A Hand on the Shoulder

01 · The 2 a.m. knock

A roommate who noticed

Aditya is in the second year of engineering at a well-known institute. On paper, everything is fine. He cleared one of the toughest entrance exams in the country; his parents tell every relative about it. But over one semester his roommate, Imran, noticed small things. Aditya stopped coming to the mess. He slept through classes and stayed awake all night. He gave away his cricket kit, saying he "wouldn't need it". Once, half joking, he said, "Sometimes I think everyone would be better off without me."

Most of us would laugh that off. Imran didn't. At two in the morning he knocked, sat on the edge of the bed, and asked the question most people are afraid to ask: "Are you thinking of killing yourself?" Aditya was quiet for a long time. Then he said yes. And then, for the first time in months, he cried.

Imran stayed. He didn't lecture or panic. The next morning he walked Aditya to the campus counselling centre. Today, a year later, Aditya is doing well. He changed his branch, and he talks to his parents differently. He says that knock saved his life.

Aditya and Imran are composites of many young people; names and details are changed.

Imran had never read a textbook of psychiatry. What he did was mental health first aid: noticing, asking, listening, staying and connecting to help. It works the way CPR works. You don't need to be a doctor. You just need to know what to do in the first few minutes, and not look away.

02 · What the numbers say

Behind every number, a name

I share these figures carefully, because each one was someone's son or daughter, someone's roommate. But we cannot fix what we refuse to look at.

What struck me most about recent national data is this: while suicides in the country as a whole stayed roughly flat, student suicides kept climbing. Among students, girls now account for almost half of all deaths, a far narrower gap than in the general population, where men make up nearly three-quarters. "Family problems" and "failure in examination" are the most commonly recorded reasons, though anyone who has worked in this field knows that suicide almost never has a single cause. And these are only the deaths that get reported. Stigma, family fear and police paperwork mean the true numbers are almost certainly higher.

The picture inside our elite institutions is not reassuring either. Parliament has been told that close to a hundred students died by suicide in five years across central institutions such as the IITs, NITs, IIMs and central universities, with the engineering institutes reporting the most. In the same period, more than thirteen thousand students from Scheduled Caste, Scheduled Tribe and Other Backward Class communities left these institutions midway. Officials say many simply moved to other courses. That is likely true for some. But a national task force set up by the Supreme Court has also flagged a campus culture where students from less privileged backgrounds must pass an unspoken "vibe check" to belong. When someone quietly packs their bags and leaves, it is worth asking what they were carrying.

Coaching hubs add another layer. Studies of young people who died while preparing for engineering and medical entrance exams show that most were between fifteen and twenty years old. Children, really, living alone in rented rooms, hundreds of kilometres from anyone who loves them.

03 · The pressure cooker

Why technical campuses are different

A pressure cooker isn't dangerous because of heat alone. It becomes dangerous when the steam has nowhere to go. That's a good way to think about our campuses. The pressure itself isn't new. What's missing are the safety valves.

Add sleeplessness, endless phone scrolling, sometimes alcohol or other substances, rigid hierarchies for research scholars and resident doctors, and the silence that surrounds mental illness, and you can see how steam builds up in someone who looks perfectly fine from the outside. Even among doctors, the people who should know better, distress often goes unspoken until it's too late. That silence is precisely what first aid is meant to break.

04 · Inside a mind in crisis

The tunnel

People often ask me, "How could such a bright student not see other options?" The answer is that a suicidal crisis narrows thinking. Psychiatrists call it cognitive constriction; I call it tunnel vision.

Three things about this tunnel matter for anyone who wants to help. First, crises come in waves. The most intense period of risk is often short, measured in hours or days, not years. Getting someone safely through that wave matters enormously; most people who survive a suicidal crisis go on to live full lives. Second, almost everyone in the tunnel is torn. One part of them wants the pain to end; another part wants very much to live. When we reach out, we are speaking to that second part. Third, pain is being measured against resources. When emotional pain grows bigger than a person's ability to cope, the tunnel closes in. We can't always shrink the pain overnight, but a friend, a phone call or a counsellor adds resources immediately.

05 · Myths that cost lives

What we get wrong

06 · Signs to notice

What a friend might see

Watch especially around results, backlogs, placement season, break-ups, ragging, family crises and the first months away from home. One sign alone doesn't mean danger, but a cluster of them, or any direct talk of suicide, means it's time to act.

07 · Mental health first aid

SAATH: five steps anyone can take

We teach every child what to do when someone chokes or bleeds. Almost nobody teaches them what to do when a friend says, "I don't want to live." That gap is costing us lives. Studies of mental health first aid training show that trained people know more, feel more confident and, most importantly, actually step in more often. And in a country with too few psychiatrists and counsellors for its size, the first helper is usually going to be a friend, a parent, a warden or a teacher.

I use a simple Hindi word to remember the steps: SAATH, which means "together".

If someone is in immediate danger, don't leave them alone, and call 112 or take them to the nearest emergency department. Putting distance between a person and the means of harm, even for a few hours, is one of the most effective steps in suicide prevention.

Remember, too, that helping someone in crisis can shake you. Talk to someone yourself afterwards.

08 · Who needs to do what

It takes a whole campus

Prevention works best in circles, with the student at the centre: friends, family, faculty and wardens, the institution, and finally law and policy.

Friends and classmates

Learn SAATH. Check on the quiet ones, not just the loud ones. A simple "chai pe chalein?" can open a door.

Parents

In every phone call, say some version of: "We're proud of you, whatever the rank. If it ever gets too much, you can come home, and we'll figure it out together." Your child may never tell you how much they needed to hear it.

Faculty, wardens and staff

The mess worker, the security guard and the hostel warden often notice changes first. Train them. Replace public shaming of marks with private conversations. Make it normal to ask for an extension, a break or help.

Institutions and coaching centres

The Supreme Court's 2025 guidelines now require every institution with a hundred or more students to engage a trained counsellor, to stop segregating or shaming students by performance, to train staff in psychological first aid and warning signs, and to publish a mental health policy. These are a floor, not a ceiling. Good campuses also add anonymous help channels, buddy systems for new students, strong action against ragging and discrimination, flexible academic pathways, and counselling services that students actually trust. India's national suicide prevention strategy aims to cut suicide deaths by a tenth by 2030. Campuses are where that promise will be kept or broken.

09 · If you are the one struggling

You are not the truth your tunnel is telling you

A single honest question, asked by someone who cares, can open a door that has been locked for months. Be the one who knocks.

Questions people ask me

Frequently Asked Questions

• How many students die by suicide in India?

  National records show 14,488 student deaths by suicide in 2024, about 40 a day, and the highest number ever recorded. The real figure is likely higher because of under-reporting.

• What is mental health first aid?

  It is the help you give someone in emotional distress until professional help is available: noticing, asking, listening, keeping them safe and connecting them to care. Like CPR, anyone can learn it.

• Will asking about suicide make things worse?

  No. Asking directly and calmly does not increase suicidal thoughts. It usually brings relief and opens the door to help.

• Why are students at technical institutes under so much pressure?

  Intense competition, marks tied to identity, loneliness far from home, financial stakes, discrimination and a lack of visible alternatives all add up, often with too few trusted support systems.

• What should I do if my friend says they want to die?

  Stay with them, listen without judging, remove anything they could use to harm themselves, and connect them to help right away: Tele-MANAS 14416, the campus counsellor, or 112 in an emergency.