Being a critical global issue, suicide affects individuals and communities worldwide. World Suicide Prevention Day, established in 2003 by the International Association for Suicide Prevention (IASP) in conjunction with the World Health Organization (WHO) on 10 September of each year, focuses on reducing stigma and raising awareness among organizations, governments, and the public, giving a singular message that suicide can be prevented.
As an effort to encourage a positive change, IASP has announced the new theme for World Suicide Prevention Day 2024-2026 as “Changing the Narrative on Suicide”. The aim of the theme is to raise awareness about the importance of changing the narrative surrounding suicide and transforming the way suicide is perceived. Changing the narrative requires a systemic change, shifting from a culture of silence and stigma to one of openness, understanding, and support. It also involves (1) advocating for policies and legislations that prioritize mental health, increase access to care, and provide support for those in need, (2) investing in research to better understand the complexities of suicide and (3) developing evidence-based interventions.
Suicide accounts for more than one in every 100 deaths globally and for every death by suicide there are more than 20 suicide attempts. In 2019, an estimated 703 000 people across all ages (or 9 per 100 000 population) lost their lives to suicide globally, and 77% of all suicides occurred in Lower Middle-Income Countries, where most of the world’s population lived. In 2019, the suicide was the fourth leading cause of death among 15–29-year-olds and accounted for 8% of all deaths.
Suicide and self-harm remain a significant public health concern in Sri Lanka. Sri Lanka has achieved a substantial reduction in suicide since 1997, mostly by the implementation of national bans on identified toxic pesticides. Despite these reductions, there is a higher than global average rate of suicide recorded continuously in Sri Lanka. The suicidal rate in Sri Lanka in 2022 was 27 per 100 000 and 5 per 100 000, in males and females respectively, with an overall suicide rate of 15 per 100 000 population based on the national police statistics. The rate of suicide increases by age, with the highest rate among older males (55+ years: 65 per 100 000) while, among females, it is found mainly in young women (17–25 years: 10 per 100 000). Analysis by method categorizations shows that in 2022, the highest proportion of suicide deaths was due to hanging (69.9%), followed by pesticide self-poisoning (14.0%), other methods (12.2%), and non-pesticide self-poisoning (3.9%). (figure 1).
Suicide by hanging, over the past 20 years, has been steadily increasing among males and females. Hence, although the current suicide rate in Sri Lanka is substantially lower than it was during the 1990s, the upward trend in hanging seen in the last few years, particularly among older men and young women, is of concern.
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Figure 1: Age-standardized suicide rate by method in males and females in Sri Lanka, 1997–2022 (Reflections on the trends of suicide in Sri Lanka, 1997–2022: The need for continued vigilance, https://doi.org/10.1371/journal.pgph.0003054)
WHO advocates for countries to take action to prevent suicide, by implementing a comprehensive national suicide prevention strategy, adopting ‘LIVE LIFE’, WHO’s approach to suicide prevention, detailing the practical aspects of implementing evidence-based interventions for preventing suicide. Reducing the global suicide mortality rate by one third by 2030 is both an indicator and a target in the United Nations Sustainable Development Goals (SDGs) and in WHO’s Comprehensive Mental Health Action Plan 2013– 2030.
Among the several important South-East Asia Regional Committee resolutions related to mental health, SEA/RC65/R5 on non-communicable diseases, mental health and neurological disorders, along with the regional strategies developed to address suicide, have urged the Member States to develop comprehensive policies and strategies for promotion of mental health and prevention of suicides. Through the ‘Paro Declaration’ on universal access to people-centred mental health care and services, Member States further committed to expand community-based mental health services, and develop and implement multisectoral policies across the life-course, addressing mental health risks.
The ongoing monitoring of suicide rates should be a priority during the coming years, while addressing the current risk factors for suicide in Sri Lanka, such as significant financial insecurity, unemployment, depression, alcohol misuse, and domestic violence. WHO Sri Lanka supported the Ministry of Health to develop and implement the Suicide Prevention Strategy and Suicide Prevention Action plan which is being implemented at the primary health care level as a resource that guides policy makers to address the risk factors. Further WHO rendered its support in capacity building of the healthcare workforce as well as other categories of staff in provision of psychosocial support mainly by training the National Youth Services counselors on psychosocial counselling, training of Sunday school teachers on psychosocial support and mental well-being, training of media personnel on responsible reporting of suicide and training of health care staff to extend and strengthen the national mental health helpline (1926) at district level.
Every suicide is a tragedy, yet suicides are preventable and the impact on families, friends and communities is devastating even after the persons have taken their own life. World Suicide Prevention Day serves as a reminder that suicide prevention is a public health priority and urgent action is required to make sure suicide mortality rates are reduced. WHO will continue to work with its partners to support Sri Lanka to take concrete measures in this direction.
International Association for Suicide Prevention- Changing the Narrative on Suicide - IASP
World Mental Health Report-World Mental Health Report (who.int)
Bandara P, Wickrama P, Sivayokan S, Knipe D, Rajapakse T (2024) Reflections on the trends of suicide in Sri Lanka, 1997–2022: The need for continued vigilance. PLOS Glob Public Health 4(4): e0003054. https://doi.org/10.1371/journal.pgph.0003054
Knipe DW, Metcalfe C, Fernando R, Pearson M, Konradsen F, Eddleston M, et al. Suicide in Sri Lanka 1975–2012: age, period and cohort analysis of police and hospital data. BMC Public Health. 2014;14(1):839. Epub 2014/08/15. pmid:25118074; PubMed Central PMCID: PMC4148962.