More than 700,000 people are estimated to die by suicide every year. Almost 80% of suicides occur in low and middle-income countries, including in Asia, Africa and South America. For every suicide, there are at least 10-20 other people who self-harm and many more who have thoughts of suicide. An individual may have struggled with their problems until they reached a point where death may have appeared as the only option. Millions of people worldwide are affected by either a suicide of a loved one or may have survived a self-harm attempt themselves.
Suicide is a serious global public health problem that cuts across all national, ethnic, religious, gender, age and social class boundaries. However, there are significant differences in risk factors, socio-demographics and methods used between regions of the world, countries and even within regions of the same country. The vast majority of suicidal deaths are preventable, but this requires a concerted effort on the part of individuals, organisations and governments worldwide.
Each suicidal death is a public health concern that profoundly impacts those around them. Research shows that most suicides are carried out by young people in the most productive years of their lives. Hence the loss is not only for their families but for society as a whole.
In most countries, suicide is not a criminal offence. Still, in 20 countries, including Pakistan, anyone attempting suicide can be arrested, prosecuted, punished by fines, and/or given a prison sentence.
The criminalisation of suicide deters people from seeking help, further stigmatises mental ill health, and hampers efforts to prevent, diagnose and treat mental health conditions. In addition, it impedes accurate information gathering on suicide and self-harm, leading to underestimation of the true extent of the problem.
While there are no official figures for suicide in Pakistan, the WHO estimates that in 2019, as many as 19,331 people – 14,771 males and 4,560 females – killed themselves, with age-standardised rates of 9.8/100,000.
In Pakistan, efforts are underway to decriminalise suicide. A suicide decriminalisation bill, passed by the Senate, is now under consideration by the National Assembly.
To raise awareness and focus attention on suicide prevention, every year, 10th September is observed as World Suicide Prevention Day (WSPD). Established in 2003, this is a day to remind governments worldwide that suicide prevention must be a national priority, and to recognise the suffering of and support those who have been bereaved by the suicide of a loved one.
‘Creating hope through action’ is the three-year theme for WSPD from 2021-2023. This theme is a reminder that we must not lose hope, even in the face of extreme distress; that there is always an alternative to suicide; and that we must reach out to those in need of help. And the time to act is now, for it is only through action, however big or small, that we can send a powerful message of hope to those who may be contemplating suicide. This is particularly so in countries like Pakistan where access to quality affordable mental health services and professionals is very low, and suicide prevention is not recognised within the national public health agenda.
Clearly, suicide prevention will continue to pose as big a challenge for the foreseeable future as it did in the last century. This is particularly so for those countries where lack of resources, poorly established primary and mental health services, and weak political processes make prevention efforts doubly difficult. However, as recent figures from the US and Scotland show, even high-income countries with well-established health systems are not immune from increases in suicide rates.
Public health and mental health professionals, governments and non-governmental organisations, and civil society across the globe need to work together to take up this challenge. On 10th September 2022, let us, therefore, renew this commitment.
Published in The Express Tribune, September 10th, 2022.
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