%) in comparison to the rest of India. There is also a high preva lence of mental health conditions such as bipolar disorder and eating disorders in Sikkim³.

While there are high rates of suicides and mental health concerns in India and Sikkim, the treatment gap (percentage of people who require treatment but do not receive the same) remains as high as 86% 10. While estimates suggest that there are 2.3 psychiatrists per 1,00,000 population in Sikkim, the state lacks other trained mental health profes sionals such as psychologists or psychiatric social workers".

In India, mental health is approached through a predominantly biomedical model, with an excessive focus on diagnosis and curative treatments through medication by mental health professionals. Closing the mental health care gap in India and in Sikkim requires a shift from the biomedical model to a biopsychosocial model, addressing the need to look at mental health inclusive of both health and social-care related outcomes, focusing on also addressing the social determinants of mental health and suicides.