In April 2016, Waseemullah, a second year student at the Aga Khan School of Nursing, hanged himself from the ceiling fan of his room. According to his friends, he was a lively boy who had come all the way from Gilgit to pursue his studies on a full-term scholarship. Friends say he had a promising career to look forward to.

Waseemullah isn’t the only suicide victim in this dorm — some news reports claim that around five students have taken their lives in the same dormitory in the last few years. In fact, a 21-year-old medical student from Chitral committed suicide in the very same room as Waseemullah’s in April 2010.

Waseemullah’s case and those of his peers are indications of an unaddressed and seemingly increasing problem among Pakistani youth. The Karachi-based Madadgar police helpline national database shows that in the first six months of 2015, around 1,061 suicide attempts were reported, which are speculated to be almost double this year. National media reports and anecdotal evidence also indicate a rise in suicide rates in the 14 to 30-year-old age group.

According to a 2012 World Health Organisation (WHO) report, “There are around 15,000 suicides committed in Pakistan annually.” Dr Murad Khan, chairman of the Department of Psychiatry at Aga Khan University Hospital, Karachi, earlier estimated that there are “5,000 to 7,000 suicides yearly. Of these, approximately 25 per cent of the cases would be in teens and over 50 per cent occur in youth under the age of 30 years.”

Anecdotal evidence suggests there might be a growing problem among Pakistani youth but there has been little public debate about the reasons behind it

Youth suicide has been emerging as a threatening issue in recent years across the world. A 2014 WHO report estimated, “around two million teenagers commit suicide worldwide while four million adolescents attempt it.”

South Asia is considered the world’s suicide focal point. In India, according to a 2012 National Crime Bureau Report, “around 20 students kill themselves everyday due to stress related to exams and competition for admissions in reputable educational institutions.”

While high suicide rates among Pakistani youth remain a concern for the public and authorities alike, the exact extent of the problem is hard to determine. The deep social stigma attached to suicide means a large number of such cases are swept under the carpet.

In addition to suicide being prohibited in Islam (as it is in other religions), it is considered a criminal offence punishable with imprisonment and financial penalty in Pakistan. This means most suicide survivors and families of suicide victims are reluctant to discuss the topic in public or to admit to it on record which makes it difficult for researchers and authorities to ascertain the exact number of suicides and attempted suicides in the country.

According to the Royal College of Psychiatrists, around 29 percent of youth displayed clinical levels of psychological distress while suicide had increased by 170 percent globally in the last two decades up to 2015. In the local context, Dr Khan estimates that almost 34 percent of Pakistani population suffers from mental disorders, and depression is implicated in more than 90 percent of suicide cases.

In absence of any authentic official national data on suicide, researchers like Dr Khan agreed that one has to rely on the accumulating anecdotal evidence that suicide rates have increased in Pakistan over the last few years.

Stuck between a rock and a hard place — do students at campuses have anyone to turn to for help?

If one looks closely at many of the suicide cases to get national attention, authoritarianism and the high pressure environment of academia seems to have played a role.

In February 2016, Saqiba, a 17-year-old college student, first position-holder of Matric Board from district Qila Saifullah, Balochistan, swallowed sleeping pills when, according to her statement, her college principal refused to send her an examination form she needed. The principal allegedly did so as retaliation for Saqiba leading a protest against the negligence of school authorities regarding the arrangement of teachers and classes for almost a year.

In April 2016, 27-year-old Abdul Basit, a final year dental student at Hamdard University, immolated himself in front of his university campus when barred from appearing in the final exam for arriving late. According to his college principal, Basit was enrolled in the four-year Bachelors of Dental Sciences programme since 2007, but failed every year.

These incidents are just the tip of the iceberg and are among the few that have come to the public attention due to extensive media coverage.

But while much has been covered on the incidents, there is little public conversation about what could have been done to prevent suicides and what drove Waseemullah, Saqiba and Basit to commit suicide on what might have been considered minor setbacks by many.

Could Basit have been steered away from his plans of self-immolation if he had a counselling service on campus that he could turn to for help? Would Saqiba still be alive if she had a university board to appeal the alleged unfair treatment meted out by the college principal? Or had someone to discuss her quandary with? How much pressure did these students face on campus? These are essential questions that still remain unanswered in the national narrative around suicide among youth.

Despite the evidently rising demand for mental health services by the educated youth of Pakistan, there are hardly a few educational institutions that offer consultation and mentoring facilities to its students with psychological and emotional issues. Though some private schools, colleges and universities partially hire educational psychologists on a need-basis, the role of student counsellors is often limited to disciplinary matters and student activities in most educational institutions.

What pushes so many youth over the edge?

A large majority of victims apparently attempt suicide on issues related to domestic affairs, academic challenges and financial crunch.

“Youth of this age have to handle multiple pressures, cut-throat competition and unrealistic parental and social expectations,” says Dr Uzma Ambreen, a renowned psychiatrist and medical director of Karachi-based Recovery House. “Most youngsters are just pushed into the rat race of grades and prominence irrespective of their aptitude and capacity. Patience, stress management and problem solving required for handling such challenges of life are simply missing at this tender age especially in the absence of supportive family, friends and mentors.”

The details of each case might be somewhat different. However, most suicide attempts revolve around fear, hopelessness and unrealistic expectations related to academic and professional success, social acceptance and relationships.

What is disturbing is the growing involvement of juveniles in such cases. In February 2016, for example, two disturbing incidents were reported where 14-year-old Salman in Peshawar and 16-year-olds, Navroz and Fatima, in Karachi shot themselves when their parents refused to accept their childhood affairs.

The second incident specifically raised several questions about society’s deteriorating value system, in which a 10th grade student killed his girlfriend and himself in school. Apparently inspired by recent Bollywood movies, the victims left a suicide note requesting for adjacent graves like filmy lovers.

Dr Anusha, a clinical psychologist based in Kerala, South India (with the highest literacy and suicide rate) said “Our children are living under immense pressure to deliver, succeed, live their parents’ dreams and make them proud.”

Dr Nosheen Shahzad, an educational psychologist and director of Karachi’s Neuro-Psychology Center identifies three dimensions of suicidal-thoughts including personality type, parent-child relationship and environment (having many factors such as peer pressure, need for social acceptance, companionship and sense of purpose).

PhD scholar and faculty in a private university in Karachi Dua shared her teenage suicide attempt in the following words: “At the age of 13, I struggled with my studies. I used to be an average student with a low self-esteem. My father always compared me with the high-achiever children of his friend. One day I failed a math test and hid my result from my parents. However, during a parent-teacher meeting they learnt about it and really got mad at me. I was so upset that I took some pills to die. Apparently, the pills were not harmful so I didn’t end up in the hospital and overslept only.”  

The disturbing fact is that Dua attempted suicide due to immense parental pressure but they remained unaware of her agony for long. She did not go for any therapy; however, her mother has been her biggest supporter throughout her teenage year.

“As I grew up, I have made peace with the fact that no matter what I do, I can’t please my father. I am grateful that I survived and came out of this miserable state,” she added.  

Ideally, education should make the young generation mentally stronger, enabling them to develop coping strategies for facing the challenges of life. On the contrary, our existing knowledge-based education system and isolated family set-up somehow fail to nurture the survival skills in our youth. While a few, such as Dua, survive, until we have a public conversation on how better to support our youth emotionally, it’s only a matter of time till another story similar to Waseemullah’s or Saqiba’s hits the headlines.

Published in Dawn, Sunday Magazine, October 2nd, 2016