Why do people attempt suicide? A mixed methods research from South India


  • Punithakumary Purushothaman Department of Community Medicine, PSG Institute of Medical Science and Research, Coimbatore, Tamil Nadu, India
  • Kariyarath Cheriyath Premarajan Department of Preventive and Social Medicine, JIPMER, Pondicherry, India
  • Jayalakshmy Ramachandran Department of Preventive and Social Medicine, JIPMER, Pondicherry, India
  • Susila Thangaraj Department of Community Medicine, Stanely Medical College, Coimbatore, Tamil Nadu, India




Suicide, Suicidal ideations, Attempted suicide, Mixed methods research, South India


Background: Every 40 seconds a person dies by suicide. Suicide is the second leading cause of death among young people 15-29 years of age, globally. In India, there is an increasing trend of suicide from 10.4 per lakh in 2003 to 10.9 per lakh in 2009.

Methods: A (QUAN – QUAL) sequential explanatory design was used. Among 200 patients admitted for attempted suicide in JIPMER and Indira Gandhi Government Hospital and Post Graduate Institute Pondicherry were assessed for the reasons for attempting suicide using a semi-structured questionnaire. For a subsample of 40 (20%) In-depth interview was done to explore and understand the reasons and the undermined situation associated with attempted suicide at their residence.

Results: Among the study subjects (n=200), mean (±standard deviation) age of suicide attempt was 26±9.1 years. Commonest reason for attempting suicide was verbal abuse, most often by parents (31.9%). Other precipitating factors were physical abuse, illness, marital conflict, family related problem, etc. On IDI, it was found that there were several factors like, background factors, aggravating, and protective factor. A conceptual diagram was generated depicting the imbalance between the protective and aggravating factors acting on the background factors before the execution of a suicide attempt.

Conclusions: There is lot of scope to reduce the suicidal attempts in our country. Opportunistic screening should be done to identify any psycho-social issues among patients attending OPD. Strong social support and enabling environment should be provided for counselling individuals with suicidal ideation and intentions.


World Health Organization. 2014. Preventing suicide global imperative. Available at: https://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng.pdf?sequence=1. Accessed on 3 March 2019.

WHO. Suicide Prevention: Emerging from Darkness. Facts and Figures. Mental Health and Substance Abuse. 2006. Available at: http://www.searo.who.int/en/Section1174/Section1199/Section1567/ Section1824_8081.htm. Accessed on 3 March 2019.

Crime in India. National Crime Record Bureaue. Ministry of home affairs. Govt of India. East block-7, R.K Puram, New Delhi, 2009.

Suicides in India, Chapter 2. Available at: http://ncrb.gov.in/ADSI2010/Suicides-10.pdf. Accessed on 3 March 2019.

World Health Organization. World Health Report. Mental Health — New Understanding-New Hope. Geneva: WHO; 2001.

Bertolote JM, Fleischmann A, Butchart A, Besbelli N. Suicide, suicide attempts and pesticides: A major hidden public health problem. Bull Word Health Organ. 2006;84:840.

Maselko J, Patel V. Why women attempt suicide: The role of mental illness and social disadvantage in a community cohort study in India. J Epidemiol Community Health 2008;62:817-22.

Das PP, Grover S, Avasthi A, Chakrabarti S, Malhotra S, Kumar S. Intentional self-harm seen in psychiatric referrals in a tertiary care hospital. Indian J Psychiatry. 2008;50:187-91.

Chowdhury AN, Banerjee S, Brahma A, Das S, Sarker P, Biswas MK, et al. A prospective study of suicidal behaviour in Sundarban Delta, West Bengal, India. Natl Med J India. 2010;23:201-5.

Chandrasekaran R, Gnanaseelan J, Sahai A, Swaminathan RP, Perme B. Psychiatric and personality disorders in survivors following their first suicide attempt. Indian J Psychiatry. 2003;45:45-8.

Narang RL, Mishra BP, Mohan N. Attempted suicide in Ludhiana, Indian J Psychiatr. 2000;42(1):83-7.

Sudhir Kumar CT, Chandrasekaran R. A study of psychosocial and clinical factors Associated with adolescent suicide attempts. Indian J Psychiatr. 2000;42(3):237-42.

Srivastav MK, Sahoo RN, Ghotekar LH, Dutta S, Danabalan M, Dutta TK, et al. Risk factors Associate with Attempted Suicide. Indian J Psychiatr. 2004;46(1):33-8.

Ponnudurai. R, Jeyarar J, Saraswathi M. Attempted suicide in Madras. Indian J Psychiatr. 1986;28(1):59-62.

Gouda NMR, Rao SM. Factors Related to Attempted Suicide in Davanagere, Indian J Community Med. 2008;33:15-8.

Prathaim P, Gorver S, Avasthi A, Chakrabarti S, Malhotra S, Kumar S. Intentional self harm seen in psychiatric referrals in a tertiary care hospital. Indian J Psychiatr. 2008;50(3):187-91.

Makiko N, Chiaki K, Tomoki Y, Yoko I, Ryoko S, Hana H, et al. Characteristics of suicide attempters with family history of suicide attempt: a retrospective chart review. Br Med J Psychiatr. 2009;9:32.

Suresh Kumar PN. Age and gender related analysis of psychosocial Factors in attempted suicide. Indian J Psychiatr. 1998;40(4):338-45.

Aleem S. The suicide: Problems and Remedies, Ashish Publishing House, 1994.

Sanjush B, Manju PH, Yesudas KF. Psychiatric diagnosis in attempted suicide. Calicut Med J. 2006;4(3):e2.

Kral MJ, Links PS, Bergmans Y. Suicide Studies and the Need for Mixed Methods Research. J Mixed Methods Res. 2012;6(3):236-49.

Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG, editors. Analysing qualitative data. London: Routledge; 1994: 173-194.

Why People Die By Suicide: Further Development and Tests of the Interpersonal-Psychological Theory of Suicidal Behavior Thomas E. Joiner, Jr. Florida State University. Available at: http://portal.idc.ac.il/ en/symposium/hspsp/2011/documents/cjoiner11.pdf. Accessed on 3 March 2019.

Baca-Garcia E, Diaz-Sastre C, Ceverino A, Perez-Rodriguez MM, Navarro-Jimenez R, Lopez-Castroman J, et al. Suicide attempts among women during low estradiol/ low progesterone states. J Psychiatr Res. 2010;44(4):209-14.

The international handbook of suicide and attempted suicide by Hawton and Herringen V. Jhon Willy &Sons, Ltd. 2000.




How to Cite

Purushothaman, P., Premarajan, K. C., Ramachandran, J., & Thangaraj, S. (2019). Why do people attempt suicide? A mixed methods research from South India. International Journal Of Community Medicine And Public Health, 6(7), 2821–2827. https://doi.org/10.18203/2394-6040.ijcmph20192809



Original Research Articles