Estimating the economic and societal burden of suicide and suicide attempts in India: a study protocol.

INTRODUCTION: Suicide has a substantial economic burden, yet in low- or middle-income countries, the analysis is constrained by the absence of disaggregated economic data. Existing studies primarily rely on gross costing methods, overlooking sector-specific costs such as healthcare, law enforcement and productivity losses at the family and community levels. Furthermore, the societal perspective, essential for understanding the multifaceted economic impacts of suicide, remains insufficiently explored in the Indian context. METHODS AND ANALYSIS: This study will quantify the economic burden of suicide and suicide attempts in India. The initial phase will involve developing a resource-use measure instrument to capture the societal costs associated with suicide. Subsequently, a retrospective, incidence-based study will be conducted in India using the developed instrument. This will also be complemented with the Health-Related Quality of Life Assessment using EuroQOL (EQ-5D-5L). Exploratory subgroup cost comparisons (eg, suicide methods, healthcare facility type) will use non-parametric tests, including the Mann-Whitney U and Kruskal-Wallis tests. Generalised linear mixed models (gamma distribution and log link) will analyse longitudinal cost and HRQoL data, besides bootstrapping techniques and sensitivity analyses. ETHICS AND DISSEMINATION: Ethics approval was obtained for the study from the institutional review board of the Indian Law Society (ILS/141/2024). All data collected during the study will adhere to ethical guidelines, taking informed consent. The findings of the study will be disseminated through peer-reviewed journals to aid data-driven decision-making. TRIAL REGISTRATION: Clinical Trial Registry of India (CTRI/2025/02/080380), date of registration: 12/02/2025.