The Curious Case of Coaching Industry as a Commercial Determinant of Mental Health: Unpacking the Kota Suicide Cluster in India

Kota, Rajasthan, India, has emerged both as the "coaching capital" and a suicide cluster. The coaching industry is fueled by high-pressure entrance examinations and preference and parental pressure for science, technology, engineering, and mathematics courses, particularly for male children. This article draws upon the World Health Organization's definition of Commercial Determinants of Health to demonstrate that the commercial coaching model has resulted in serious adverse health outcomes, culminating in a suicide cluster. These suicide clusters need to be viewed through the lens of a commercial determinant of health, beyond an individual medical-psychiatric approach. This calls for both health systems and societal responses.