Centring Communities, Not Just Counsellors, in Suicide Prevention

Today, at the core of suicide prevention strategies in India lies the presumption that death by suicide is a problem that can be dealt with by providing individuals one-on-one help (such as access to counsellors and helplines). And while such interventions are important, they are missing the bigger picture. Through the Mariwala Health Initiative – my philanthropic effort to make mental healthcare accessible – I am rooting for us to acknowledge the elephant in the room.

Individual-focused approaches often view suicide through the narrow lens of personal failure or mental health breakdown, overlooking the broader context in which people live and struggle. Individuals are embedded within families, communities and systems that can either support or harm their mental well-being. This is particularly true in low-and-middle-income countries (LMICs), where over 70% of global suicide deaths occur. Of these, less than 50% can be attributed to mental illness.

While individual interventions such as counselling or helplines may provide critical support during moments of crisis, they rarely address the structural drivers of distress – poverty, discrimination, exclusion – that affect entire communities. In India, these systemic challenges are starkly visible in suicide data. Of the 1.7 lakh suicide deaths recorded in 2022, nearly one-third were daily-wage earners. The highest suicide rates are among youth aged 18 to 29, and disproportionately so among Dalit, Bahujan and Adivasi communities. For young women, suicide is the leading cause of death, surpassing even maternal mortality. These figures underscore the need to move beyond individualised solutions to those that address the deeper, systemic roots of suicide.

Also read: Mental Health for Sexual and Gender Minorities: Some Ground Realities

Community-based suicide prevention flips this lens. It acknowledges that suicide is not just a private tragedy – it is a public health issue. Whether it's lack of access to education and jobs, gender-based violence, caste discrimination, queerphobia or agrarian distress, community-based approaches focus on the environments that shape mental health.

They are not about offering isolated support to a few, but about building systems of care that are inclusive, localised and led by the communities themselves. They may take the form of peer-led support groups, pressure campaigns for policy change, access to livelihood entitlements or education reform. These interventions not only play a pivotal role in preventing suicide, but they do so without relying solely on a limited number of expert-led services. By drawing on local knowledge, peer support and collective efforts, they offer more accessible and context-responsive care. At all MHI-supported programmes, we consider a range of community solutions such as increasing access to government services and entitlements, peer support or even collective movements. Even when we look at helplines, one of the most common tools for suicide prevention, it is important to approach them with a psychosocial approach that understands. This can ensure a more effective support mechanism. For instance,  while Sneha Foundation, which we have been partnering with since 2019, primarily works as a suicide prevention helpline, it advocated with the Tamil Nadu government to introduce supplementary exams to lower exam stress and suicide ideation among students.

In Maharashtra, where death by suicide is exceptionally high among farmers, we cannot limit suicide prevention to just providing counselling or mental health support. Our partner, Shivar Foundation’s three-tiered approach provides resolution of real-time, immediate agricultural stressors with sustainable plans, linkages to the government, NGOs and individual support schemes, as well as a helpline and farmer’s friend centre to provide crisis support. The development of this approach comes from a deep-rooted understanding of the community’s stressors, led by persons from the community.

Suicide prevention that focuses on the community recognises the importance of access to basic life and livelihood opportunities. Given Puducherry’s status as a Union Territory with a high suicide rate, MHI partner, Trust for Youth and Child Leadership, has taken a unique social approach to suicide prevention among the youth. Services such as the Puducherry Youth Helpline and the Mobile Mental Health Clinic address some of the causes of youth suicidality by providing counselling, job assistance, career guidance, positive masculinity training for young boys and men, as well as free vocational courses for youth to increase employability.

These examples make one thing clear: when prevention efforts emerge from within communities, they are more relevant, and more sustainable.

Also read: Mental Health Funding in India: When Economic Surveys and Budget Realities Diverge

To truly prevent suicide, we must go beyond awareness campaigns and crisis helplines. We need to invest in community-based mental health ecosystems that understand local realities, foster peer support and address inequalities. For policymakers, this requires the development of inclusive and context-sensitive frameworks that recognise and respond to the complex interplay of factors driving suicide in India. For donors and philanthropists, I believe this requires us to reimagine our funding priorities – moving beyond short-term, individual-level interventions toward sustained, community-based models that are deeply rooted in local realities and meaningfully linked to existing systems of care. For civil society and mental health professionals, it means making space for community leadership, especially from those most affected by suicide – migrants, Dalits, Adivasis, LGBTQI+ persons and young people.

To effectively reduce suicide rates in India, we must shift our approach. Suicide is not a mental health crisis; it is a crisis rooted in inequality, isolation and disconnection. Our focus on suicide prevention must evolve from rescuing individuals to fostering collective strength.

Harsh Mariwala is the Founder of Mariwala Health Initiative, Chairman of Marico Limited, and Chairman and Managing Director of Kaya Limited.

The Wire is now on WhatsApp. Follow our channel for sharp analysis and opinions on the latest developments.