When we think about tuberculosis (TB), we think of deaths due to the condition itself or other diseases such as HIV. Yet there is another comorbidity which often goes overlooked: TB and mental illness.
The recent death of a student by suicide has brought this condition to light. India struggles with mental health issues as a whole, yet certain groups are isolated as having particularly high suicide rates. Among the groups bearing the highest risk are poverty-stricken farmers and students. When it comes to the latter group, the issue has become so prevalent that it is estimated that an Indian student loses their life to suicide at a rate of one death per hour.
The recent death of Manisha Kumari, a junior resident at the Ophthalmology Department of Banaras Hindu University in Varanasi echoes a number of incidences reported by Health Issues India last year, in which several students were found hanged in their dormitory rooms. This manner of death seems to be a frequent occurrence, likely due to the often isolated nature of students within their bedrooms.
Kumari’s health held an additional complication: she was struggling with tuberculosis. this was explained in a two-page suicide note in which she mentioned that she was frustrated with her tuberculosis ailment. At the time of writing there is little additional information available besides her parents being informed of the incident.
Mental health care is sparsely available in India. The treatment gap is staggering, with the majority of individuals unable to avail even basic counselling services. For many, this leaves them isolated, without the ability to obtain even basic treatment.
The stigma associated with mental health issues also plays a large role in the issue. Negative views held by a large segment of the population against those with mental health concerns leaves many feeling compelled to hide their suffering. This adds to both the stress and isolation.
Many of India’s students face considerable volumes of work, often coupling long hours in lectures or laboratories with independent study at home. This results in many being left in all but total isolation, with little time for social activity. Such an environment where they often find themselves alone in a bedroom in a city away from their families can severely worsen mental health concerns. Adding physical conditions and stigma to the mix, the stress may seem unbearable. Dealing with the symptoms of other health concerns can heighten the anxiety and depression often faced by those with mental illness, as the case of Manisha Kumari conveys.
Tragedies such as this highlights the need for greater mental health coverage in India. It also illustrates that mental health and other issues such as infectious conditions or noncommunicable diseases (NCDs) do not exist in isolation of each other. In these situations greater concern and potential medical intervention is necessary. Otherwise, tragedies such as this will continue to occur.