Low and middle-income countries have additional factors that cause suicides 

When it comes to researching the prevalence of suicide across
the world, much of it is focused on high-income earning
individuals. But it turns out, the vast majority of suicides^[1]
each year are by people living in low and middle-income
countries. 

That’s the findings of new research by the University of
Bristol, which was published in journal PLOS Medicine^[2]
to coincide with World Mental Health Day.

RELATED: NEW STUDY INVESTIGATES
LINKS BETWEEN INTELLIGENCE, EMOTIONAL CONTROL AND SUICIDE
RISK^[3]

Low and middle-income countries have additional factors
that cause suicides 

“The burden of suicide is greatest in low- and
middle-income countries and this partly reflects the fact that this
is where the majority of people live,” Dr. Duleeka Knipe,
Elizabeth Blackwell Institute (EBI) Vice Chancellor’s Research
Fellow at the Bristol Medical School told
Interesting Engineering in an e-mail interview. “Suicide is a
complex behaviour and people die for a variety of reasons. In these
settings, there are additional factors which may contribute to a
person’s suicide risk which are seen less commonly in a high-income
setting.”

Source: Ery Burns ^[4]

According to the international research team, which is
made up of academics from universities of Manchester,
Birmingham, Sheffield Hallam, Nottingham, Western Sydney, and
National Taiwan University, there are 800,000 suicide deaths each
year with 76% from low and middle-income countries. The researchers
analyzed data from 112 studies on 30,030 episodes of non-fatal
suicide behaviors and 4,996 suicide deaths in 25 low and
middle-income countries. They found 58% of the suicide deaths and
45% of the non-fatal suicidal behaviors were caused by psychiatric
disorders.

“In high-income countries suicide prevention initiatives
have focussed on the treatment of psychiatric disorders, and this
approach is also being adopted in low- and middle-income settings.
We conducted this review to find out whether psychiatric disorder
was also an important target for suicide prevention in low and
middle-income settings,” Knipe said.

Psychiatric disorders vary from one country to the
next

The study also revealed the psychiatric disorders found in
the suicidal behaviors^[5]
were variable which could be due to the differences in the
countries. While treating the psychiatric disorder in high-income
countries is the main way to prevent suicide in these low and
middle-income countries it may require a wider approach for
prevention. 

“Our analyses show there is a lot of variability between
studies and countries, and this suggests there is no one answer but
does support our thinking that psychiatric disorder is perhaps not
as important in these settings as in higher-income countries,” said
Knipe in a press release^[6]
highlighting the results of the work. “Of course, the
treatment of underlying psychiatric illness is important but
prevention efforts should also incorporate a wider range of
activities which aim to reduce access to lethal means, poverty,
domestic violence and alcohol misuse. For example, population level
solutions, such as banning highly toxic pesticides, have been shown
to be effective in reducing the number of suicide
deaths.”

Knipe told Interesting Engineering more research needs to be
done into suicidal behavior in low and middle-income countries.
“We probably need to be more creative in the prevention
approaches adopted in these settings. Activities should, for
example, include reducing poverty, access to lethal means, and
domestic violence,” said Knipe.