The silent global epidemic — we have to change the narrative on suicide

It’s time for us to openly discuss suicide and its impact on our society. Suicide is a public mental health crisis – worldwide, more than 700,000 people die by suicide annually, resulting in wide-ranging social, emotional, and economic consequences. 

Each year on 10 September we observe World Suicide Prevention Day to draw attention to this global crisis and to emphasise one crucial message: suicide is preventable.

This year’s theme, Changing the Narrative on Suicide, focused on our perceptions of this complex phenomenon and changing from a culture of silence and shame to one of openness, empathy and support. 

Suicide is highly stigmatised, and many people with suicidal thoughts and behaviours, and the families affected by suicide, suffer in silence. The stigma attached to suicide is often rooted in misplaced associations of weakness, blame, shame, and even sin or crime.

These misconceptions about suicide are usually worsened by existing stigma toward common mental disorders such as depression, anxiety or traumatic stress disorder.

There is a large body of research, mostly from high-income, Westernised countries, that demonstrates the link between suicide and mental disorders. For example, nine out of 10 suicide deaths in high-income settings are associated with a diagnosed mental disorder.

Similarly, people with depression are 20 times more likely to die by suicide compared with people without the disorder. The dual burden of suicide and mental disorders results in a synergy of stigma: people are reluctant to reach out for help due to fears of being rejected and ridiculed; and we are reluctant to offer help due to negative stereotypes and misinformation.

In low- and middle-income countries, which represent nearly 80% of the global suicide burden, suicide and related behaviours present differently. There is increasing evidence that socioeconomic and psychosocial factors are important drivers of suicide in low-resource settings.

For instance, unemployment is a significant risk factor for suicide across geographical settings, and even when considered in combination with depression, unemployed people are nearly twice as likely to report suicidal ideation and elevated suicide risk.

It is no coincidence, then, that the highest suicide rates are found in some of the least-resourced nations in the world, including Lesotho and Eswatini.  

Rather than viewing suicide as a weakness, a selfish act, or a “mental case”, let us reconsider: suicide often results from a confluence of stressors, leading to feelings of defeat and humiliation. Trapped by our circumstances, ending our lives may seem like the only viable way out of this stress.

Changing the narrative