Home Print this page Email this page
Users Online: 328
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
CASE REPORT
Year : 2020  |  Volume : 9  |  Issue : 3  |  Page : 294-295

The economic burden of attempted suicide


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 Submission21-Jan-2020
Date of Decision07-May-2020
Date of Acceptance16-Apr-2020
Date of Web Publication28-Jul-2020

Correspondence Address:
Dr. M Kishor
Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_12_20

Rights and Permissions
  Abstract 


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 23];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.[1]

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.[2] 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.[3]

The burden of noncommunicable diseases is rising in India, particularly chronic diseases and injuries (that include suicides).[4] 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.[5] 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.[6]

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.[7],[8] 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

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Investing in Mental Health. Available from: http://www.who.int/mental_health/media/investing_mnh.pdf. [Last accessed on 2020 Jan 18].  Back to cited text no. 1
    
2.
Collins PY, Patel V, Joestl SS, March D, Insel TR, Daar AS, et al. Grand challenges in global mental health. Nature 2011;475:27-30.  Back to cited text no. 2
    
3.
Bloom DE, Cafiero ET, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The Global Economic Burden of Non-Communicable Diseases. Geneva: World Economic Forum; 2011.  Back to cited text no. 3
    
4.
Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C, et al. Chronic diseases and injuries in India. Lancet 2011;377:413-28.  Back to cited text no. 4
    
5.
Chisholm D, Sekar K, Kumar KK, Saeed K, James S, Mubbashar M, et al. Integration of mental health care into primary care. Demonstration cost-outcome study in India and Pakistan. Br J Psychiatry 2000;176:581-8.  Back to cited text no. 5
    
6.
Hu TW. Disease Control Priorities Project. Working Paper No. An International Review of the Economic Costs of Mental Illness, 31 October; 2004. Available from: http://www.dcp2.org/file/45/wp31.pdf. [Last accessed on 2020 Jan 18].  Back to cited text no. 6
    
7.
Kinchin I, Doran CM. The economic cost of suicide and non-fatal suicide behavior in the Australian workforce and the potential impact of a workplace suicide prevention strategy. Int J Environ Res Public Health 2017;14:347.  Back to cited text no. 7
    
8.
Shepard DS, Gurewich D, Lwin AK, Reed GA Jr., Silverman MM. Suicide and suicidal attempts in the United States: Costs and policy implications. Suicide Life Threat Behav 2016;46:352-62.  Back to cited text no. 8
    




 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
References

 Article Access Statistics
    Viewed66    
    Printed0    
    Emailed0    
    PDF Downloaded14    
    Comments [Add]    

Recommend this journal