World Suicide Prevention Day 2019

Author’s Note: This article discusses suicide and may be triggering for individuals with lived experience. While resources will be presented later on, this website has a list of country specific resources for those who need them. If you or someone you know is struggling with passive or active suicidal ideation, please reach out for help. 

The National Suicide Prevention Hotline in the USA is 1-800-273-8255.

Every 40 seconds someone, somewhere in the world, takes their own life. That amounts to over 800,000 deaths per year. On September 10th each year, World Suicide Prevention Day, the world comes together to reflect on the lives lost and bring suicide prevention to the forefront of the conversation. 

What Suicide Looks Like Around the World

Like most things in global health, there’s no single causal factor and no “one-size-fits-all” solution. Preventing suicide globally will require an understanding of the way individual, interpersonal, societal, and cultural factors interact to affect suicidality. High income countries, on average, have higher rates of suicide than low- and middle- income countries (LMICs), with the exception of LMICs in South-East Asia where the regional suicide rate is the highest in the world (17.7 deaths per 100,000 people). While rates may be higher elsewhere, suicide isn’t just a problem for high-income countries. The majority of suicides actually occur in LMIC settings, highlighting these countries as important stakeholders in the global conversation around suicide. 

Image Credit: World Health Organization (WHO)

Like the rates themselves, at-risk sociodemographic groups vary from region to region. Suicide is the second leading cause of death, globally, for young adults (18-29 years of age). Middle aged men in high-income countries generally have a higher risk, while adolescents and aging adults in LMICs are more likely to take their lives. 

Globally, males are 2-3 times more likely to complete suicide than women. This has long been blamed on differences in care seeking behaviors and socially acceptable coping mechanisms deemed acceptable for different genders. But it’s important to keep in mind that women are generally more likely to experience suicidal ideation and more likely to attempt suicide. Men, however, have historically used more lethal methods of suicide and more likely to take measures to prevent intervention. 

The means of suicide attempts vary drastically and adapt to environments. Pesticide poisoning accounts for about one-third of global suicides. Almost all of these deaths occur in rural subsistence farming communities. Self-inflicted firearm injuries account for a large proportion of suicides in the Americas. Urban contexts with much stricter firearm regulations, such as Hong Kong and Singapore, experience a higher number of deaths related to jumping from buildings and bridges. 

What We Can Do

Suicide may look differently depending on where we sit on a map, but the truth remains that the pain and suffering that causes and is caused by suicide cuts across every sociodemographic variable and exists in every corner of the world. Despite its inclusion in both the WHO’s Mental Health Action Plan and the United Nation’s Sustainable Development Goals (Target 3.4), suicide remains a low-priority agenda item for policy-makers worldwide. Only about 40 countries currently have national strategies or action plans in place to respond to suicide, and even fewer of these are in LMIC settings where the majority of suicides occur. 

While national strategies with government engagement will be crucial to eliminating suicide, suicide prevention requires multisectoral and multilevel approaches that treat suicide as the complex public health problem that is. It is the community and the individuals close to a victim of suicide that will suffer the most in the aftermath and have the most power in targeted prevention efforts delivered to the individual. 

Primary care professionals, especially those serving communities that are underserved by specialists, can and should be more familiar with using depression screeners like the Patient Health Questionnaire or Beck Depression Inventory to assess suicidality in the exam room. Educators can advocate for school-based intervention and encourage (not punish) help-seeking behaviors. And while we can’t all be psychiatrists, suicide crisis line volunteers, or counselors, we can all be kind people to those around us. Use today to raise awareness for the issue. Educate yourself (and others) about suicide prevention resources available in your community. As friends and family members, we can all do a better job of dismantling the stigma around mental health and identifying when those close to us are experiencing acute stress or grief that may serve to trigger or exacerbate existing suicidality. 

Where we live might affect what suicide looks like, who is at risk, and how often it happens. Our professional roles may dictate at what level we help break the cycle. But today is a reminder that we are all responsible, as stewards of humanity, for reducing the number of suicides in our world. In the time it took you to read this article, five people will have taken their own life. Every suicide death is one too many, so now is the perfect time to consider: what will YOU do to make sure it doesn’t happen again?

Looking for a starting point? I’ve compiled a wealth of resources that may be helpful, in addition to the links embedded in the text throughout the article. 

Helping Individuals At-Risk:

List of International Suicide Crisis Lines
Learn the Signs Factsheet (Take 5 to Save Lives)

Helping Someone in Crisis (Take 5 to Save Lives)

Find a Mental Health First Aid Course (USA)

Suicide Prevention: A Resource for General Physicians (Available in Multiple Languages)

Get Involved in World Suicide Prevention Day:

Download and post a WSPD banner in your native language

“Light a Candle” for victims and survivors of suicide

Post on social media using the hashtags: #wspd, #suicideprevention

Data:
Look up your country’s suicide rates

Suicide Factsheet (WHO)

Suicide Prevention: A Global Imperative (WHO)

World Suicide Prevention Day Fact Sheet (IASP)

National Prevention Strategies:
Does your country have a national action plan for suicide prevention? 

National suicide prevention strategies: progress, examples and indicators (WHO)

Evidence based strategies for safer access to pesticides (WHO)

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