On the morning of January 30, Udaya Jayesh, a newly elected ward member in Mullurkara panchayat in Thrissur district, recalled receiving a phone call from an acquaintance. He told her that something was amiss about a family of three elderly sisters residing in her ward.

Experts flag need to address mental health crisis among Kerala’s elderly“I rushed there to find the gate of their home shut. The morning newspaper was still lying on the front porch. We knocked and called out to them, but there was no response. That’s when I called the police,” Udaya told HT over the phone.

A few minutes later, a police team reached the spot and entered the house to find the three elderly inhabitants, aged 75, 80 and 83 unconscious and cold. Two of the sisters were found lying on the bed in one of the rooms while the eldest one was found in the next room. A few hours earlier, the three of them, all unmarried, had attempted suicide by ingesting a form of pesticide.

The eldest sister, bedridden for years and aged 83, was declared dead at the nearby private hospital the same day. The youngest sister, diagnosed with a form of cancer and retired from the health department, succumbed to the effects of the poison the next day. The middle sister, aged 80, followed her siblings and passed away on February 2, leaving the local community in Mullurkara in shock.

A senior police officer, who began a preliminary probe into the suicides, said his team retrieved a suicide note from the house in which the elderly siblings spoke about battling age-related illnesses with no one to care for them. “They must have felt lonely,” the officer said.

Udaya said she had several conversations with two of the sisters during her visits to their home as part of her election campaign. While the eldest sister was bedridden and spoke very little, the other two siblings were quite energetic and handled all the household errands despite their advanced age and health conditions, she said.

“They didn’t interact a lot with the neighbours and kept to themselves. But on my visits, I felt they wanted someone to talk to. So I would often sit and lend an ear to what they had to say, even if they were mundane topics,” added the ward member.

Even as they may be interpreted as isolated incidents, the deaths nevertheless raise uncomfortable questions about the state of the elderly population in Kerala and whether enough is being done by the government and the larger civil society to make their lives better and more comfortable. Experts say such questions are extremely relevant in a state with the highest proportion of elderly residents in India.

The office of the Registrar General of India (RGI) underlines that the proportion of people aged 60 years and above in Kerala in 2026 is 18.7% compared to the national average of 11.4%. In 2031, the proportion in Kerala is set to rise to 20.9% against 13.1% in India. And in 2036, it will touch 22.8% in Kerala against 14.9% in the country. In short, in just a decade, the population of 60 and above in the southern state will inch closer to one-fourth of the state’s population. In real numbers, estimates in 2021 put the elderly population at roughly 6.5 million.

A working paper of the International Institute of Migration and Development (IIMAD) said the demographic transition in Kerala of rising ageing population was a result of the state reaching below-replacement fertility levels as early as 1987 due to progress in family planning measures and higher awareness of reproductive health. The success of the healthcare system has contributed to the transition.

“The availability of primary healthcare services, access to safe drinking water and proper sanitation have all contributed to a decline in mortality rates, particularly among children and younger adults. This has resulted in an increase in the proportion of elderly people in the state,” the paper noted.

In recent times, the rising exodus of young people for education and jobs from the state has deepened concerns about the elderly population becoming more isolated in their homes and prone to bouts of loneliness and other mental health challenges, as the Mullurkara episode has hinted. A study conducted in 2024 in Thalayazham panchayat in Kottayam highlighted that over 70% of the elderly respondents rely solely on social security pensions, which are currently at ₹2000 a month, and 88% remain financially dependent on their children. The study pointed to ‘poor insurance coverage’ and ‘limited social engagement’ – half of the respondents were not active in community groups.

There are signals that the State is serious about tackling these challenges among the elderly population. For example, after several years of demands, Finance Minister KN Balagopal presented the first ‘elderly budget’ along with the state budget, listing the key allocations in various sectors like health, culture and social justice aimed at ensuring a smoother life for the ageing population.

As part of the ‘elderly budget’, the FM has promised ‘retirement homes’ in all 14 districts on a fee-paying basis, a new pneumococcal vaccination programme against pneumonia incidence and modern day-care centres to address the needs of the elderly.

Arun S Nair, director of the social justice department, said several initiatives are being taken in a targeted approach for the elderly community.

“The senior citizens commission, a statutory body in nature, has already started functioning. A first in India, it has the power to receive complaints and take action. Additionally, we have started a programme under which rapid response team (RRT) are deployed in all districts with a field response officer, a technical officer and councillor to address all complaints of elderly people including abandonment or abuse. At the grassroot level, it’s a mobile unit which can help with rehabilitation and legal issues,” Nair told HT.

To deal with problems of loneliness and anxiety among senior citizens, Nair said, the department has ushered the ‘Sallapam’ initiative in which young college students run a helpline to interact and chat casually with elderly folks. The first phase, he said, has been successful and there are efforts to expand it statewide.

Dr PM Vijayan, psychologist and IGNOU faculty member, advocates for the State and NGOs to use ‘befriending’ techniques to solve mental health issues among seniors.

“Rather than a formal counselling session, befriending helps the senior citizen find the solution to his/her problem from within. It’s an informal, one-to-one casual conversation in which we want the solution to come from within their mind. It helps those having suicidal tendencies,” said Dr Vijayan.

He also calls for more assisted living and retirement facilities in every district of the state. “As more and more young people move away from home, retired people struggle to lead a daily life. Time often becomes a burden for them. We need to develop more social groups for elders and get them involved in community activities,” he said.

Vishnu Varma is Assistant Editor and reports from Kerala for the Hindustan Times. He has 10 years of experience writing for print and digital platforms and has worked at The New York Times, NDTV and The Indian Express in the past. He specialises in longform reportage at the intersections of politics, crime, social commentary and environment.Read More