The World Health Organisation (WHO) has issued some guidelines this month with focused efforts and preventive measures to curb suicide rates at global level. For the WHO, suicide is a tragedy and it needs an in- depth study as global epidemiology. The global attention has shifted to suicide amidst this pandemic regardless of many Covid-19 related deaths. The ongoing pandemic has given rise to many risk factors such as job loss, stress, isolation, anxiety and personal loss which can trigger suicide and suicidal tendency.
Enormous discussions, talks and research papers related to mental health condition during the pandemic as well as the role of climate change on our mental health have drawn world’s attention to contemplate the seriousness of suicide mortality and its societal impact.
The United Nation’s SDG target 3.4 emphasizes to reduce one third premature mortality from non-communicable disease by 2030 through safeguarding mental health. Suicide is subcategorised in SDG 3.4.2 as an indicator.The WHO’s new released booklet titled “Suicide worldwide in 2019: Global Health Estimates” is a prismatic statistical analysis of suicide mortality across the globe. Suicide is defined as the intentional killing of oneself. It is pathological.There are many key studies on the suicide. All the studies maintain that suicide depends on individual psychology, its physical environment and nature of individual’s relation to society.
As per this report one in every 100 deaths in world was due to suicide in 2019. It is also estimated that as many as 703,000 people died by committing suicide in 2019. Globally, suicide is one of the leading causes of mortality.
Death rates in suicide are more than the deaths due to war, homicide, AIDS/HIV, malaria and breast cancer. As per this WHO’s suicide worldwide in 2019, global age-standardized suicide rate for all sexes was 9.0 per 100, 000 population for the year 2019. To calculate the age-standardized mortality rate (ASMR), we must first calculate the age-specific (mortality) rates for each age group by dividing the number of deaths by the respective population, and then multiplying the resulting number by 100,000. Surprisingly, this report stated a big difference in the range of age-standardized suicide rate globally. Few countries had a suicide death of 2.0 per 1lakh where many others had 80.0 per one lakh.
For example Lesotho a country in Africa had 87.5 suicidal deaths per 100,000 whereas Barbados, a country from America region had 0.3 death per 1 lakh .
If we consider the gender aspect of this age-standardized suicide rate, we shall find that males commit more suicides than females. The global age-standardized suicide rate for males was 12.6 deaths per 1 lakh as compared to 5.4 deaths per 1 lakh females. It indicates that male suicide rate is 2.3 times more than female suicide rate.As far as India is concerned, this WHO suicide statistics says that overall age-standardized suicide in 2019 was 12.9 per one lakh.
For males in India age-standardized suicide rate was 14.7 per one lakh against 11.1 deaths per one lakh females. There is a ratio indicator for male: female suicide ratio. It says if the ratio is more than one then it shows that suicide rates are higher in males than in females. India is in the ratio category of 1.0 to 1.9.
Further this report says 58% of suicide occurs before the age of 50. Low and middle income countries have 77% of suicide deaths globally. Of course in these two categories of countries most of the world’s population live. In another finding it says that globally 88% adolescents who die by committing suicide are from low and middle income countries. For the young people aged between 15–29 years irrespective of gender, suicide stands as the fourth leading cause of death globally. The other top three causes are road injury, tuberculosis and interpersonal violence.
In a positive note this report says that in past 20 years i.e from 2000 to 2019 global age-standardized suicide rate has decreased by 36%. This is a good sign for SDG goals to reduce the suicide mortality by 2030. But another concern is that this declining trend is not applicable to all the countries in the world.
Suicide is a global health issue, a threat to economy and productivity, a loss to social capital and a sorrow to the family affected. In this connection, Director General of the WHO, Tedros Adhanom Ghebreyesus correctly said that “We cannot - and must not - ignore suicide”. WHO comes forward with a guide named as LIVE LIFE Implementation Guide for Suicide Prevention In Countries (WHO 2021). It has some effective interventions summed up to prevent suicide globally such as limiting the access to the means of suicide i.e hazardous things, poison particularly pesticides etc, a responsible and sensible reporting on suicide deaths by media, inculcating socio-economic skills among youth and identification and assessment of suicidal behaviour.
On a recent development, the WHO has also a serious concern on attempted or Para-suicide. These attempted suicides are different from successful suicides. The basic distinction between the two is a matter of possibility. In a recent report it is established that behind every suicide there are many more people who attempt suicide. A prior suicide attempt is the single most important risk factor for suicide in the general population. The high rate of suicide attempts are invariably made by vulnerable groups who experience discrimination such as prisoners, refugees and LGBTQ.
The pandemic induced loneliness and anxiety instigates many to commit suicide and attempt to suicide. A collective responsibility is needed now. Teachers, health workers, prison officers and media should take the lead now to curb this act.
There is no specific reliable data available worldwide. As of now 87 countries have good quality vital registration data on suicide. Only 38 countries worldwide have a national suicide prevention strategy. So, every country should design national prevention strategy for suicide.
(abash.parida@gmail.com)