The global suicide rate has seen a net decline. What caused it?

Progress Watch

By some accounts, 2018 was a difficult year – conflicts raged in the Middle East, migrants swung between the difficulties of lives left behind and uncertain futures, and rising populist anger threatened to reshape political landscapes. Yet amid the doom and gloom shone one significant point of progress: The global suicide rate hit its lowest point in two decades.

The rate fell by 38 percent since its peak in 1994, according to data from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle. More than 4 million lives have been saved as a result, The Economist reports. In countries like China and India, where both urbanization and social liberation have created new opportunities for women, drops in suicide are dramatic. In Russia, the rate is high but significantly lower than its post-Soviet Union levels in the 1990s. Meanwhile, policies that reduced access to means of suicide – from bans on the herbicide paraquat to gun control laws – contributed to suicide declines in Sri Lanka, South Korea, and Israel.  

“There are these shifts happening, where some people might be benefiting from these economic changes, and others are worse off,” says Jane Pearson, chair of the Suicide Research Consortium at the National Institute of Mental Health (NIMH) in Bethesda, Md. “Means of dying by suicide can start shifting over time, too, but I think overall there’s been some success addressing these issues.” 

Ali Mokdad, professor of health metrics sciences at the IHME in Seattle, agrees. 

“Not as many people are dying from suicide, and this is very good news for everyone in the world,” he says. “So many lives have been saved, especially young people and females as well.” 

This last point – that fewer young people and women are dying by suicide – is most apparent in countries with expanded social freedoms. In both China and India, for example, young rural women have more options, such as making a living on their own in cities or attaining higher levels of education, rather than languishing in abusive or unhappy marriages. And that has played a large role in the drop in suicide rates, says Professor Mokdad.

“We know when a women gets more educated, she’s more likely to manage her finances, she’s more likely to seek medical care ... so we see an improvement in female health in general,” he explains. 

In Russia, a different subpopulation has contributed to dropping suicide rates: middle-aged men. Rates were highest in this group during the 1990s and early 2000s after the collapse of the Soviet Union. In 2000, the age-adjusted suicide rate among Russian men was 85.8 per 100,000 people; the rate among Russian women was approximately one-sixth that number, World Health Organization data show. 

But general quality of life has steadily improved, writes William Pridemore, dean and professor in the School of Criminal Justice at the University at Albany, State University of New York, in an email to The Christian Science Monitor. The current political context and economy are both more stable relative to the 1990s, he writes, causing “individuals, families, communities, governments, and societies to be healthier.” 

Accordingly, rates among Russian men sank to 48.3 per 100,000 people in 2016 – a number that, while relatively high, shows a marked decline from the years after the Soviet Union’s collapse. 

Sri Lanka banned the importation of a number of pesticides in the ’90s and again in 2009, when it stopped importing an herbicide called paraquat. The bans are credited with cumulative reductions in suicide, with a decline of 21 percent in the overall rate of suicides between 2011 and 2015.

Similarly, as part of a suicide prevention program, Israel sought to reduce access to firearms. Israel Defense Forces soldiers usually have their weapons with them at all times, but a 2006 rule banned them from bringing firearms home over the weekend. Following the policy change, the country’s total suicide rate decreased by 40 percent; most of the change was due to a decrease in suicide using firearms on weekends. 

These success stories add credence to the idea that restricting the means of self-harm can reduce suicide rates. This could also explain why the United States, unlike most other countries, has seen its suicide rate jump 28 percent during the past two decades: Firearms are widely accessible to Americans, and experts say the 2008 recession and the opioid epidemic have increased the number of those considering suicide. 

“In the US, most suicides are committed through guns, whereas in other parts [of the world], insecticides. If people are considering it, they have access to [guns] easier than anyone else,” says Mokdad. 

Dr. Pearson of NIMH says efforts are under way in the US to promote suicide prevention and firearm safety in tandem, in order to address this issue. “The current approach, as far as physicians see it, is we want to talk about how to use firearms safely,” she says. “We feel like there’s enough common ground between suicide prevention and responsible firearm owners where we can start making some headway at least to have some conversations....” 

Besides access to firearms, there are other factors driving the US suicide rate, Pearson says, including concerns over the economy and the opioid epidemic. Because the rate varies considerably by state and even county, it’s difficult to design a one-size-fits-all approach. 

Yet suicide is also a global phenomenon, Mokdad says, and looking to other countries for solutions would benefit the US.

“It’s time for us in the US to look at other countries and say, what have they done? What systems have they put in place to reduce suicide...? We don’t live by ourselves,” he says. “Other people have faced the same problems in this world.”