700,000 people, one in 100, died of suicide in 2019, says WHO

Suicide remains one of the leading causes of death worldwide, according to World Health Organisation’s (WHO) latest estimates, published yesterday in “Suicide worldwide in 2019.”

The apex United Nations (UN) health body said every year, more people die as a result of suicide than Human Immuno-deficiency Virus (HIV), malaria or breast cancer or war and homicide.

According to the report, in 2019, more than 700,000 people died by suicide: one in every 100 deaths, prompting WHO to produce new guidance to help countries improve suicide prevention and care.

Director-General, WHO, Dr. Tedros Adhanom Ghebreyesus, said: “We cannot – and must not – ignore suicide.

“Each one is a tragedy. Our attention to suicide prevention is even more important now, after many months living with the COVID-19 pandemic, with many of the risk factors for suicide – job loss, financial stress and social isolation – still very much present. The new guidance that WHO is releasing today provides a clear path for stepping up suicide prevention efforts.”

Among young people aged 15-29, suicide was the fourth leading cause of death after road injury, tuberculosis and interpersonal violence.

Rates vary between countries, regions and between sexes. More than twice as many males died due to suicide as females (12.6 per 100,000 males compared to 5.4 per 100,000 females). Suicide rates among men are generally higher in high-income countries (16.5 per 100,000). For females, the highest suicide rates are found in lower-middle-income countries (7.1 per 100,000).

Suicide rates in Africa (11.2 per 100,000), European (10.5 per 100,000) and Southeast Asia (10.2 per 100,000) regions were higher than the global average (9.0 per 100,000) in 2019. The lowest suicide rate was in the Eastern Mediterranean region (6.4 per 100 000).

Globally, the suicide rate is decreasing; in the Americas, it is going up

Suicide rates fell in the 20 years between 2000 and 2019, with the global rate decreasing by 36 per cent, with decreases ranging from 17 per cent in the Eastern Mediterranean Region to 47 per cent in the European Region and 49 per cent in the Western Pacific.

But in the Americas Region, rates increased by 17 per cent in the same time period.

Although some countries have placed suicide prevention high on their agendas, too many countries remain uncommitted. Currently, only 38 countries are known to have a national suicide prevention strategy. A significant acceleration in the reduction of suicides is needed to meet the SDG target of a one-third reduction in the global suicide rate by 2030.

To support countries in their efforts, WHO yesterday releasing comprehensive guidance for implementing its LIVE LIFE approach to suicide prevention. The four strategies of this approach are: limiting access to the means of suicide, such as highly hazardous pesticides and firearms; educating the media on responsible reporting of suicide; fostering socio-emotional life skills in adolescents; and early identification, assessment, management and follow-up of anyone affected by suicidal thoughts and behaviour.

Given that pesticide poisoning is estimated to cause 20 per cent of all suicides, and national bans of acutely toxic, highly hazardous pesticides have shown to be cost-effective, such bans are recommended by WHO. Other measures include restricting access to firearms, reducing the size of medication packages, and installing barriers at jump sites.

The guide highlights the role the media plays in relation to suicide. Media reports of suicide can lead to a rise in suicide due to imitation (or copycat suicides) – especially if the report is about a celebrity or describes the method of suicide.

The new guide advises monitoring of the reporting of suicide and suggests that media counteract reports of suicide with stories of successful recovery from mental health challenges or suicidal thoughts. It also recommends working with social media companies to increase their awareness and improve their protocols for identifying and removing harmful content.

Adolescence (10-19 years of age) is a critical period for acquiring socio-emotional skills, particularly since half of mental health conditions appear before 14 years of age. The LIVE LIFE guidance encourages actions including mental health promotion and anti-bullying programmes, links to support services and clear protocols for people working in schools and universities when suicide risk is identified.

Early identification, assessment, management and follow-up applies to people who have attempted suicide or are perceived to be at risk. A previous suicide attempt is one of the most important risk factors for a future suicide.

Health-care workers should be trained in early identification, assessment, management and follow-up. Survivors’ groups of people bereaved by suicide can complement support provided by health services. Crisis services should also be available to provide immediate support to individuals in acute distress.

The new guidance, which includes examples of suicide prevention interventions that have been implemented across the world, in countries such as Australia, Ghana, Guyana, India, Iraq, the Republic of Korea, Sweden and the USA, can be used by anyone who is in interested in implementing suicide prevention activities, whether at national or local level, and in the governmental and nongovernmental sectors alike.

Suicide prevention expert at the WHO, Dr. Alexandra Fleischmann, said: “While a comprehensive national suicide prevention strategy should be the ultimate goal for all governments. Starting suicide prevention with LIVE LIFE interventions can save lives and prevent the heartbreak that follows for those left behind.”