"The common conception is that suicide is a problem for high-income countries," says Dr. Shekhar Saxena, director of the Department of Mental Health and Substance Abuse at the World Health Organization.
But WHO's first ever report on suicide prevention offers a startlingly different perspective: three-fourths of the world's 800,000 yearly suicide deaths occur in low- and middle-income countries. We spoke with Saxena about the findings.
Why do people commit suicide in low- and middle-income countries? Can you cite one example?
We know that farmers in southern India have shown a high rate of suicides. Many times, the reason is they are in debt. They buy seeds and fertilizers after borrowing money. And if the crop fails, they suffer serious financial consequences trying to return the debt, when they have no money.
Is there anything unusual about the suicides in these countries?
You will be perhaps surprised to know that about 30 percent of all suicides in the world are by the ingestion of pesticides, especially in rural areas. The regions where it is common are the Asian countries as well as countries in Central America and many African countries.
Is there a way to prevent this kind of suicide?
Many countries are taking this issue quite seriously. For example, the government of Sri Lanka is already bringing the antidote for the fatal pesticide poisoning to the majority of health care settings. People don't have to wait for many hours before they receive the emergency treatment for pesticide poisoning. That's the kind of policy that we need in the majority of countries where this problem is at a high level.
When a famous person like Robin Williams commits suicide, there's a concern about copycat suicides. Is that a problem in the low- and middle-income world?
Yes, we are very aware of this phenomenon called the copycat and we are very concerned. In fact, we have noticed this in many parts of the world, in high- as well as low-income countries. We believe that responsible reporting by media can actually decrease the copycat phenomenon. WHO has guidelines about how media should report suicide responsibly. Not too much attention should be given to the method of suicide. Information should be included in the reporting which tells people where to go for help.
Any other surprises in this study?
In the studies we found, only 28 countries have established suicide prevention strategies.
Is it a matter of funding?
Suicide prevention is not expensive. It's a matter of getting the right policies, training the existing health and associated staff in recognizing people at high risk and also mobilizing communities and civil society and self-help groups to create the kind of awareness that one needs.
Note: This interview was edited and condensed for clarity.