Abstract
Abstract. This chapter provides an update on suicide and suicide prevention in the Southeast Asia Region, which covers 11 low- and middle-income countries, accounting for 26% of the world's population. More than one third (39%) of all suicides globally, occur in this region, with the highest suicide rate of 17.7 per 100,000, which is likely to be an underestimate due to differences in study populations, research methodology, and uncomprehensive data registration systems. The risk profile of people who die by suicide and the characteristics of suicides in Southeast Asia are distinctly different from other regions in many ways. In this region the male–female ratio for suicide is closer to 1, compared with 3:5 in higher-income countries, and the overall reported prevalence of mental disorders, such as depression or other psychiatric conditions, is lower. Both older people and adolescents show the highest rates of suicide. Suicide involving pesticide poisoning is the most common method used in both rural and urban areas in countries in this region. Updates are provided on national and regional suicide prevention activities in Bangladesh, Bhutan, Nepal, India, Sri Lanka, and Thailand.
References
(2017). Suicide and depression in the World Health Organization South-East Asia Region: A systematic review. WHO South East Asia Journal of Public Health, 6(1), 60–66. 10.4103/2224-3151.206167
(2018). Suicide prevention activities in Bangladesh. Asian Journal of Psychiatry, 36, 38. 10.1016/j.ajp.2018.06.009
(2019a). Current challenges of suicide and future directions of management in Bangladesh: A systematic review. Global Psychiatry., 2(1), 9–20.
(2019b). Psychological autopsy study in Bangladesh: An unmet need to formulate preventive strategy of suicide. Asian Journal of Psychiatry, 43, 85–86. 10.1016/j.ajp.2019.05.019
(2018). Demography and risk factors of suicidal behavior in Bangladesh: A retrospective online news content analysis. Asian Journal of Psychiatry, 36, 96–99. 10.1016/j.ajp.2018.07.008
(2019). Quality of online news reporting of suicidal behavior in Bangladesh against World Health Organization guidelines. Asian Journal of Psychiatry, 40, 126–129. 10.1016/j.ajp.2018.10.010
(2018). Assessing the quality of media reporting of suicide news in India against World Health Organization guidelines: A content analysis study of nine major newspapers in Tamil Nadu. Australian & New Zealand Journal of Psychiatry, 52(9), 856–863. 10.1177/0004867418772343
(2008). Psychological autopsy of 101 suicide cases from northwest region of India. Indian Journal of Psychiatry, 50(1), 34–38. 10.4103/0019-5545.39757
(2012). Suicide in Asia: Opportunities and challenges. Epidemiologic Review, 34, 129–144. 10.1093/epirev/mxr025
(2016). Suicide first aid guidelines for Sri Lanka: A Delphi consensus study. International Journal of Mental Health Systems, 10(1), 53. 10.1186/s13033-016-0085-3
(2017). Policy and governance to address depression and suicide in Bhutan: The national suicide-prevention strategy. WHO South East Asia Journal of Public Health, 6(1), 39–44. 10.4103/2224-3151.206163
(2000). Patterns and problems of deliberate self-poisoning in the developing world. QJM, 93(11), 715–731.
(2016). Suicide estimates by country. Retrieved from http://apps.who.int/gho/data/view.main.MHSUICIDEv?lang=en
(2012). A community survey on the prevalence of suicidal attempts and deaths in a selected rural area of Bangladesh. Journal of Medicine, 13(1), 3–9. 10.3329/jom.v13i1.10042
(2007). The global distribution of fatal pesticide self-poisoning: Systematic review. BMC Public Health, 7, 357. 10.1186/1471-2458-7-357
(2007). The impact of pesticide regulations on suicide in Sri Lanka. International Journal of Epidemiology, 36(6), 1235–1242. 10.1093/ije/dym164
(2017). Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: A systematic review of the international evidence. Lancet Global Health, 5(10), e1026–e1037. https://doi.org/10.1016/S2214-109X(17)30299-1
(2004). Risk factors for completed suicides: A case-control study from Bangalore, India. Injury Control and Safety Promotion, 11(3), 183–191. 10.1080/156609704/233/289706
(2017). Suicide in Nepal: A modified psychological autopsy investigation from randomly selected police cases between 2013 and 2015. Social Psychiatry and Psychiatric Epidemiology, 52(12), 1483–1494. 10.1007/s00127-017-1433-6
(2016). Suicide surveillance and health systems in Nepal: A qualitative and social network analysis. International Journal of Mental Health Systems, 10, 46. 10.1186/s13033-016-0073-7
(2016). Suicide and poverty in low-income and middle-income countries: A systematic review. Lancet Psychiatry, 3(8), 774–783. 10.1016/S2215-0366(16)30066-9
India State-Level Disease Burden Initiative Suicide, C. (2018). Gender differentials and state variations in suicide deaths in India: The Global Burden of Disease Study 1990–2016. Lancet Public Health, 3(10), e478–e489. 10.1016/S2468-2667(18)30138-5(2018). Suicidal ideation and behaviour among community and health care seeking populations in five low- and middle-income countries: A cross-sectional study. Epidemiology and Psychiatric Sciences, 27(4), 393–402. 10.1017/S2045796017000038
(2014). Suicide in South Asia: A scoping review. BMC Psychiatry, 14, 358. 10.1186/s12888-014-0358-9
(2015). Association of socio-economic position and suicide/attempted suicide in low and middle income countries in South and South-East Asia – a systematic review. BMC Public Health, 15, 1055. 10.1186/s12889-015-2301-5
(2017). Suicide prevention through means restriction: Impact of the 2008 – 2011 pesticide restrictions on suicide in Sri Lanka. PLoS One, 12(3),
e0172893 . 10.1371/journal.pone.0172893(2018). Attempted suicide in Sri Lanka – an epidemiological study of household and community factors. Journal of Affective Disorders, 232, 177–184. 10.1016/j.jad.2018.01.028
(2017). Is socioeconomic position associated with risk of attempted suicide in rural Sri Lanka? A cross-sectional study of 165 000 individuals. BMJ Open, 7(3), e014006. 10.1136/bmjopen-2016-014006
(2017). Regional variation in suicide rates in Sri Lanka between 1955 and 2011: A spatial and temporal analysis. BMC Public Health, 17(1), 193. 10.1186/s12889-016-3961-5
(2009). Risk factors for suicide in Bali: A psychological autopsy study. BMC Public Health, 9, 327. 10.1186/1471-2458-9-327
(2006). Suicide in Thailand during the period 1998 – 2003. Psychiatry and Clinical Neurosciences, 60(1), 90–95. 10.1111/j.1440-1819.2006.01465.x
(2010). Risk factors for suicide in rural south India. British Journal of Psychiatry, 196(1), 26–30. 10.1192/bjp.bp.108.063347
(2017). Suicide burden and prevention in Nepal: The need for a national strategy. WHO South-East Asia Journal of Public Health, 6(1), 45–49. 10.4103/2224-3151.206164
National Crime Record Bureau . (2018). Accidental deaths & suicides in India: 2018. Retrieved from http://ncrb.gov.in/StatPublications/ADSI/ADSI2018/chapter-2%20suicides.pdf(2010). Rethinking the role of mental illness in suicide. American Journal of Psychiatry, 167(7), 731–733. 10.1176/appi.ajp.2010.10040589
(2014). Risk factors of suicide and para suicide in rural Bangladesh. Journal of Medicine, 14(2), 123–129. 10.3329/jom.v14i2.19653
Royal Government of Bhutan . (2015). Suicide prevention in Bhutan – a three year action plan. Retrieved from http://www.searo.who.int/bhutan/suicide_action_plan.pdf?ua=1(2017). Demography and risk factors of suicide in Bangladesh: A six-month paper content analysis. Psychiatry Journal, 2017,
3047025 . 10.1155/2017/3047025(2018). Demography and risk factor of suicidal behavior in Bangladesh: A cross-sectional observation from patients attending a suicide prevention clinic of Bangladesh. Asian Journal of Psychiatry, 35, 4–5. 10.1016/j.ajp.2018.04.035
(2017). The burden of suicide in rural Bangladesh: Magnitude and risk factors. International Journal of Environmental Research and Public Health, 14(9). 10.3390/ijerph14091032
(2018). Decriminalizing suicide in Bangladesh. Asian Journal of Psychiatry, 39, 91–92. 10.1016/j.ajp.2018.12.012
(2018). Suicide and self-harm in Nepal: A scoping review – A scoping review. Asian Journal of Psychiatry, 32, 20–26. 10.1016/j.ajp.2017.11.018
(2017). Challenges and opportunities in suicide prevention in South-East Asia. WHO South East Asia Journal of Public Health, 6(1), 30–33. 10.4103/2224-3151.206161
(2013). A central storage facility to reduce pesticide suicides – a feasibility study from India. BMC Public Health, 13, 850. 10.1186/1471-2458-13-850
(2017). CASP – an intervention by community volunteers to reduce suicidal behaviour among refugees. International Journal of Social Psychiatry, 63(7), 589–597. 10.1177/0020764017723940
(2008).
Socio-economic, cultural and religious factors affecting suicide prevention in Asia . In H. HendinL. Vijayakumar (Eds.), Suicide and suicide prevention in Asia (pp. 19–30). Geneva, Switzerland: World Health Organization.(1999). Are risk factors for suicide universal? A case-control study in India. Acta Psychiatrica Scandinavica, 99(6), 407–411.
(2018). Potential interventions for preventing pesticide self-poisoning by restricting access through vendors in Sri Lanka. Crisis, 39(6), 479–488. 10.1027/0227-5910/a000525
World Health Organization . (2014). Preventing suicide: A global imperative. Retrieved from http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/World Health Organization. (2018a). Global health estimates 2016. Retrieved from http://apps.who.int/gho/data/view.main.MHSUICIDEv?lang=enWorld Health Organization . (2018b). National suicide prevention strategies: Progress, examples and indicators. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/279765/9789241515016-eng.pdf?ua=1(2000). Urban/rural and gender differentials in suicide rates: East and west. Journal of Affective Disorders, 57(1 – 3), 99–106.
