The Indian American community has welcomed the US government move to transition a 10-digit national suicide prevention lifeline to a three-digit easy-to-remember number 988.
According to Department of the Health and Human Services (DHHS), the 988 lifeline is the culmination of a three-year joint effort by the DHSS, the Federal Communications Commission (FCC) and the US Department of Veterans Affairs (VA) to put crisis care more in reach for people in need. The lifeline also links to the Veterans Crisis Line. A DHHS communication said that President Joe Biden’s administration “invested $432 million to scale crisis center capacity and ensure all Americans have access to help during mental health crises.”
Dr Sampat Shivangi, the newly appointed chair of the Mississippi State Board of Mental Health said that though 988 is a 24-hour helpline, “Unless you come out openly and make the call, nobody is going to change the situation.” He said 988 is a big step forward. “It is not that mental health clinics are not there, but post-Covid, the need has increased.”
Shivangi, who also serves at the Substance Abuse and Mental Health Services Administration (SAMHSA) in the Biden administration added that substance abuse in the post-Covid era has gone up by 30-40%, and this has increased the demand for mental health services. SAMHSA works under the DHSS and leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.
According to the DHSS, the 10-digit lifeline received 3.6 million calls, chats, and texts in 2021, a number that is expected to double within the first full year after the transition to 988. Data compiled by the Centers for Disease Control and Prevention (CDC) shows that the country had one death by suicide every 11 minutes in 2020, and was the second leading cause of death for young people aged 10-14 and 25-34. From April 2020 to 2021, more than 100,000 people died from drug overdoses.
Shivangi feels that community awareness is key to reduces suicide deaths. “We need to reach out to temples, gurdwaras, mosques, and schools. We know no one wants to talk about this underlying issue, but we have to take first step.” As the founding president of the American Association of Physicians of Indian Origin in Mississippi, Shivangi plans to meet Mississippi governor Jonathon Tate Reeves on August 8. “We have to reach out through various organizations, WhatsApp groups, and invited people to community meetings to talk about it.”
New Jersey-based Shikha Sadhar who in 2019 launched Janani, a suicide loss survivor support group, told indica over the phone that 988 might help prevent suicide. “I lost my spouse in 2016. He was in severe depression and was clinically diagnosed. He just lost the battle,” Sadhar said. It was this deep personal loss that led her form Janani.
“There are (suicide prevention) programs in this country, but they are voluntary. They should be mandated because a person struggling with mental illness should not give up treatment.”
Sadhar’s experience tells her that mental health patients don’t want to go to meetings or take a step back and look at themselves. “The medical system cannot do anything,” she said. “If the patient doesn’t want to do it, they cannot force that person.”
She started with two families, but now her organization supports 10. “South Asians,” she said, “don’t talk about it (death by suicide); instead, they say, a person died of a heart attack. It is really hard to talk.”
Sadhar added, “We have families who have lost children, siblings, one lost her boyfriend and parents. I myself lost my husband. Most of them are south Asians. I have families hailing from Boston, Virginia, North Carolina and New Jersey. It takes a lot of courage and time for people to come and talk about such a sensitive topic.”
According to a report titled ‘Suicide among South Asians in the United States: Perspectives, Causes, and Implications for Prevention and Treatment’ by University of Texas Rio Grande Valley professors Susheelabai Srinivasa, Sudershan Pasupuleti, Rani Dronamraju and Denise Longoria published last October, even though South Asians have a lower documented suicide rate than the national average, this is misleading and doesn’t capture hidden reality. Data presented in research studies have revealed that one per cent of South Asians reported suicidal ideation; 4.13 per cent reported feelings of hopelessness and 12.35 percent were identified with depressive symptoms.
More notable perhaps is that 1.34 per cent of Indian Americans, the largest ethnic group among the South Asian population, reported suicidal ideation, attempts and deaths by suicide.
Several experts, apart from Shivangi and Sadhar, have pointed out how South Asians do not feel comfortable sharing their personal information or family problems with healthcare providers. South Asians do not tell counsellors about any suicidal thoughts because they don’t trust them. There is also stigma associated with seeking help. Cultural non-acceptance, stigmatization of mental health services, and a lack of cultural sensitivity in the existing mental health services all contributed for underutilization of mental health services, experts said.
They have also pointed out how the western model of mental health treatment approach may not be seen as ideal or meeting the needs of the South Asian community. Culture-bound restrictions in help-seeking contributed to perceptions about mental health of this ethnic group.
Moreover, there is limited data on mental health issues of South Asians in the United States. Although the rate of prevalence of suicide among South Asians is higher some other ethnic groups, the risk factors among Asian and Non-Asian cultures are widely different.
For example, in 2019, an NGO named South Asian Americans Leading Together (SAALT) reported that nearly 5.4 million South Asian origin live in the US, or which 472,000 live in poverty. Poverty, SAALT reported, has ramifications on mental and physical health as well as access to services.