|Year : 2020 | Volume
| Issue : 3 | Page : 294-295
The economic burden of attempted suicide
Nidal Ammanullaha1, Vedavathi Gowda2, Vinod Patel2, M Kishor1
1 Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
2 Department of Psychiatric Social Work, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
|Date of Submission||21-Jan-2020|
|Date of Decision||07-May-2020|
|Date of Acceptance||16-Apr-2020|
|Date of Web Publication||28-Jul-2020|
Dr. M Kishor
Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka
Source of Support: None, Conflict of Interest: None
Suicide is major concern in India, 1,34,516 people committed suicide in 2018 according to National Crime Records Bureau. There are many causes for Suicide and one of the treatable causes is Depression. Burden of non -communicable diseases are rising in India, particularly chronic diseases & injuries that includes suicides. Although economic impact of suicide is reported, there is scarcity of economic cost of suicide attempt in Indian context. Here we report a case report to estimate the economic cost of attempt on life, managed at tertiary care hospital.
Keywords: Suicide, Suicide attempt, economic burden of mental health conditions
|How to cite this article:|
Ammanullaha N, Gowda V, Patel V, Kishor M. The economic burden of attempted suicide. Int J Health Allied Sci 2020;9:294-5
|How to cite this URL:|
Ammanullaha N, Gowda V, Patel V, Kishor M. The economic burden of attempted suicide. Int J Health Allied Sci [serial online] 2020 [cited 2020 Sep 30];9:294-5. Available from: http://www.ijhas.in/text.asp?2020/9/3/294/290708
Suicide is a major concern in India; a total of 134,516 people committed suicide in 2018 according to the National Crime Records Bureau. There are many causes for suicide, and one of the treatable causes is depression. Depression accounts for huge burden in terms of morbidity and mortality. Depression is one of the common psychiatric disorders which are also leading cause for years lived with disability.
Disability-adjusted life years (DALY) of unipolar depressive ranks first among all mental disorders with 65.5, 10.0, and 55.5 (DALYs in millions) for the worldwide data, for high-, low-, and middle-income countries, respectively. The global cost of mental illness for the year 2010 was around US$ 2.5 trillion and for the year 2030, it is estimated that the global cost of mental illness will be US $6 trillion.
The burden of noncommunicable diseases is rising in India, particularly chronic diseases and injuries (that include suicides). In a cost–outcome study carried out in India and Pakistan to demonstrate the cost of mental health care, in India, Rs. 700 per month was the overall cost at baseline for treating common mental health disorder, making indirect cost more than the direct cost. Direct costs are costs for medication, clinical visits (fees), hospitalization, diagnostic services, residential expenses, and community services. Indirect costs are costs for unemployment, poor educational attainment, homelessness, and medical complication.
Lethal suicide attempts consume more money for offering emergency treatments than nonlethal attempt, and it is estimated that the cost of one nonlethal attempted suicide is Rs. 10,000 per person and for lethal attempt, it is estimated to be around Rs. 100,000., There is scarcity of economic cost of suicidal attempts in the Indian context. Here, we report a case report to estimate the economic cost of attempt on life managed at a tertiary care hospital.
Mr. BK, aged 23 years, an unmarried man, agriculturist hailing from a nuclear family of lower socioeconomic strata, and residing at a rural area near Mysuru, reported to the psychiatry department for follow-up after consumption of a pesticide 3 weeks ago. He had been admitted at a tertiary care hospital for attempt on life and was treated symptomatically. The patient was admitted in the intensive care unit (ICU) for 20 days and was intubated. Subsequently, he was shifted to the ward on day 21 after admission.
With informed consent, he was interviewed at the psychiatry outpatient department; Mr. BK was found to have financial liability of Rs. 200,000 which he had deposited at a financial institution that closed down with less chance of recovery. He reported to have persistent and pervasive sadness and marked anhedonia, with sleep and appetite disturbances for the past 2 months. He was having death wishes on and off for the past 1 month. He consumed a bottle of pesticide (50–100 ml of pyridalyl) at home in the morning at around 11.30 a.m. and an hour later, his mother saw him lying on bed tired. He informed his mother about the attempt and was taken to the hospital within 2 h. He expressed remorse for the act while interviewing him. His mood was low and objectively depressed at the interview. He had no past history of suicidal attempt or psychiatric illness. There was no family history of suicide or psychiatric illness. He had not written suicide note or informed any one prior to the act. Cognitive assessment in the mental state examination could not be done as he was extubated from tracheostomy. A diagnosis of severe depression without psychotic symptoms with intentional self-harm according to WHO ICD-10 was made, and he was started on tablet sertraline 100 mg/day and tablet clonazepam 0.5 mg at night. He was further referred to clinical psychology and psychiatric social work for further management.
Upon inquiry his expenses following hospital admission such as Intensive Care Unit (ICU) charges, laboratory charges and medication charges were calculated. The total expense. The total expense on day 30 was Rs. 475,000. The ICU cost was around Rs. 170,000. The medication, laboratory investigation, and ward expense was little more than Rs. 300,000. The cost estimate on the earning loss of the patient because of his hospitalization or other costs involving the caregiver was not included.
Depression is a common psychiatric disorder and suicidal attempt has a huge impact on the financial resources of a person. This case report highlights the economic cost of suicidal attempt. More systematic studies are needed to understand the economic burden of suicidal attempts in India so that more effective strategies are initiated to prevent suicide and reduce the economic impact.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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