In five months between April and September 2023, 19 students have died by suicide in Kota, India’s coaching hub, taking the toll in the year up to 25, the highest since the district administration began collecting this data in 2015. But in that same five-month period, a survey conducted by a district medical team led by the Kota chief health and medical officer(CMHO) Jagdish Soni identified at least 83 other students with severe depression.

The team that was set up on the instructions of the then district collector of Kota, Om Prakash Bunkar, was asked to identify students vulnerable to suicide and provide them with necessary counselling and medical support to prevent further such incidents.

Also read: New Rajasthan guidelines aim to curb suicides in Kota

Over the years, Kota, over 300km from the state capital of Jaipur, has turned into a coaching factory of sorts, producing toppers of competitive examinations such as the National Eligibility Entrance Test (NEET) for admissions to India’s medical and dental colleges, or the Joint Entrance Examination (JEE) for engineering colleges. But there is a dark side; a crushing environment of pressure where several students are unable to cope with the expectation from their families, loneliness at such a young age, or the relentless competition. Data from the Kota administration says there are 225,000 students that study in the town and live in over 4,000 hostels and 5,000 registered paying guest accommodations.

During their survey, the CMHO led team was tasked with gathering relevant data on students by visiting hostels and interacting with students twice a week. “After visiting around 6602 students in 223 hostels during this period, we found 83 students suffering from severe depression,” said Dr Poorti Sharma, a member of the medical team.

CMHO Soni said that they also found two students who were on the verge of suicide. “They had started to hurt themselves which is a common symptom in these cases.”

Sharma said that many of the 83 students were sent for psychiatric counselling and medication. “We have also contacted all of their parents, hostel wardens, and the counselors and the authorities of the coaching centers, shared their reports confidentially and asked for regular monitoring.”

The findings dovetail with other data that has emerged from Kota this year, that show just how deep the mental health crisis in the city is. In August, HT reported that in 55 days between June 24 and August 18, eight students died by suicide, and the Kota Abhay Command Centre– a special students cell set up by the police– had to intervene after receiving distress calls from 45 more students that had contemplated suicide.

The survey by the district medical team, Sharma said, has identified that the primary factors behind the deaths in Kota are the failure to cope with daily new classes, and surviving in a highly competitive environment. “The students usually explore the city for the first 60 days after arriving in Kota, but the situation suddenly gets difficult when they are put into full-fledged coaching classes. Getting such cases, we immediately interact the coaching centres and ask them to stay on regular touch with them to understand their obstacles,” she said.

CMHO Soni said that the department has now distributed survey teams among every community health centre(CHC) in Kota. “At the CHC level, the medical officer in charge leads the team that covers the hostels in their respective areas and reports to me.”

Commenting on the findings of the medical team, Jaipur-based sociologist Rajeev Gupta said, “This is now beyond our control. April to September is the period when competition is at its peak as all the new admissions take place along with the examination, and results of NEET and JEE. The fear of exam, uncertainty about the result, and the aspirations of a high-class future rattle all these students. Such environment also create a tension in every family which causes more stress on the students. Such survey is not an alternative as it is never the responsibility of the doctors. State should take up the accountability and ensure the entire education system is transformed immediately.”

The surveys come at a time when the government has attempted to intervene, and in September this year, a committee led by Rajasthan higher education secretary Bhawani Singh Detha issued guidelines to coaching centres that included a mandatory screening test, the alphabetical sorting of students into sections instead of this being based on rankings, and barring the admission of students in classes lower than grade 9.