Q&A: Suicide and self-harm

This piece discusses suicide. In the US, if you or someone you know is experiencing thoughts of suicide, call the national 988 Suicide & Crisis Lifeline at 988 or text HOME to 741741 (the Crisis Text Line). 

IHME Research Scientist Gregory Bertolacci shares findings from a new study on global rates of suicide and self-harm, showing the progress made over the past 30 years, but ongoing challenges that remain to be addressed.

This transcript has been lightly edited for clarity

What are the key findings of your research on suicide?

The key findings from our research are that globally, 740,000 people die from suicide every year, where two-thirds of those deaths are in males. This means that, on average, one person dies every 43 seconds. Since 1990, the world has made a lot of progress on this topic, and we’ve observed nearly a 40% decrease in mortality rate. However, suicide is still the leading cause of death in many regions for 10–29-year-olds.

What general trends have been observed, and are there any exceptions?

The general trend that we observed is that there’s been a large decline in suicide rates worldwide over the past three decades, with the majority of this progress coming from regions within Southeast Asia, East Asia, and Oceania, as well as Central Europe, Eastern Europe, and Central Asia.

On the other hand, there are some locations where the rate of suicide has gone up, like Latin America and the Caribbean. We’re also seeing that the mean age at which someone dies from suicide is generally increasing. On a global scale, the mean age at the time of death in 1990 was 4.4 years younger than it is in 2021. But there are some areas in the world where the opposite is occurring. In sub-Saharan Africa, for example, the mean age of death was 45.7 in 1990, but 45 in 2021.

What findings were observed regarding suicide by firearm?

Our results on suicide by firearms are that in 2021, we found that the locations with the highest rate of suicide by firearm are Greenland, the USA, Uruguay, and Venezuela, while the lowest locations were found in East Asia.

Globally, males use a firearm 10% of the time to commit suicide, while females use a firearm 3% of the time. The use of firearms did not affect the mean age of death in males, but it did lower the mean age of death in females by three years.

What differences did you find between male and female suicides?

Some of the key differences we found are that females attempt suicide 50% more often than males. But males are three times more likely to die from their attempts.

Research has described this as the gender paradox, and there are several complicated factors that contribute to this difference. One of these factors is that males often choose more lethal means of suicide. This is supported by our findings that men use firearms in 10% of suicides, while women only use firearms in 3% of suicides. When less lethal means of suicide are used, there can be a greater opportunity to save a person’s life with medical intervention.

Who is especially at risk, and what can be done to reduce that risk?

Suicide is a tragedy that can affect people across all geographies, ages, sexes, and socioeconomic backgrounds. No group is immune, but we see that some groups appear at a higher risk than others. In some regions, suicide is the leading cause of death for young people. However, the mortality rates are higher for older age groups, even though suicide may not rank as a leading cause of death for them. It’s important to remember that suicide is preventable when we are taking the right approach. The key is making sure that we tailor interventions to specific age groups we’re trying to support.  

Prevention strategies for older ages might focus on increasing access to health care for people living with chronic conditions, but strategies for young ages might include anti-bullying campaigns. Strengthening social connections, supporting economic stability, and addressing cultural barriers and stigma are all important steps to help reduce the risk of suicide.