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Estimating patterns in the under-reporting of suicide deaths in India: comparison of administrative data and Global Burden of Disease Study estimates, 2005–2015
  1. Vikas Arya1,2,
  2. Andrew Page1,
  3. Gregory Armstrong3,
  4. G Anil Kumar4,
  5. Rakhi Dandona4,5
  1. 1Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia
  2. 2International Association for Suicide Prevention, Washington, DC, USA
  3. 3Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4Public Health Foundation of India, Gurugram, India
  5. 5Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  1. Correspondence to Vikas Arya, Translational Health Research Institute (THRI), Western Sydney University, Building 3 David Pilgrim Avenue, Campbelltown, Sydney, NSW 2560, Australia; v.arya{at}westernsydney.edu.au

Abstract

Background It has been proposed that the National Crime Records Bureau (NCRB), which reports suicides in India, differentially underenumerates suicides by geographic and demographic factors. We assessed the extent of potential underenumeration by comparing suicides recorded in NCRB data with recent estimates of Indian suicides developed by the Global Burden of Disease (GBD) initiative.

Methods Age-standardised suicide rates were calculated for both data sources by sex, age and state, and rate ratios of NCRB to GBD estimates by corresponding strata were compared to ascertain the relative under-reporting in the NCRB report.

Results The GBD Study reported an additional 802 684 deaths by suicide (333 558 male and 469 126 female suicide deaths) compared with the NCRB report between 2005 and 2015. Among males, the average under-reporting was 27% (range 21%–31%) per year, and among females, the average under-reporting was 50% (range 47%–54%) per year. Under-reporting was more evident among younger (15–29 years) and older age groups (≥60 years) compared with middle age groups. Indian states belonging to low Socio-Demographic Index (SDI) generally had greater underenumeration compared with middle and high-SDI states.

Conclusion NCRB data under-report suicides in India, and differentially by sex, age and geographic area, possibly because of lack of community-level reporting of suicides due to social stigma and legal consequences. While the recent decriminalisation of suicide is expected to improve community-level reporting of suicides, suicide prevention policies should be developed, with a priority to address social stigma attached with suicide and suicidal behaviour, especially among females.

  • suicide
  • gender
  • socio-economic
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  • Correction notice This article has been corrected since it first published. ORCID iDs have been added to the last two authors and the data availability statement has been amended.

  • Contributors VA, AP and RD conceptualised this paper and drafted the manuscript. GA and GAK contributed to the interpretation.

  • Funding VA is supported by an Australian Government Research Training Program Scholarship and GA is supported by a National Health and Medical Research Council Early Career Fellowship (GNT1138096).

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  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. This study uses two data sets: National Crime Records Bureau (NCRB) and Global Burden of Disease (GBD). While the NCRB data are freely available online, the GBD data are available on request.

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