Why Women Attempt Suicide: The Role of Mental Illness and Social Disadvantage in a Community Cohort Study in India

Joanna Maselko, Harvard School of Public Health
Vikram Patel, London School of Hygiene and Tropical Medicine

The goal of this study was to describe the risk for attempted suicide in women associated with social disadvantage and mental disorder. The data is based on a cohort study of 2318 women in Goa, India. Information was collected at baseline on socioeconomic adversity, gender disadvantage, and physical and common mental disorders (CMD). The main outcome was self-report attempted suicide (AS) over the 12-month study period and the main method of analysis was exact logistic regression. Gender-based violence (OR=5.04, 95%CI: 1.69-15.45), CMD (OR=3.50, 95%CI: 1.04-10.90) and indebtedness (OR=2.89, 95%CI: 1.02-8.89) were the strongest independent predictors of incident AS cases. Experiencing both gender-based violence and CMD increases the risk of AS 25-fold when compared with women who have experienced neither risk factor. Strategies to reduce gender-based violence and discrimination, provide debt relief and improve the recognition and treatment of common mental disorders may reduce the population burden of attempted suicide.