Choosing death over life

Without waiting for changes in the law or development of a policy, we must all try and inform ourselves to respond to people experiencing psychological distress. Suicide rarely impacts our consciousness, except when news involving a celebrity hits television screens or newspaper headlines. It is not something, though, that our society can afford to deny. It is not glamorous. It is an unnecessary end of a life, which has memories, beliefs, feelings, thoughts, relationships, experiences and aspirations. The sense of isolation of the person who attempts suicide is unfathomable. Sometimes, suicide may seem like an impulsive decision to an overwhelming crisis; at other times it may seem that it is a response to ongoing anguish and despair, when the individual loses the reason to live. More often than not it happens when the balance between pain and suffering and between the reasons to live and the resources to cope with the difficulties faced in life is tipped towards hopelessness. Alarming reality Beyond the personal reality of individual lives, the Indian reality on suicide is alarming. In a recent study focussed on India and published in The Lancet, a premier medical journal, it was estimated that for nearly 1,87,000 people in 2010 the cause of death was suicide. It was estimated in the same study that in India the standardised rate of suicide per 1,00,000 people aged 15 years or older, of 263 for men and 175 for women, was the second highest in the world. The same study also reported suicide as the second most common cause of death for unnatural death that is, more deaths are caused by suicide than by HIV/AIDS, cancer or cardiac illness. This is in the context of the situation in India where 90 per cent of people who need mental health support do not have access to it. There is a significant human resource gap of mental health professionals. There is no policy for mental health or suicide prevention. And attempted suicide is still a crime! Suicide, however, is not merely a health issue. We are a society in transition. There is significant violence, discrimination, exclusion and intolerance that form the social canvas of our times. There is a mismatch of aspirations and opportunity. Relationships are not based on respect and knowledge, but transactional contracts of one-upmanship. The discourse with our children is full of criticism and unreasonable expectations. The young, the old, the women and men in our society are vulnerable to demoralisation. Such demoralisation is a breeding ground for helplessness. Is it possible for a society to reach out to people who are thinking about suicide before they attempt it with a fatal or a non-fatal end? Is it possible for a person to be offered support? Is it possible to help a person step back and see at least a speck of hope to explore alternatives and choices one more time? The answer is a clear yes. Without waiting for changes in the law or development of a policy, we all must try and inform and skill ourselves to respond to people experiencing psychological distress. We must start by creating space for conversations in our relationships. Let us learn not to judge people or force our opinions on them. Just listen and validate the persons experiences. We must learn to recognise symptoms of psychological distress and illness. If people tell you that they are sad or feeling hopeless, do take them seriously. If they have lost interest, if they are not able to enjoy, if they have become withdrawn or if they are extremely anxious, recognise these as features of depression, which if treated early, will prevent suicidal thoughts. Do not just ask a depressed person to pull up their socks and live. Explore if they have had thoughts of harming themselves. Have they attempted self-harm in the past? If they have, it increases the likelihood that they might attempt it again. Also remember, if the person is intoxicated, it is more likely that he/she would attempt suicide. Do not patronise. Do not make the person feel guilty. Be with the person. Your words have power; do not use them in a trivial manner. Sometimes, sensitive silence is better than goading. Help people navigate their problems without imposing a solution on them. Vulnerable people If you are overwhelmed, do not be brave by trying to support the person on your own. Involve other people, share the responsibility of caring. Most large cities have volunteer organisations that provide phone-based support to people in distress. Most medical colleges have departments of psychiatry and most district headquarters have psychiatrists in private practice. If you cannot find a mental health professional, approach any system that provides support to people who are vulnerable such as the resident welfare association, the police, a health service, etc. There is a psychological framework that precipitates suicidal thoughts. It includes black-and-white thinking, a sense of hopelessness and helplessness. The person also may be coping with poverty, unemployment and debt. There may be a rejection in a relationship and failure in examinations. For women, experiences of violence and abuse in intimate relationships may be a determining factor. For a large number of people, there may be an underlying illness like depression or schizophrenia. There may be a history of substance abuse with alcohol, cannabis or benzodiazepines. There is a relatively easy access to means of suicide in our country. Pesticides and easily available prescription only medicines create a risky environment for such vulnerable individuals. How does an individual who is considering suicide as an option help himself/herself? Let me address you directly and urge you to seek help immediately. First, it is important to remember that there are many people who did step back and live and were able to be hopeful one more time. People are resilient and people do survive. You are resilient and you can survive! Step back for a moment. Talk to someone. It could be a friend, a colleague, a family member, a counsellor, a spiritual person, or any other person that you may have access to. You have a right to live. Plan the next hour to be with someone or talk to someone, then with his or her help, plan the next 24 hours. Include the step of seeking professional help in the plan. 31-01-2014

During this time, do not attempt to solve all your problems or even answer the question as to why you should live. Just let someone know how you feel and be with them. No decisions need to be taken. Each passing moment will give you a breather and then you will be able to look at your experiences and problems afresh. Policy challenges The lawmakers and policymakers have to shed their denial of mental health issues and put mental health and well-being on the agenda. The proposed Mental Health Care Bill which was recently introduced in the Rajya Sabha at least does two positive things: it creates a parity between health and mental health and it proposes to decriminalise suicide. Let us hope it is considered in the last session of this Lok Sabha. The mental health policy has to clearly state goals and targets for reducing the frequency of suicide in the country. The access to mental health services in the community has to be increased substantively, and this will not only require a financial outlay for developing service delivery systems that do not exist, but also a change of thinking on how we develop a new mental health workforce. An immediate solution would be to embed online skills-based training on mental health and suicide prevention into training programmes for all teachers, doctors, nurses, psychologists, social workers, nurses and human resource professionals. We have helplines and call centres for so many issues in this country. Is it not time for a 24x7 national suicide prevention hotline with trained professionals? Another step that would help decrease the rural suicide rates would be to increase awareness about locking pesticides away and safe. We are the only country which perhaps spends more on investigating suicide as a crime instead of preventing it. Let us change that, for each life is as precious as any other. (Dr. Achal Bhagat is senior consultant psychiatrist and psychotherapist, Apollo Hospitals, and chairperson, Saarthak, a mental health non-governmental organisation.) Keywords: death sentence, psychological distress, HIV/AIDS, medical journal, suicidal thoughts, psychological framework

Dynasty versus democracy

To democratise a Congress brought up on dynasty is difficult because the mere presence of Rahul Gandhi is enough to encourage sycophancy At the All India Congress Committee (AICC) session in Delhi on January 17, Rahul Gandhi, the Congresss election campaign chief, demonstrated his capacity to speak cogently about his motivations and plans, while taking the partys competitors head-on. But precisely 10 days later, his 80-minute long interview with Times Now virtually undid what he had achieved: he fluffed answers to questions that he should have expected on the comparisons between the anti-Sikh riots of 1984 and the anti-Muslim carnage of 2002, and on corruption that, together, incidentally, occupied roughly 40 per cent of the interview. Mr. Gandhis vain efforts to stay on message to talk about his efforts to democratise the system, and allow more voices to be heard rather than get drawn into a conversation on the Bharatiya Janata Partys prime ministerial candidate failed. Unlike the speech he gave at the AICC session, where he was able to control the narrative, faced with questions from a skilled interviewer, he floundered. So even as the Congresss media managers sought to do damage control, elaborating on what Mr. Gandhi should have said, a young Congress activist who had attended the AICC session told The Hindu sadly, If Rahulji had participated in more debates in Parliament, and interacted regularly with the media, he would have known how to answer questions. The only point on which Mr. Gandhi scored over his principal political rival is that he as party general secretary Digvijaya Singh said stood his ground, neither expressing annoyance or walking out as Mr. Narendra Modi, the BJPs prime ministerial candidate has done on more than one occasion. But in making himself accessible, in demonstrating that he was open to questions, in stressing that power by itself held no attractions for him, and that the collective was more important than the individual all democratic traits he rendered himself vulnerable. Winds of change At the AICC session, he said the United Progressive Alliance government had deepened democracy through rightsbased laws, its landmark Right to Information arming citizens to question the functioning of government. The citizen had to be empowered, he said, but not by destroying democratic institutions like Parliament. Democracy, he reminded his listeners, is not rule by diktat. It is not rule by one man. It is rule through empowered elected representatives. He had also acknowledged without referring to the Aam Aadmi Party (AAP) that the Congress had no option but to address the demands of an aspirational citizenry: The imperative before us, is not whether to change, he said, stressing, but when and how to change. On January 18, as Mr. Gandhi met party delegates, Statewise, many noticed a change: What was new, a delegate from Uttar Pradesh told The Hindu, was that he wanted to hear what we had to say: I have met him many times but I must say his attitude was far more positive than it has ever been in the past. But this delegate, like many others I spoke to, said the hope was that Mr. Gandhi would be able to sustain the momentum generated by the AICC session, and actually implement, for instance, fairer selection methods when it came to choosing functionaries or giving party tickets, and push the generational change visible that day. The problem is, most 31-01-2014

decisions are still taken behind closed doors, the selection committees for the elections still have, by and large, the same people. When will the doors open? asked a delegate from Madhya Pradesh. No one can fault either the passion or the content of Mr. Gandhis speech at the AICC session, but the party faithful are still waiting for its future leader to translate his ideas into action. In his first five years, i.e. till 2009, the spotlight was on Ms Gandhi who had achieved sainthood after rejecting the prime ministership in 2004. But after 2009, the focus shifted to him. He demonstrated his interest in issues in the tribals versus development question, in the problems of land acquisition. Now, more recently, he has set in motion the revival of the partys SC department with the objective of identifying Dalit leaders from the block to the Statelevel, and helping Dalits access social welfare schemes. While it would be premature to comment on this latest venture, in the case of the first two, he was unable to sustain either the momentum or leverage them for electoral gains. If he has worked consistently on any issue, it is in trying to put systems into place, selecting poll candidates through a fairer process, and democratising the party through internal elections, starting with the Youth Congress. The going has been tough, as there is resistance to being organised; as for elections, the results have been mixed certainly some new faces have emerged, but money power has ensured that entrenched elements have also managed to win elections. Party workers continue to complain that very few can get past a tight circle of advisers, while debunking his scientific method of choosing potential youth leaders through examinations. Clearly, democratising the Congress is an uphill task, harder in a party where dynasty is still paramount. Mr. Gandhi is acutely aware of this paradox. In 2012, when I asked him whether he was aware of the contradiction between being a member of a political dynasty and his efforts to democratise the Congress, he responded: I agree its a paradox. But I have got this opportunity. I could say I dont want it. Im saying I want to work for this country, let me try to steer it in a positive direction. But more recently, at an informal interaction, he was not quite as conciliatory when posed the same question: instead, he pointed out that there were many other political dynasties flourishing in the country: from the Badals in Punjab, to the Yadavs in Uttar Pradesh to the Thackerays in Maharashtra, something he repeated in the Times Now interview. To democratise a Congress brought up on dynasty is difficult because Rahul Gandhis mere presence is enough to encourage sycophancy, as is evident at every party event. But can the Congress, given its history and culture, choose anyone for the moment at least other than Rahul Gandhi to be the face of its future? There may be murmurs of discontent at the top of the food chain, but at the level of the delegates who filled the Talkatora Stadium on January 17 there seemed to be unanimity that the Nehru-Gandhi family held the party together and, currently, there was no leader outside it who had the same kind of pan-India appeal. The really successful rajas in the past, a delegate from a Hindi heartland State said, wielded absolute power, while creating a democratic system below. That is what Rahul Gandhi has to do. Checking the drift It is not that the Congress had not anticipated the negative impact of corruption or of the changing aspirations of an emergent middle class. In December 2010, at the partys plenary session in Burari, Ms Gandhi had set in motion the battle against corruption, resulting in a flurry of laws and the removal of discretionary powers in Congress-ruled States. In January 2013, at the chintan shivir in Jaipur, she said the Congress could not allow the growing educated and middleclasses to be disillusioned and alienated from the political process. But the Congress has failed to address these changes partly because there is hardly any sustained discussion or putting together of heads in a formal forum on key issues relating to the economy, foreign policy, development, and reasons for growing social unrest. The Congress Working Committee seldom meets and the little discussion that takes place is in the informal core group that deals with emergent problems. The Congress is now a party where general secretaries and ministers themselves scramble for information, where intrigue replaced any world view as ideology a long time ago, and ginger groups are a thing of the hoary past. As senior Congress leaders, a majority wearing the partys traditional Gandhi topi, walked in to attend the AICC session on January 17, a collective gasp had gone up in the media stands at Talkatora stadium. It should not have been an unexpected spectacle as the starched white khadi cap is customarily worn at formal party occasions. But with that familiar cap embellished with the slogan Main hoon aam aadmi now a common sight on the streets of Delhi with the AAP in power in the national capital, the vision of Congressmen donning the once evocative symbol of the freedom struggle sent out a new message: it was time for the countrys oldest party to reclaim the ground it had lost to its competitors. But can an organisation currently bearing the brunt of peoples disenchantment with the traditional political class and the burden of a decade-old corruption-scarred government, achieve that? If the AAP has jogged the Congress out of its complacency, the question is: can Mr. Gandhi retrieve the Gandhitopi and win back the affections of the aam aadmi? smita.g@thehindu.co.in Keywords: AICC meeting, dynasty politics, democracy politics, AAP government, Congress election committee chief, Lok Sabha polls 2014, AICC session

31-01-2014

A love that is unequal in the eyes of the law

If personal liberty, freedom and justice are the foundations of this republic, surely tolerance and diversity are its strongest pillars. Nations are born of ideals and ideals are what preserve them. Few Indians would disagree that the ideals behind a diverse and inclusive democracy and society like India are plurality, equality and justice. Yet, every now and then comes a moment when a nation or a society must stand up and defend its ethos. Indias Supreme Court faced such a moment this week to review its own flawed judgment upholding a discriminatory Victorian law against unnatural sexual acts between consenting adults. The Courts decision not to review this judgment laid bare not only its lack of concern for minority rights but also its intention not to protect the ideas of justice, liberty, and equality guaranteed to all Indian citizens by our Constitution. Several questions arise from the stand of the Court. Should the law control and discipline our bodies and our right to choose our sexualities, our right to love? Would you as an Indian allow the state to dictate whom you can love and how you choose to love within the confines of your own private spaces? If not, then how can any court, however supreme, deny this right to some Indians or even one? The law that this judgment upholds makes criminals of all Indians whose desire for sexual intimacy does not abide by a certain definition, regardless of sexual orientation. For a moment, lets consider who gave us this definition. And does it stand up to any scrutiny? We, the argumentative Indians, have never adhered to any particular definition of sexual pleasure. Strangely, the Court ignored the rich and diverse cultural, historical material placed before it to prove that sexual diversity and same-sex love have been an essential part of Indian history. Why was our history, our celebrated diversity, our inclusiveness ignored in this case? Are sexual minorities, any less Indian because they seek the right to love that many may not approve of? Persecution Even though this law applies to every Indian, it has primarily been used to harass, coerce and terrorise Indias sexual minorities. There exist countless testimonies illustrating this misuse. By refusing to review an unjust judgment, the Court has strengthened oppressive forces and encouraged intolerance, increasing the fear with which Indias sexual minorities live everyday. How can any court in a democracy allow for the deliberate persecution of a minority? Can our love be so unequal in the eyes of the law? During the hearings, the earlier bench admitted they didnt know of any gay people and later termed them minuscule. Well, minuscule or not we exist. Indias sexual minorities are now a visible part of its mainstream. We work in diverse professions, pay taxes, vote, and abide by the rulebook like other Indians. We also feel fear, joy and sadness and want to love with dignity and seek happiness like all other human beings. The Court cannot, on account of majoritarianism or its ignorance or prejudice, deny us our fundamental human right to love and seek happiness. As acts go, this one is truly unnatural. Perhaps, the Court does not realise that its position on this matter will determine and shape the discourse on not just the rights for sexual minorities but all minorities in India. The Court need only to have remembered the multiple histories of the womens movement, the Dalit movement, the movements for workers rights. Would equal rights ever have been possible for any of these constituencies if ideas of equality, justice and inclusiveness had been dispensed with? Were not ideas of inter-caste or inter-religious marriage radical and socially unacceptable till some time ago? Yet, we did not allow the curtailment of the right to love on the basis of social acceptability. Then why should it be constrained on the basis of sexual orientation? It was our hope that the Court would introspect and discover in itself the courage to self-correct a regressive and erroneous judgment. Instead, it dismissed us tersely without explanation or compassion. It has upheld an unjust colonial law inserted into the Constitution by a prudish colonising power. By doing so it takes away hope and dignity, making millions into criminals. We are disappointed but not defeated. We are determined to fight every day in our homes, in our workplaces, on the streets you will see us everywhere, seeking our right to love. We will not be silenced. We will also not forget the just and compassionate 2009 judgment decriminalising homosexuality that gave us sanctuary in constitutional ideas of equality and justice, reinforcing the inclusiveness of the Indian state. It will strengthen our resolve to fight till we can love with freedom and dignity. A right the Court could not find the strength and the courage to give to us. (Chapal Mehra is an independent writer based in New Delhi.) Keywords: strongest pillars, flawed judgment, Supreme Court, sexual minorities, same sex, gay sex, LGBT community

Israel seeks to export cybertech

Israeli Prime Minister Benjamin Netanyahu announced a bold initiative this week calling on tech giants and western powers to band together to protect the world from cyberattacks, vowing to relax export restrictions normally placed on security-related technologies so that Israeli cyberdefence companies can sell their expertise around the globe. Making this vision a reality, however, will be complicated. Industry experts say that tech companies and intelligence agencies would likely be loath to trade secrets and reveal their own vulnerabilities. Israel also risks compromising its own national 31-01-2014

security by allowing cybercompanies, mostly formed by graduates of stealth Israeli security units, to export advanced technologies that enemies could use against Israel. We are taking a gamble, Mr. Netanyahu acknowledged at a cybertechnology conference on Monday. Entailing some risks, but willing to do so to get much bigger gain. Israel established a national cyberbureau two years ago to coordinate defence against attacks on the countrys infrastructures and networks, such as a virus that recently shut down a major Israeli roadway two days in a row. The bureau also seeks to boost Israels economy by building up its cyber-defence industry. In the last few years, the number of Israeli cyberdefence companies has ballooned from a few dozen to more than 200, accounting for five to 10 per cent of the global cyber-security industry, said Eviatar Matania, head of Israels national cyber bureau. Dr. Matania estimated the global industry to be worth $60 to $80 billion a year. Check Point Software Technologies, one of the worlds leading cybersecurity firms, was founded in Israel. By developing more and more human capital in the area ... we will be able to be a global cyberincubator, Dr. Matania said. This week, international giants IBM and Lockheed Martin announced new cyberresearch projects in Israel, and Deutsche Telekom and EMC have also established research centres in the country. Hundreds of cybersecurity companies and experts, including directors of cybersecurity in the U.S. Department of Homeland Security, attended this weeks expo of Israeli security companies and start-ups in Tel Aviv. Seeking to learn from that Israeli prowess, Symantec, a leading computer security company, hosted a hackathon at the expo, inviting Israeli hackers including some teenagers who ditched high school for the day to try to pierce through its systems. Ewa Lis of Symantec said the company has hosted similar hacking challenges throughout Europe. Israel has established itself as a world leader in cybertechnology innovation, fuelled by graduates of prestigious and secretive military and security intelligence units. These units are widely thought to be behind some of the worlds most advanced cyberattacks, including the Stuxnet virus, which attacked Irans nuclear energy equipment. Each year, these units churn out a talent pool of young Israelis who translate their experience executing or protecting against advanced cyberattacks to the corporate world. But regulation of the industry to bar Israeli secrets and know-how from leaving the country like limits that Israel puts on weapons exports has been almost nonexistent. The same is true in other countries. Only last month did western signatories to the Wassenaar Arrangement, an international treaty that regulates arms sales, move to place restrictions on the cybertechnology trade. Israel is not a signatory to the Wassenaar Arrangement, but the country says its weapons trade policies follow the spirit of the agreement. Israels national cyberbureau said it is currently formulating rules on what cybertechnologies cannot be exported. Rami Efrati of the bureau said those regulations would be completed within six months. I dont think cyber is a secret, said Mr. Efrati, who is heading the bureaus effort to boost the Israeli cyberdefence industry. On the other hand we have to be very sensitive about this question, in order to make sure we will have an advantage in such technology. In 2011, Bloomberg News reported that Internet traffic monitoring software made by Israeli company Allot Communications Ltd. and shipped to Denmark ended up in Iran, Israels arch-foe. The company denied the charge, and Israels Defence Ministry later cleared it of any wrongdoing. Alon Hazay, a former cyberdefence expert in Israels internal security service, the Shin Bet, who now serves as a private consultant, said he was aware of at least two Israeli startups formed by graduates of Israeli security units whose software contains sophisticated defences that provide tell-tale clues of the kinds of sophisticated attacks Israel uses against its foes. He said the companies are working for international clients, with one developing mobile phone security solutions and the other providing security for computers. But in the field of cyberspace, Mr. Hazay said, it is difficult to ascertain what technology constitutes an Israeli national security asset. He said it was inevitable that such technologies would make their way to the marketplace. The guys coming out of the army are going to make money. The only thing they know how to do is security, said Mr. Hazay. You cant prevent them from using their minds. Keywords: Israeli Prime Minister Benjamin Netanyahu, cyberattacks, internal security service

31-01-2014