Abstract

Globally, over 800000 people died by suicide in 2012 and there are indications that for each adult who died of suicide there were likely to be many more attempting suicide. There are many millions of people every year who are affected by suicide and suicide attempts, taking into consideration the family members, friends, work colleagues and communities, who are bereaved by suicide. In the WHO Mental Health Action Plan 2013-2020, Member States committed themselves to work towards the global target of reducing the suicide rate in countries by 10% by 2020. Hence, the first-ever WHO report on suicide prevention, Preventing suicide: a global imperative, published in September 2014, is a timely call to take action using effective evidence-based interventions. Their relevance for low- and middle-income countries is discussed in this paper, highlighting restricting access to means, responsible media reporting, introducing mental health and alcohol policies, early identification and treatment, training of health workers, and follow-up care and community support following a suicide attempt.

Highlights

  • Over 800 000 people died by suicide in 2012, according to World Health Organization (WHO) Global Health Estimates (WHO, 2014a, b, c)

  • Taking into consideration the family members, friends, work colleagues and communities, who are bereaved by suicide (Pitman et al 2014), there are many millions of people every year who are affected by suicide and suicide attempts (Berman, 2011)

  • Three times as many men die of suicide as do women, but in low- and middle-income countries (LMICs) the male-to-female ratio is much lower at 1.5:1

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Summary

Background

Over 800 000 people died by suicide in 2012, according to World Health Organization (WHO) Global Health Estimates (WHO, 2014a, b, c) This corresponds to a global age-standardized suicide rate of 11.4 per 100 000 population; 15.0 and 8.0 per 100 000 for males and females, respectively. Despite a drop in the estimated global age-standardized suicide rate between 2000 and 2012, that may partially be explained by an improvement in global health, regionally there have been increases in LMICs in the African Region and among men in LMICs in the Eastern Meditteranean Region, emphasizing the need to concentrate and prioritize suicide prevention efforts in LMICs (WHO, 2014a). Comprehensive strategies in high-income countries have demonstrated the additive and synergistic effects of integrating multiple interventions (WHO, 2014a); this approach could be replicated in LMICs taking into consideration varying cultural contexts. For the interventions presented in the following, the evidence is consolidated at the WHO mhGAP Evidence Resource Centre (WHO, 2015)

Restricting access to means
Responsible media reporting
Introducing mental health and alcohol policies
Early identification and treatment
Training of health workers
Findings
Reaching the global target reduction of the suicide rate in countries
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