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A matter of life or death

Economic poverty should be a red flag for the risk of suicide.
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Each year, an estimated 800,000 people around the world take their own lives, making suicide one of the most common causes of death globally. Ms Valentina Iemmi of the Department of Social Policy analysed the relationship between poverty and suicide in low and middle income countries, and discusses how her work could help inform efforts to address this global health crisis.

Seventy-five per cent of suicides occur in the low- and middle-income countries (defined in 2017 as countries where the average income of a citizen is below $12,475) where the majority of the world lives. Using a range of data sources, Ms Iemmi, a Research Fellow at LSE, sought to understand the relationship between suicide and poverty, in collaboration with LSE colleagues, and Dr Jason Bantjes of Stellenbosch University and Professor Crick Lund of the University of Cape Town.

Ms Iemmi said: “Suicide is an understudied but vitally important issue in mental health. While there is a long-established link between poverty and mental health, the quantity of the evidence that links poverty and suicide is relatively sparse.”

Suicidal phenomena are notoriously difficult to define, and the authors used a comprehensive description which encompassed various suicidal ideations: suicidal plans, self-harm, suicide attempts, and the completion of the act of ending one’s life. In contrast, the authors did not use a broad definition of poverty, and instead focused on economic poverty at the macro-level.

“This helped us to go further than the mere statistics of people committing suicide in a specific country, and reflects the complexity of the issue,” Ms Iemmi said.

Ms Iemmi analysed 37 studies exploring the association between poverty and suicide. The authors found a consistent trend at the individual level supporting the association between poverty and suicide, in particular with circumstances where lower economic status, diminished wealth and unemployment are common. In low and middle- income countries, which often have large agrarian sectors, both chronic poverty and economic shocks such as crop failure were found to increase the risk of suicide.

Ms Iemmi sees establishing the role of poverty in suicide in low and middle- income countries as a crucial component of suicide prevention strategies. According to Ms Iemmi, the solution involves both economic development and investment in healthcare resources: “Our study suggests that focusing on economic development may contribute in reducing suicide rates in low and middle-income countries.”

“Also, economic poverty should be a red flag for the risk of suicide. In these instances, public health programmes for suicide prevention need to be considered,” Ms Iemmi added.

While Ms Iemmi views her work as a starting point for understanding the economic conditions in which suicide is more likely, a possible next step is to analyse the social and cultural differences in different countries, which may explain why suicide is more common in certain societies.

Ms Iemmi said: “For example, there are different levels of stigma attached to suicide and mental health in different societies. In some societies, seeking support from healthcare professionals­ is not the social norm, even when they are available. This means that access to care becomes more difficult and this may exacerbate the risk of suicide.”

“Understanding the various factors at work in suicidal phenomena is vital to understand this global health crisis,” Ms Iemmi added.

Behind the article

 

Valentina Iemmi is Research Fellow in the Personal Social Services Research Unit at the LSE. She is currently carrying out her PhD in the Department of Social Policy at the LSE on the role of international public and private donors investing in mental health in low and middle income countries.

 

Suicidal behaviour and poverty in low- and middle-income countries: a systematic review (2016) by Valentina Iemmi, Jason Bantjes, Ernestina Coast, Kerrie Channer, Tiziana Leone, David McDaid, Alexis Palfreyman, Bevan Stephens and Crick Lund was published in The Lancet Psychiatry

 

The theme of the World Health Day 2017 on the 7th April 2017 is Depression: Let's talk. http://www.who.int/campaigns/world-health-day/en/ #LetsTalk

 

For further information about how suicide affects societies please visit http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

 

 

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