The Silent Tragedy Unfolding in Kerala's Homes
Shruti (name changed) recalls the horrific day that shattered her family forever. "My father violently assaulted my mother, causing severe head injuries. We rushed her to the hospital, but she could not be saved. By the time we returned home, he had died by suicide," she recounts with palpable pain.
Joseph (name changed) shares a similarly traumatic experience. "I woke up to screams in the middle of the night. My father was attempting to strangle my brother. When I intervened, he revealed he had already killed our bedridden mother," he says, his voice trembling with emotion.
A Disturbing Pattern Emerges
These are not isolated incidents. Across Kerala in recent years, numerous such tragedies have quietly occurred within domestic spaces, leaving families devastated by trauma, shame, and unanswered questions. These cases follow a clear global pattern in homicides and homicide-suicides:
- Perpetrators are typically men aged 65 and above
- Victims are intimate partners or close family members
- Incidents almost always occur within the home
"None of these individuals are habitual criminals. They are people experiencing acute distress who act on impulse," explains Dr. Dinesh R S, a psychiatrist at Thiruvananthapuram's Mental Health Centre who has conducted psychological autopsies in multiple such cases.
Dr. Dinesh was part of a three-member psychiatric team that recently studied elder homicides and homicide-suicides in Kerala. Their research, though yet to be published, reveals critical insights into this growing crisis.
The Triggers Behind the Violence
Several interconnected factors contribute to these tragic events:
- Long-standing marital conflicts that reach breaking points
- Declining mental health among elderly individuals
- Caregiver stress for those tending to bedridden or chronically ill spouses
- Financial strain that compounds existing pressures
"The involvement of elderly individuals in impulsive murders is increasing," notes Dr. Dinesh, highlighting a particularly concerning trend given Kerala's demographic realities.
Kerala's Aging Population Intensifies the Crisis
Kerala is aging faster than any other Indian state, creating a perfect storm for such tragedies. According to RBI's "State Finances: A Study of Budgets of 2025-26":
- The population aged 60 and above is projected to increase from 18.7% in 2026 to 22.8% by 2036
- This rapid demographic shift occurs alongside inadequate mental health infrastructure
"Affordable and accessible mental health services remain scarce across India, and free support systems are difficult to find," says Dr. Shabbir Amanullah, immediate past president of the Canadian Academy of Geriatric Psychiatry.
He emphasizes that "not every mental health issue requires a psychiatrist. Many psychosocial stressors can be effectively addressed by psychologists, counsellors, or social workers."
The Healthcare System's Critical Gaps
India's mental healthcare system faces multiple challenges:
- Inadequate funding allocations for mental health services
- Severely insufficient doctor-patient ratios
- Dedicated geriatric mental health services limited to a few private institutions
- Most specialized care remains unaffordable for average families
This systemic failure explains why many perpetrators and victims had untreated depression. Some individuals were later diagnosed with neurodegenerative conditions and psychotic disorders that impaired their impulse control.
In one particularly tragic case, an 84-year-old man killed his wife while in a delirious state, believing someone was trying to strangle her. He was subsequently diagnosed with frontotemporal dementia, a condition that severely affects impulse regulation.
Global Patterns, Local Realities
According to Dr. Sen Kallumpuram, a consultant psychiatrist with the NHS in London, patterns observed in the UK and US are likely to manifest in Kerala as well. "In these countries, services expanded gradually as aging populations created sustained demand and drove necessary policy reforms," he explains.
The situation in Kerala mirrors this trajectory but without the corresponding service expansion, creating dangerous gaps in care and prevention.
The Forgotten Survivors
Survivors of these tragedies often become "secondary victims" whose needs remain largely unaddressed. Having lost one parent—and sometimes having witnessed the violence firsthand—many withdraw into themselves, burdened by shame and trauma.
Shruti and Joseph represent the few willing to speak about their ongoing struggles. Six years after her tragedy, Shruti continues to battle suicidal thoughts and social isolation. "My son, who was only five at the time, has withdrawn from his peers and remains under psychiatric care," she reveals.
Joseph similarly experiences persistent psychological distress. "I still wake up shaken in the middle of the night. I feel completely helpless—nobody seems to understand what I'm going through," he confesses.
The Stigma That Silences
The experiences of survivors and elderly couples point to a broader societal issue: the persistent stigma surrounding mental health in Kerala.
"Regardless of age, anyone who speaks about anxiety or depression faces immediate judgment. We haven't reached the level of acceptance seen in many Western societies because open discourse about mental health remains limited," observes Dr. Shabbir.
For survivors, isolation often deepens once initial support from relatives and neighbors fades. While some helplines and counseling centers exist, they prove insufficient for addressing long-term needs.
Pathways to Prevention
Given Kerala's robust local governance system, Dr. Dinesh sees considerable potential for community-level interventions:
- Risk assessment programs for vulnerable elderly individuals
- Awareness campaigns to destigmatize mental health discussions
- Sustained psychosocial support networks
- Dedicated trauma and grief counseling services
- Psychological first-aid training for non-professionals
"As with suicides, there is no single cause behind homicides or homicide-suicides, and therefore no single solution," emphasizes Dr. Dinesh. "Only a comprehensive, multi-pronged strategy can prevent these silent tragedies unfolding within our homes."
The need for action grows more urgent each day as Kerala's population continues to age and mental health resources remain inadequate. Without systemic changes, more families will face the unimaginable trauma that Shruti, Joseph, and countless others have endured.
