Documentation from WHO (in part):

(adapted from: World Health Organization. Figures and facts about suicide. WHO, Geneva, 1999)

According to WHO estimates, in the year 2000, approximately one million people died from suicide, and 10 to 20 times more people attempted suicide worldwide. This represents one death every 40 seconds and one attempt every 3 seconds, on average.

This also indicates that more people are dying from suicide than in all of the several armed conflicts around the world and, in many places, about the same or more than those dying from traffic accidents. In all countries, suicide is now one of the three leading causes of death among people aged 15-34 years; until recently, suicide was predominating among the elderly, but now suicide predominates in younger people in both absolute and relative terms, in a third of all countries.

Some WHO Member States have been reporting on causes of death since WHO’s inception. For several countries, information series are available from 1950 onwards, whereas other countries started sending this information later on. Although country data are available almost always on a yearly basis, an option was made to present the data on a five-year interval, because it was generally felt that this time interval provided a reasonable overall picture.

Whenever figures on suicide are presented or discussed, there is always someone to question their reliability, insisting that in many places - and due to several reasons - suicide is hidden and that the real figures must be much higher. This point is acknowledged, which only reinforces the gravity of what is presented here. Another question frequently raised refers to the comparability of data across countries. The information on which the graphs are based reflects the official figures made available to WHO by its Member States or by their national officers responsible for suicide prevention; in turn, these are based upon real death certificates signed by legally authorized personnel, usually doctors and to a lesser extent police officers. We prefer to believe that they have not as a rule, misrepresented the information and that the real dimension of eventual distortions introduced by misreporting remains to be demonstrated. It is our hope that these graphs will be a solid ground against which corrections and improvements will be brought about.

The most recent data refer to some years ago and a word about the time to process the information is appropriate. Mortality data (due to all cases, not just suicide) in a given year are collected and processed in subsequent years at a central level in each country. Once the data have been collected, there is an internal verification; should there be any inconsistency, these are returned to where they originated from for rectification. If a single province delays sending its data, the information on the whole country will be delayed. Also, when there is a judicial procedure to define the cause of death, this may represent a certain delay in the compilation of the country’s whole mortality information. Only when the country’s central level is satisfied with the data set, it is sent to WHO, where it is again re-examined for internal consistency. In the best of conditions this whole process usually takes 2-4 years. This explains why, the “most recent data” refer to a few years ago, but vary from country to country.

A word of caution is needed in relation to the interpretation of rates (per 100,000) in countries with small populations: a few more - or less - suicides can greatly modify the rates, thus giving a wrong impression of important increases or decreases, respectively.

The reduction of mortality and morbidity associated with suicidal behaviours is high in WHO’s agenda. Obtaining appropriate information is the first step in a public health strategy for the prevention of undesirable outcomes. Unfortunately, information about means employed for committing suicide - a fundamental information for suicide prevention programmes - is not available at the same level as the information presented here on the incidence of suicide. This is something to be rectified in the future.

Since monitoring mortality related to suicide and updating the pertinent information is an ongoing task of WHO, any additional information or comments are most welcome.

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Worldwide Suicide Rates:

The World Health Organization (WHO) estimated in 2002, in the year 2020 there will be approximately 1.53 million people who will die by suicide, according to current trends. Woldwide, suicide attempts will be about 10-20 times more than deaths by suicide. This is an average of one suicide every 20 seconds and every 1-2 seconds, there will be a suicide attempt.

In Europe, particularly Eastern Europe, the highest suicide rates are reported for both men and women.

The Eastern Meiterranean Region and Central Asian republics have the lowest suicide rates.

Nearly 30% of all suicides worldwide occur in India and China.

Suicides by age globally:
55% - age 5 to 44 years
45% - age 45 years +

Elder suicide is increasing at the greatest rate, when the elder population is compared to the population of other age groups.

Youth suicide is increasing at the greatest rate of all age groups.

End of WHO documentation

• Talk about suicide, death, and/or no reason to live.
• Be preoccupied with death and dying.
• Withdraw from friends and/or social activities.
• Have a recent severe loss (especially relationship) or threat of a significant loss.
• Experience drastic changes in behavior.
• Lose interest in hobbies, work, school, etc.
• Prepare for death by making out a will (unexpectedly) and final arrangements.
• Give away prized possessions.
• Have attempted suicide before.
• Take unnecessary risks; be reckless, and/or impulsive.
• Lose interest in their personal appearance.
• Increase their use of alcohol or drugs.
• Express a sense of hopelessness.
• Be faced with a situation of humiliation or failure.
• Have a history of violence or hostility.
• Have been unwilling to “connect” with potential helpers.
  

Nearly everyone at some time in his or her life thinks about suicide. Most everyone decides to live because they come to realize that the crisis is temporary, but death in not. On the other hand, people in the midst of a crisis often perceive their dilemma as inescapable and feel an utter loss of control.

Frequently, they:

• Can’t stop the pain If you experience any of these feelings, get help!
• Can’t think clearly
• Can’t make decisions If you know someone who exhibits these feelings, offer help!
• Can’t see any way out
• Can’t sleep eat or work
• Can’t get out of the depression
• Can’t make the sadness go away
• Can’t see the possibility of change
• Can’t see themselves as worthwhile
• Can’t get someone’s attention
• Can’t seem to get control
  

• To seek help.
• To escape from an intolerable situation.
• To get relief from a terrible state of mind.
• To try to influence some particular person.
• To show how much they loved someone.
• To make things easier for others.
• To make people feel sorry for them.
• To make people understand how desperate they were feeling.
• To find out whether they are really loved.
• Fear of loss of control.
• Desire to die.
  

Suicide Facts and Myths

There are many commonly-held misconceptions about suicide. These myths of suicide often stand in the way of providing assistance for those who are at-risk. By dispelling the myths, those responsible for the care and education of young people will be in a better position to identify those who are at-risk and to provide the help that is needed.

MYTH
Young people who talk bout suicide never attempt or complete suicide.

FACT
Talking about suicide can be a plea for help and can be a late sign in the progression toward a suicide attempt. Those who are most at risk will show other signs apart from talking about suicide. If you have concerns about a young person who talks about suicide: - Encourage them to talk further and help them to find appropriate counseling assistance - Ask if they are thinking about making a suicide attempt. - Ask if they have a plan. - Think about the completeness of the plan and how dangerous it is. Do not trivialize plans that seem less complete or less dangerous. ALL suicidal intentions are serious and must be acknowledged as such. - Encourage the young person to develop a personal safety plan. This can include time spent with others, check-in points with significant adults, plans for the future.

MYTH
A promise to keep a note unopened and unread should always be kept.

FACT
Where the potential for harm, or actual harm, is disclosed- then confidentiality cannot be maintained. A Sealed note with the request for the note not to be opened is a very strong indicator that something is seriously amiss. A sealed note is a late sign in the progression towards suicide.

MYTH
Attempted or completed suicides happen without warning.

FACT
The survivors of a suicide often say that the intention was hidden, however it is more likely that the intention was not recognized. These warning signs include:

• The recent suicide, or death by other means, of a friend or relative.
• Previous suicide attempts.
• Preoccupation with themes of death or expressing suicidal thoughts.
• Depression, conduct disorder or problems with adjustment such as substance abuse (particularly when two or more of these are present).
• Giving away of prized possessions, making a will or other final arrangements.
• Major changes in sleep patterns- too much or too little.
• Sudden and extreme changes in eating habits, losing or gaining weight.
• Withdrawal from friends/family or other major behavioral changes.
• Dropping out of group activities.
• Personality changes such as nervousness, outbursts of anger, impulsive or reckless behavior, or apathy about appearance or health.
• Frequent irritability or unexplained crying.
• Lingering expressions of unworthiness or failure.
• Lack of interest in the future.

FACT
A suicide attempt is regarded as an indicator of further attempts. It is likely that the level of danger will increase with each further suicide attempt.

MYTH
Once a person is intent on suicide, there is no way of stopping them.

FACT
Suicides CAN be prevented. people CAN be helped. Suicidal crisis can be relatively short-lived. Suicide is a permanent solution to what is usually a temporary problem. Immediate practical help such as staying with the person, encouraging them to talk and helping them build plans for the future, can avert the intention to attempt or complete suicide. Such immediate help is valuable at a time of crisis, but appropriate counseling will then be required.

MYTH
Suicidal young people cannot help themselves.

FACT
While contemplating suicide, young people may have a distorted perception of their actual life situation and what solutions are appropriate for them to take. However, with support and constructive assistance from caring and informed people around them, young people can gain full self-direction and self-management of their lives.

MYTH
The only effective intervention for suicide comes from professional psychotherapists with extensive experience in this area.

FACT
All people who interact with suicidal adolescents can help them by way of emotional support and encouragement. Psychotherapeutic interventions also rely heavily on family and friends providing a network of support.

MYTH
Most suicidal young people never seek or ask for help with their problems.

FACT
Evidence shows that they often tell their school peers of their thoughts and plans. Most suicidal adults visit a medical doctor during the three months prior to killing themselves. Adolescents are more likely to 'ask' for help through non-verbal gestures than to express their situation verbally to others.

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MYTH
Suicidal young people are always angry when someone intervenes and they will resent that person afterwards.

FACT
While it is common for young people to be defensive and resist help at first, these behaviors are often barriers imposed to test how much people care and are prepared to help. for most adolescents considering suicide, it is a relief to have someone genuinely care about them and to be able to share the emotional burden of their plight with another person. When questioned some time later, the vast majority express gratitude for the intervention.

MYTH
Suicidal young people are insane or mentally ill.

FACT
Although suicidal adolescents are likely to be extremely unhappy and may be classified as having a mood disorder, such as depression, most are not legally insane. However, there are small numbers of individuals whose mental state meets psychiatric criteria for mental illness and who need Psychiatric help.

MYTH
Most suicides occur in winter months when the weather is poor.

FACT
Seasonal variation data are essentially based on adult suicides, with limited adolescent data available. However, it seems adolescent suicidal behavior is most common during the spring and early summer months.

MYTH
Some people are always suicidal.

FACT
Nobody is suicidal at all times. the risk of suicide for any individual varies across time, as circumstances change. This is why it is important for regular assessments of the level of risk in individuals who are 'at-risk'.

MYTH
Every death is preventable.

FACT
No matter how well intentioned, alert and diligent people's efforts may be, there is no way of preventing all suicides from occurring

MYTH
People who threaten suicide are just seeking attention.

FACT
All suicide attempts must be treated as though the person has the intent to die. Do not dismiss a suicide attempt as simply being an attention-gaining device. It is likely that the young person has tried to gain attention and, therefore, this attention is needed. The attention that they get may well save their lives.

MYTH
Talking about suicide or asking someone if they feel suicidal will encourage suicide attempts.

FACT
Talking about suicide provides the opportunity for communication. Fears that are shared are more likely to diminish. The first step in encouraging a suicidal person to live comes from talking about feelings. That first step can be the simple inquiry about whether or not the person in intending to end their life. However, talking about suicide should be carefully managed.

MYTH
Only certain types of people become suicidal.

FACT
Everyone has the potential for suicide. The evidence is that predisposing conditions may lead to either attempted or completed suicides. it is unlikely that those who do not have the predisposing condition (for example, depression, conduct disorder, substance abuse, feeling of rejection, rage, emotional pain and anger), will complete suicide.

MYTH
Depression and self-destructive behavior are rare in young people.

FACT
Both forms of behavior are common in adolescents. Depression may manifest itself in ways which are different from its manifestation in adults. Self-destructive behavior is most likely to be shown for the first time in adolescence and its incidence is on the rise.

MYTH
Suicide is painless.

FACT
Many suicide methods are very painful. Fictional portrayals of suicide do not usually include the reality of the pain.

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What You Can Do To Help

Here are some ways to be helpful to someone who is threatening suicide:
Be direct. Talk openly and matter-of-factly about suicide.
Be willing to listen. Allow expressions of feelings. Accept the feelings.
Be non-judgmental. Don’t debate whether suicide is right or wrong, or feelings are good or bad. Don’t lecture on the value of life.
Get involved. Become available. Show interest and support.
Don’t dare him or her to do it.
Don’t act shocked. This will put distance between you.
Don’t be sworn to secrecy. Seek support.
Offer hope that alternatives are available but do not offer glib reassurance.
Take action. Remove means, such as guns or stockpiled pills.
Get help from persons or agencies specializing in crisis intervention and suicide prevention.

If you experience these feelings, get help! If someone you know exhibits these symptoms, offer help!

Contact:

A community mental health agency
A private therapist or counselor
A school counselor or psychologist
A family physician
A suicide prevention or crisis center

Online Screening Tools and Tests Anxiety Screening Test BiPolar Disorder Screening Depression Screening Test Stress Level Test

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