Change The Narrative - SAMRC contributes to Special Lancet Public Health Series on Suicide Prevention

In 2019 alone, suicide claimed over 700,000 lives across the globe, according to the World Health Organization. This means 1,925 people commit suicide a day, or one every 45 seconds. A change in the narrative is needed to move from presenting suicide as a purely mental health issue to also acknowledging the impact of social factors, such as poverty, debt, homelessness, substance use, discrimination and social isolation.

Contributing to finding the solution, the Mental Health, Alcohol, Substance Use and Tobacco Research Unit (MAST-RU) at the South African Medical Research Council (SAMRC) has contributed to two publications within a special Lancet Public Health Series on ‘Suicide Prevention’ to be launched on World Suicide Prevention Day – 10 September 2024.

MAST-RU conducts and facilitates high-quality scientific research to inform policy, healthcare services, and interventions that promote mental health and reduce harmful effects of substance use in South Africa.

Prof Jason Bantjes, Deputy Director at MAST-RU said: “Suicide is an important public health concern in South Africa. While it is difficult to determine suicide rates accurately, data collected by the SAMRC’s Burden of Disease Research Unit suggests that in the year 2020/21, approximately 11.5 people out of every 100,000 in the country died by suicide. The highest rate of suicide was among people aged 15 to 44, with 16.8 suicides per 100,000 people in this age group. Men in South Africa are much more likely to die by suicide than women—about 4 times more likely.

The Series Lead author, Prof Keith Hawton at the University of Oxford in the UK, said: “Many suicides are preventable and public health strategies generally have the biggest impacts on reducing population suicide rates. This Series highlights key areas where public health policies are needed and examples of their effective implementation. We hope this will inspire those responsible for suicide prevention across the world to ensure that such approaches are applied in their countries and localities.”

Additionally, Prof Jane Pirkis, University of Melbourne, Australia, said: “Suicide is often thought of as stemming from mental illness, but factors like financial hardship, social isolation, discrimination, and domestic violence and abuse wield a major influence. This Series demonstrates that addressing these more upstream factors is likely to lead to sizeable reductions in suicide rates. We are calling on governments from around the world to take a “suicide prevention in all policies” approach that would see consideration given to how actions in a range of sectors might influence suicide and its prevention.”

Significance of findings

Study findings indicate that tackling social factors that contribute to suicide requires a policy re-set.  Government should adopt the approach of holding politicians and policymakers from all sectors accountable for decisions that may help or hinder suicide prevention efforts. Furthermore, clinical treatment services are critical for people in a suicidal crisis, however upstream measures that address social factors must also be included in national suicide prevention strategies to prevent people from reaching a crisis point.

Potential interventions to address social factors as suggested by the series include:

• Economic policies to reduce poverty such as minimum wage legislation and income protection policies. Financial insecurity, unemployment, and income inequality are all associated with increased risk of suicide at a population level. Policies which help protect people from poverty and associated problems like food insecurity and housing insecurity, can help to reduce national suicide rates.
• Regulation of commercial products such as policies that limit alcohol consumption and increased regulation of social media platforms. Consuming alcohol can dramatically increase the risk of engaging in suicidal behaviour and chronic alcohol use can exacerbate symptoms of depression. In some countries suicide rates decreased significantly when the state introduced policies to limit consumption of alcohol by for example, restricting trading hours for alcohol outlets and prohibiting alcohol advertising, or raising the minimum legal drinking age from 18 to 21. We also know that harmful social media content can increase the risk of suicidal behaviour among vulnerable people. When misinformation about suicide, graphic details about suicides and/or reports about celebrity suicides are posted on social media it can contribute to a contagion effect creating suicide clusters.
• Policies, legislation and cultural change that can help reduce domestic and gender-based violence. Suicide is closely associated with domestic violence, sexual assault and other forms of interpersonal abuse. National suicide rates can be reduced through whole of government strategies to address problems like gender-based violence and to improve access to support for those individuals who experience trauma and violence.

“Suicide is preventable and effective treatments are available. If you or someone you know is having thoughts of suicide, reach out and ask for help. Stay connected – stay alive. Thinking or talking about suicide or wanting to die, should be taken seriously. Likewise, persistent feelings of hopelessness, guilt and shame can indicate an increased risk of suicide especially if someone feels trapped in these intolerable feelings and does not see a way out of feeling this way. Believing one is a burden on others or feeling socially disconnected and isolated are other warning signs. If you or someone you know is feeling this way, seek the help of your doctor or a mental health professional, talk to someone you trust, or reach out to a helpline, like SADAG (www.sadag.org, 0800 567 567) or LifeLine (www.lifelinesa.co.za, 0861-322-322)”, concluded Prof Bantjes.

Lancet Public Health Series - View all 6 publications.

To attend the launch of the Lancet Public Health Series webinar organised by the International Association of Suicide Prevention on Tuesday 10 September 2024 | REGISTER HERE

Read more about the Event | HERE

Read more about the Mental Health, Alcohol, Substance Use and Tobacco Research Unit | HERE

For further information, please contact:

1. Tendani Tsedu
   Head of Corporate and Marketing Communications: South African Medical Research Council
   Cell: 082 945 1980
   e-mail: tendani.tsedu@mrc.ac.za
2. Jason Bantjes
   Deputy Director: Mental Health, Alcohol, Substance Use and Tobacco Research Unit
   e-mail: Jason.bantjes@mrc.ac.za