key: cord-0704272-vgr490uz authors: Kar, Sujita Kumar; Arafat, S.M. Yasir; Ransing, Ramdas; Menon, Vikas; Padhy, Susanta Kumar; Sharma, Pawan; Marthoenis, Marthoenis title: Repeated celebrity suicide in India during COVID-19 crisis: An urgent call for attention date: 2020-08-27 journal: Asian J Psychiatr DOI: 10.1016/j.ajp.2020.102382 sha: 89763ca7bd242fac6c183c728bf57e4a6e75b2f5 doc_id: 704272 cord_uid: vgr490uz nan Please cite this article as: Kar SK, Arafat SMY, Ransing R, Menon V, Padhy SK, Sharma P, Marthoenis M, Repeated celebrity suicide in India during COVID-19 crisis: An urgent call for attention, Asian Journal of Psychiatry (2020), doi: https://doi.org/10. 1016/j.ajp.2020.102382 This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ORCID ID: https://orcid.org/0000-0003-0521-5708 Short title: Celebrity suicide during COVID-19 crisis in India To the Editor, The COVID-19 pandemic has affected people of all ages, races and socio-economic strata, across the globe. People have been experiencing a wide spectrum of psychiatric disorders such as fear, anxiety, depression, panic, distress, discomfort, and even suicidal behaviours (Kar et al., 2020; Rogers et al., 2020) . Several suicides have been reported during this COVID-19 pandemic in India though the exact attribution demands further exploration study (Dsouza et al., 2020; Menon et al., 2020) . Celebrities (film actor and actress) go through enormous challenges during this pandemic due to loss of employment, cancellation of contracts, loss of public identity, life-style limitations, boredom, etc., which may attribute to stress and suicidal behaviour. As per the media reports, several Indian celebrities committed suicide during this COVID-19 pandemic. The latest news reports the suicide of popular, young Marathi Actor Ashutosh Bhakre on 30th July 2020. The report mentions the possibility of depression in the actor (PTI, 2020) . Similarly, Kannada actress Chandana, committed suicide on 28th May 2020 following relationship challenges (Times of India, 2020). Another young Kannada actor Susheel Gowda, committed suicide in the first week of July 2020 (The Indian Express, 2020). Sushant Singh Rajput (SSR), a popular mainstream Bollywood actor also committed suicide on June 14, 2020 (Menon et al., 2020) . In the first week of June, 2020, two Tamil actors (Sreedhar & Jaya Kalyani) committed suicide. The media report mentions that these two actors (who were brother-sister) were going through financial crisis due to lockdown related job loss (Kumar, 2020a) . A TV actor Manmeet Grewal also committed suicide by hanging due to stress of financial loss during this COVID-lockdown (Kumar, 2020b) . It has been reported that people resisted themselves, to rescue the actor, when his wife shouted for help, due to the suspicion that the actor might have COVID-19 infection (Kumar, 2020b) . Mental health needs of celebrities are complex, often unaddressed due to different psychological concerns such as unwillingness to give up fame, mistrust, isolation, and character-splitting. These concerns could be the reason for the delay or lack of treatment-seeking behaviour or supportive care despite being aware of the mental health problems (for e.g. in movie Chhichore SSR has created awareness about suicide but unfortunately, he died by suicide). In addition, the published literature on the phenomenological analysis of fame among celebrities has reported that being famous leads to loss of privacy, expectations, symbolic immortality, and gratification of ego (Rockwell and Giles, 2009) . Limited or lack of research on mental health, lifestyle, and culture of celebrities limits the opportunity to develop comprehensive strategies for the prevention of suicide among celebrities in India (Driessens, 2015) . Speculatively, several causal factors could be put forward such as any pre-existing mental disorder, personality disorder, unstable personality, substance use, an unstable relationship can predispose to suicide. Furthermore, the COVID-19 pandemic, or lockdown, recent depression or psychiatric disorder, recent substance abuse, immediate life events could precipitate the events. Celebrity suicide itself is a risk factor for suicidal ideation and suicide attempts both in short term and long term among general public (Fu and Yip, 2009 ). The recent increase in the suicide rate among celebrities is alarming and needs immediate attention from researchers, mental health professionals, public health professionals, and policymakers, especially in India. Sigma related to mental health, complex coping mechanisms, frustrations, unemployment, and mistrust among celebrities need to be explored and addressed. Interventions directed towards the mental health of celebrities or famous personalities will help to reduce the glamorization of suicide or mental health issues, sensitive media reporting, and epidemic of copycat suicides in the community. Immediate action is warranted involving all the stakeholders for suicide prevention to come forward and take necessary actions to prevent it. Responsible media reporting should be implemented to minimize the effect on the general population and one recent pilot study found the reporting irresponsible (Menon et al., 2020; Zalsman et al., 2016) . Mental health services and support system should come forward to address the mental health of celebrities, who are at risk. Selected prevention strategies should be considered for celebrities focusing on the early identification of suicidal risk. The appropriate gatekeepers (family members, colleagues, directors) should be identified, trained so that they can identify the risk factors and refer them to the mental health support systems. Certainly, postvention support is necessary for the family members, and these services should be developed. Central agencies J o u r n a l P r e -p r o o f like censor board, or Ministry of information and broadcasting or Bollywood Association or Indian Psychiatric Society should come forward to take the lead and coordinate the activities of other stakeholders so that harmonization could be ensured. A periodic mental health assessment as a mandatory basis could be an option. Developing a mental health registry for celebrities, periodic mental health assessment as a mandatory basis, periodic training, and education programs focussing on mental health and suicide of celebrities, involving celebrities in awareness-building programs for the general population could important strategies. Extensive psychological autopsy studies could be beneficial to identify the risk factors. None Conflict None. Expanding celebrity studies' research agenda: theoretical opportunities and methodological challenges in interviewing celebrities Aggregated COVID-19 suicide incidences in India: Fear of COVID-19 infection is the prominent causative factor Estimating the risk for suicide following the suicide deaths of 3 Asian entertainment celebrities: a meta-analytic approach TV Actors Commit Suicide in Chennai, Decomposed Bodies Found After Neighbours Complained of Foul Smell TV Actor Manmeet Grewal Commits Suicide by Hanging Himself, Friend Manjit Says Neighbours Didn't Help Fearing he Had Coronavirus Crosscountry comparison of media reporting of celebrity suicide in the immediate week: A pilot study Actor Ashutosh Bhakre dies by suicide Being a celebrity: a phenomenology of fame Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic Actor Susheel Gowda dies by suicide. Times of India, 2020. 29-year-old Kannada actress Chandana commits suicide Suicide prevention strategies revisited: 10-year systematic review None.