Ganguli Devoja, Singh Parvati, Das Abhery
School of Public Health, University of Illinois Chicago, Chicago, IL, USA.
College of Public Health, The Ohio State University, Columbus, OH, USA.
Glob Ment Health (Camb). 2025 Jun 30;12:e74. doi: 10.1017/gmh.2025.10031. eCollection 2025.
We examine whether decriminalization of suicide in India following the 2017 Mental Health Act corresponds with changes in suicide mortality overall and by level of state development. Our study utilizes counts of suicides from the National Crime Records Bureau (NCRB) across 35 Indian states from 2001 to 2020. The exposure variable is a binary indicator for the decriminalization of suicide following 2018. We use fixed-effect Poisson regression models that include population offsets and adjust for time trends, literacy, gross state domestic product and infant mortality. We find no relation between decriminalization of suicides and overall suicide mortality (Incidence Rate Ratio (IRR): 1.037; 95% CI (0.510-2.107)). Stratification by level of state development shows that less developed states saw an increase in suicide mortality by 1.9 times following decriminalization, compared to prior years (IRR: 1.859; 95% CI (1.028-3.364)). Our findings thus indicate that decriminalization did not coincide with a decline in suicide mortality in the country, thereby highlighting the need for improved mental health infrastructure and support in India, especially in less developed states.
我们研究了2017年《精神健康法》颁布后印度自杀非刑罪化是否与总体自杀死亡率的变化以及按邦发展水平划分的自杀死亡率变化相对应。我们的研究利用了2001年至2020年期间印度国家犯罪记录局（NCRB）统计的35个邦的自杀人数。暴露变量是2018年后自杀非刑罪化的二元指标。我们使用固定效应泊松回归模型，该模型包括人口偏移量，并对时间趋势、识字率、邦国内生产总值和婴儿死亡率进行了调整。我们发现自杀非刑罪化与总体自杀死亡率之间没有关联（发病率比（IRR）：1.037；95%置信区间（0.510 - 2.107））。按邦发展水平分层显示，与前几年相比，欠发达邦在自杀非刑罪化后自杀死亡率增加了1.9倍（IRR：1.859；95%置信区间（1.028 - 3.364））。因此，我们的研究结果表明，非刑罪化与该国自杀死亡率的下降并不一致，从而凸显了印度改善精神卫生基础设施和支持的必要性，尤其是在欠发达邦。
