Teen Suicide: A Global Perspective

Suicide accounts for an estimated 800,000 deaths each year, according to the World Health Organization (WHO), making it the fifth-leading cause of death worldwide. Many experts believe the true number may be higher because some deaths are unreported or misclassified due to the sensitive nature of suicide. The scope of the problem appears even larger when you consider that there are many unsuccessful suicide attempts for each completed suicide. Since every suicide has tragic, long-lasting consequences for that person's family and community, finding ways to prevent suicide is clearly an issue of global concern.

Did You Know…
According to the WHO, a person dies by suicide somewhere in the world every 40 seconds.

Suicide affects people of all nationalities, genders, and ages. It occurs in every country in the world, regardless of its level of wealth or economic development. WHO researchers found that 75 percent of global suicides occurred in low- and middle-income countries (LMIC) in 2012. This figure is deceiving, however, because such a large proportion of the world's population lives in LMIC. In fact, the suicide rate of 11.2 per 100,000 people in LMIC was lower than the rate of 12.7 per 100,000 people found in high-income countries. A country's location or region seems to make little difference in the prevalence of suicide. Countries from all parts of the world appear near both the top and bottom of the global ranking of all nations by suicide rate.
Men are more likely to die by suicide than women. This trend is most pronounced in high-income countries, where an average of 3.5 men committed suicide for every woman who did so in 2012. In LMIC the male-to-female ratio was much lower, at 1.6 men for every woman. In most regions of the world, suicide is most common among elderly people over the age of 70. But suicide claims many lives among younger people between the ages of 15 and 29, as well. In fact, suicide accounts for 8.5 percent of all deaths in this age group, compared to 4.1 percent of all deaths among middle-aged people between 30 and 49. This makes suicide the second-leading cause of death (after accidents) for younger people worldwide.

Suicide Among Teens

Globally, the highest rates of teen suicide can be found in the regions of Southeast Asia and Eastern Europe. Teenage boys have higher suicide rates than teenage girls in most countries (with the exception of China and India). Teenagers who are members of native or indigenous ethnic minority groups face a significantly higher risk of suicide than teens who are members of the majority population.
In the United States, suicide is second only to accidents as the leading cause of death among 15- to 19-year-olds. From 1999 to 2014, the teen suicide rate in the United States rose from 8.0 to 8.7 per 100,000 people. Researchers believe that the number of suicide attempts remained relatively stable during this period, however, and blame the increase on teens using more lethal methods of suicide. The suicide rate among teens who live in rural areas of the United States, at 11.9 deaths per 100,000, is nearly twice the rate of 6.5 among teens who live in urban areas. Teens in rural areas frequently experience poverty and social isolation, while they are less likely to have access to mental-healthcare services.

Risk Factors for Suicide

There are many different risk factors that can contribute to suicidal behavior. On an individual level, the main drivers of suicide include mental disorders, depression, and substance abuse. A family history of suicide and previous suicide attempts are also major risk factors. Although these factors affect individuals worldwide, their impact is greatest in countries where people feel unable to seek help because of the social stigma attached to mental-health issues and suicide.
Many suicides occur during moments of emotional crisis, when people feel overwhelmed and unable to cope with sources of stress in their daily lives. For teenagers, peer pressure, bullying, social isolation, and relationship troubles are common factors that contribute to suicidal behavior. Suicide rates are highest worldwide among young people in vulnerable groups that are likely to experience discrimination or marginalization, such as refugees and migrants, racial and ethnic minorities, and lesbian, gay, bisexual, and transgender (LGBT) persons.
Among middle-aged people, financial problems are a common driver of suicidal behavior. Men in this age group, in particular, feel pressure to provide for their families and achieve financial stability. Among elderly people, health-related issues frequently contribute to suicidal behavior. Those who face chronic pain and illness sometimes view suicide as a way to avoid losing their independence or becoming a burden to their families.
Some of the risk factors for suicide occur on a larger, national scale. Countries that experience wars, ethnic conflicts, and violence often have much higher suicide rates than countries that are more stable. Natural disasters, such as earthquakes or hurricanes, are also associated with increases in suicide rates. People who experience trauma, loss, or displacement due to these events face high levels of stress that make them more vulnerable to suicidal behavior.
Inappropriate media reporting may also contribute to the problem by sensationalizing suicide and making it seem like an acceptable option. In 1978, at the Jonestown settlement in the South American nation of Guyana, a cult leader named Jim Jones ordered his followers to drink poison. The mass suicide of 900 people received huge amounts of media coverage. From that time onward, Guyana's relatively low suicide rate increased rapidly until it reached the highest level in the Western Hemisphere. Researchers cited the publicity surrounding the Jonestown incident as a major factor in increasing the awareness and prevalence of suicide among Guyana's youth. Teens tend to be most susceptible to the phenomenon of "copycat" suicides.

Methods of Suicide

The most common means of suicide worldwide is self-poisoning with pesticides, which accounts for about one-third of global suicides. People who live in rural, agricultural areas in LMIC often have easy access to these deadly chemicals. Other common means include hanging and firearms. The methods used vary greatly, however, depending on the country and age group. Since many suicides result from spur-of-the-moment, impulsive decisions, people tend to choose the method that is most available to them.

Prevention of Suicide

Suicide prevention requires a comprehensive, coordinated approach by multiple sectors of government and society, including healthcare, education, law, business, and the media. In many countries, however, suicide prevention is not considered an important topic of research or discussion. Without accurate data collection and statistics, many people are not aware of the extent of the problem. In addition, the stigma surrounding mental health and suicide in some countries makes people reluctant to discuss the issue or seek help. As a result, only 28 countries of the nearly 200 countries in the world have a national suicide prevention strategy in place.
The WHO is committed to raising public awareness of suicide worldwide and encouraging countries to take positive action to prevent it. Under the WHO's Mental Health Action Plan, released in 2013, member countries agreed to work toward reducing the global suicide rate by 10 percent by 2020. Strategies for preventing suicide address the problem at three main levels: the universal or national level; the selective or population subgroup level; and the individual level.
At the national level, WHO efforts are aimed at improving access to mental healthcare, creating policies to reduce substance abuse, and promoting economic development and anti-poverty programs. Other strategies at the national level may involve encouraging responsible media reporting or restricting access to the means of suicide, such as firearms or pesticides. This approach produced results in the United Kingdom, where self-poisoning with carbon monoxide gas from coal-burning furnaces once accounted for half of all suicides. After the government phased out coal in favor of natural gas as a heating source in the 1960s, the national suicide rate fell by one-third permanently.
Selective suicide-prevention strategies target vulnerable population groups within a country or region. Such strategies might take steps to increase community support for people affected by wars or natural disasters, or they might provide education to reduce discrimination against racial and ethnic minorities.
At the individual level, suicide prevention strategies aim to improve early identification and treatment of mental disorders, substance-abuse issues, emotional distress, and chronic pain. Tactics might include training healthcare workers to recognize suicidal behavior, providing follow-up treatment for people who attempt suicide, and offering positive coping methods and community support.
A vital factor in all types of suicide prevention efforts is information. Researchers must have access to high-quality data from hospitals, law enforcement, and surveys in order to identify the patterns, characteristics, and methods of suicide in each country or part of the world. This data enables researchers to track changes in suicide rates and understand the factors driving them. In this way, they can design timely, comprehensive interventions to address the underlying problems and effectively prevent suicides.