Trends and Patterns of Suicide Rates in South-East Asia Region: An Analysis from 2000 to 2019

Abstract

This study aims to identify and analyse trends in suicide rates in South-East Asia Region (SEAR) countries from 2000 to 2019. The study compares suicide rates between SEAR countries and looks at trends by gender (male, female, both sexes) to gain a sense of regional patterns. Discussion of key factors affecting suicide rates in recent years has been discussed to understand this critical public health issue better. The results of this study can be used by SEAR countries’ governments, mental health organizations, and public health advocates to promote suicide prevention actions.

This study aims to analyse temporal and geographical suicide mortality patterns in the SEAR countries and to explore the relationship between suicide mortality and socioeconomic factors, as well as mental health resources, by gender. The results identify trends and patterns, which, in turn, can be used to develop more effective preventive strategies to lower suicide rates.

Suicide is a significant but preventable global public health issue with marked geographic variability. However, the trends in mortality within SEAR countries are underexplored. This study addresses this gap using mortality data and advanced statistical analysis to understand regional trends.

Suicide mortality data from 2000 to 2019 was sourced from the World Health Organization (WHO) database. Age-standardized suicide rates (ASRs per 100,000) were calculated by sex, country, and year for populations above 90,000 in 2019 across 10 SEAR countries (Bangladesh, Bhutan, India, Sri Lanka, Maldives, Nepal, Indonesia, Myanmar, Thailand, and Timor-Leste). Joinpoint regression analysis was applied to identify significant changes in suicide patterns over time. Annual Percent Change (APC) and Average Annual Percent Change (AAPC) were calculated, and all analyses were conducted using R programming version 4.4.2.

The study found mixed suicide rates across SEAR countries. Bangladesh's AAPC was -3.30% after an early decrease of -5.60% and a later increase of +0.22%. Bhutan's suicide rate dropped consistently, with an AAPC of -1.741%. Female suicides decreased -4.03% in India, while male rates fluctuated, resulting in a -1.66% AAPC. Indonesia experienced a gradual decline of -0.69%, with notable fluctuations in male suicides, leading to an AAPC of -1.277%. Male suicides in Sri Lanka dropped by 2.78%, and AAPC decreased by 2.34 %. With an AAPC of -4.236%, female suicides dropped 11.12% in the Maldives. With an AAPC of -4.03%, Myanmar's suicide rate fell, especially among women (-8.98%). Nepal's AAPC was -1.66% due to rising female suicide rates and a 0.11% reduction. Thailand had the most significant decline (-7.80%), especially in female suicides (-16.04%), with an AAPC of -4.13%. The AAPC in Timor-Leste was +0.56% despite a -0.26% overall reduction due to a 9.31% increase in male suicide rates. These findings reveal gender disparities across the region, with female suicide rates generally showing sharper declines compared to males. While most countries reported overall declines in suicide rates, the trends were not uniform, with fluctuations and unfavourable patterns persisting in specific populations and countries.

The findings indicate that most SEAR countries experienced a decline in suicide mortality between 2000 and 2019, yet unfavourable trends persist in some populations, such as in Timor-Leste. These findings represent the need for more epidemiological research to investigate the underlying causes of these downward trends. Enhancing mental health services and socio-economic support systems is essential to tackle the ongoing issues of suicide prevention in the SEAR region.

Keywords: Suicide rates, South-East Asia, gender disparities, socio-economic factors, mental health resources.