Suicide in Paramilitary Forces
BY
Dr Roshan V Khanande
Asst. Prof. of Psychiatry
CIP, Ranchi
Central Institute of Psychiatry
• A 99 yr of excellence in mental health
• A teaching institute and hospital
• Treating nearly 80,000 patients per year
• All psychiatric specialties including
-Child psychiatry
- De-addiction psychiatry
-Geriatric psychiatry
Case Vignette
• Name: Mr. A
• Age: 45 years
• Sex: Male
• Occupation: Sub-inspector
Referral purpose:
1. Low mood- 2 years
2. Multiple suicidal attempts
3. Alcohol intake for 20 years
Occupational history
• Sub-inspector Jharkhand police
• Suspended 3 times for misbehavior and
negligence
Marital history
Poor relationship with his wife due to
• Substance intake
• Low mood
• Work stress
On Talking to Mr. A
• Low mood (Udasi)
• No interest in work and personal life
• He said, ‘I drink because I feel no happiness
and I don’t feel like working. It is better that I
end my life.’
Management
• Pharmacological- Antidepressants
• Psychological- For alcohol intake, low mood and
suicide
Report of Mr. A till now
• Mr. A stayed with us at De-addiction centre
CIP for 45 days
• Gradually he became better
• Family especially his wife was actively involved
in the management
• He has been abstinent from alcohol for a year
• On regular follow-up with medication and
therapy
• He is satisfied with work and personal life
But not every one is as fortunate as Mr. A
Between 2012 and 2015 about 450 suicides
seen across the services
•344 paramilitary personnel committed suicide in 3 years
•In 2017, 15 personnel have committed suicide so far
Mar 28, 2017
oWhere is the problem?
•Duty hours
•Frequent change in duties
•Work load
•Lack of holidays
•Trauma during ops
•Substance intake
•Lack of supervision
•Attitude towards colleagues
•Lack of mental health professionals
•Poor referral system
•Ignorance
Identification of suicidal behavior
• History of suicide/depression
• Recent poor performance
• Revelation
• Complaint by family members
• financial problems
• legal/disciplinary problems
• Failed intimate relationships
Canadian forces model of targets for suicide prevention in military
organizations (Zamorski, 2010).
No such system exists in India to the best
of our knowledge.
Possible Solutions
• Empathy and care
• System to address grievances
• Proper referral system
• Integration of the unwell
• Reduction of stigma
Empathy and care
“To protect democracy within the borders ,
autocracy must prevail at it”
• Empathy is when you allow yourself to feel
what others are feeling
• It means feeling what your colleague and
your subordinate is feeling
• Feeling of unity, and care for each other
System to address grievances
“Matters of ill temper should be
dealt without it “
• Frequency, seriousness of offence
• History of offence
• Documentation of incident
• Punishment is not always the solution
Proper referral system
• Detail history
• Involvement of family members and
colleagues
• Send family members along with the soldier to
the hospital
• Regular follow-ups
• Time specification for fitness
Integration of the unwell
• Supporting attitude
• Regular performance assessment
• Identification of early signs
• Regular follow-up
Reduction of stigma
• Coming out with problems
• Family support
• Understanding colleagues and officers
• Motivation
And call us whenever possible
Thank you