“Ensure healthy lives and promote well-being for all at all ages”, recites SDG #3 of the Agenda 2030, and more specifically, in target #3.4, it enunciates: “By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.”
Among the causes of premature mortality not due to communicable and non-communicable diseases, there is suicide. Every year, over 703 000 people take their own life and many more attempt suicide.
Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind.
Suicide is the second leading cause of death among 15-29-year-olds and the fourth leading cause of death among 15-19-year-olds.
Although it is a global public health problem, 77% of global suicides occur in low- and middle-income countries, and particularly affect vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, intersex (LGBTI) persons; prisoners and individuals bereaved or affected by suicide.
Suicide can be induced by mental disorders, like depression and alcohol use, but it is also very often caused by intense moments of crisis and stress. Financial or relationship problems, chronic pain and illness, conflict, disaster, violence, abuse, or loss and a sense of isolation are all factors strongly associated with self-harming and suicidal behavior. Still, by far, the strongest risk factor for suicide is a previous suicide attempt.
Such a complex problem requires a coordinated, comprehensive and integrated approach among several sectors of society to be efficiently prevented. The health sector and education at all levels, labor and business, law, politics, and media all play a crucial role in preventing suicides and suicides attempts at the population, sub-population, and individual levels.
WHO recognizes suicide as a public health priority. In 2014, the first WHO World Suicide Report, “Preventing suicide: a global imperative”, was published to raise awareness on the issue and call for global decision-makers to make suicide prevention a high priority on the global public health agenda. Furthermore, the report called on countries to develop or strengthen comprehensive suicide prevention strategies in a multisectoral public health approach.
Suicide is also one of the priority conditions in the WHO Mental Health Gap Action Programme (mhGAP) launched in 2008, which provides evidence-based technical guidance to scale up service provision and care in countries for mental, neurological and substance use disorders. In the WHO Mental Health Action Plan 2013–2030, WHO Member States have committed to working towards the global target of significantly reducing the suicide rate in countries by 2030.
Based on these guidelines, and with WHO technical support, the Government of Bangladesh recently finalized the National Mental Health Strategic Plan to develop and implement a holistic approach to address suicide and strengthen preventive measures.
Following a regional workshop on suicide prevention held in September 2019, the National Institute of Mental Health (NIMH), the Directorate General of Health Services (DGHS), and key stakeholders are currently training primary health care service providers for prompt assessment and management of suicide.
Responsible reporting from the media is one of the core steps towards suicide prevention. WHO and the National Institute of Mental Health (NIMH) organized in 2018 a series of workshops on responsible reporting of suicide for media professionals, broadening their knowledge of the “dos and don’ts” in reporting on suicide. Currently, WHO is also supporting the NIMH in the development of national guidelines for journalists.
So many actors can play such a significant role in suicide prevention, including family, friends and community members.
If you are struggling with self-harm thoughts, or you know someone who might be considering suicide, please seek immediate help from a trusted family member, friend or health care provider. There is no shame in this, and talking about it can bring relief, reduce anxiety and increase the sense of being understood and supported.
Suicide is preventable. Reach out for help; you are not alone.