Paper short abstract:

This paper analyses how state and non-state health actors working on suicide prevention in Tharparkar, Pakistan, understand caste and gender as etiologies of high number of suicide. These understandings deepen the existing inequalities in accessing healthcare and further depoliticises mental health.

Paper long abstract:

While my PhD fieldwork was interested in the logics of psychiatrisation within suicide prevention programmes, many of my interlocutors wanted me to research on a completely different question of ‘why people were taking their own lives?’. Most suicides reported in Tharparkar, the district reporting highest number of suicides in Pakistan, are seemingly amongst the scheduled-caste Hindu women. This has led to the public health discourse in the region often answering the question of ‘why’ with responses steeped in cultural determinism–holding individuals rather than structures responsible for poor quality of life–such as ‘lack of awareness about mental health’, 'lower rate of education’, and ‘religious predisposition to self-immolation’.

Drawing on these discourses, I argue that etiologies of suicides in Tharparkar center caste and gender as a way to push the accountability from structures to individual and from the political sphere to the personal through usage of language such as ‘awareness’ and ‘predisposition’.

Using China Mills’ work on problematisation of poverty through psychiatrisation, the paper analyses how, in the case of Tharparkar, poverty and caste both are problematised, and explanations and interventions are targeted ‘at the level of the individual psyche rather than on the structural landscapes that produce and sustain poverty/caste' (2015:4). In doing so, the paper demonstrates how these discussions surrounding etiologies of death by suicides in Tharparkar contribute to the ongoing depoliticisation of distress, while simultaneously creating justification for pharmaceutical and psychiatric interventions instead of systemic changes.