Tackling The Burden Of Suicide In Sri Lanka

By Kasun Kodituwakku –January 21, 2016

Kasun Kodituwakku

Over 800,000 suicide deaths are reported every year, 75% of these origination from the lower and middle-income countries predominantly within Asia.

Sri Lanka was listed as having the 4^th highest suicide rate in the WHO report of 2014. The conflict-ridden history of the country has meant that suicide has been a major burden of the previous three decades, nevertheless the measures and interventions implemented by the governing body has shown to positively impact suicide mortality rates, particularly legislations on pesticides. But the numbers of attempted suicides continue to increase, highlighting the inadequate attention given to the central determinants of suicidal behaviour. Means restriction and addressing social and economic factors whilst providing mental support via a robust healthcare system have shown to be key in tackling suicide.

This report explores the dynamics of suicidal behaviour in Sri Lanka and the interplaying factors that contribute to the persistent national burden. It investigates the education and employment systems as well as assessing successfulness of interventions and policies implemented by the governing body.

Burden of Suicide

Suicide is a complex multifaceted behaviour, which is induced by various stresses and predispositions. It accounts for millions of non-fatal hospital admissions and over 800,000 deaths annually, a life every 40 seconds.¹ Projections estimate mortalities to almost double to 1.53 million by 2025; with a further 15 to 30 million cases of attempted suicide, thereby demonstrating the major global health burden that suicide represents.²

Over 90% of suicides have been related to psychiatric illness in high-income countries (HIC)³, in which bipolar and major depressive disorders account for almost 60%.⁴

In the WHO 2014 report⁵, the overall suicide rate was marginally higher in HIC than low and middle-income countries (LMIC), 12.7 per 100,000 and 11.2 per 100,000 respectively. But the sheer population that reside in LMIC meant that it accounted for 75% of all suicides.

Sri Lanka

Sri Lanka is a small densely populated island located just off the southeast shores of the Indian subcontinent⁶. It’s regarded as a lower-middle income country⁷ with a relatively low expenditure on health – $89 per capita ⁸, 3.4% of the GDP^6,9. But the widespread basic healthcare system available in Sri Lanka is admirable considering its economic profile. An extensive network of government funded public health units exists alongside a robust private sector providing basic health care to the majority¹⁰. Communicable diseases remain endemic in Sri Lanka; vector-borne diseases like dengue fever along with diarrhoeal diseases and hepatitis A pose the greatest threats⁶. Sri Lanka, like many LMIC, is facing the double burden of disease, today non-communicable diseases account for over 70% of mortalities, cardiovascular disease, chronic respiratory diseases and diabetes are extremely prevalent^10,11. Mental health was previously a neglected topic, but in recent years especially post-conflict (1983-2009) there has been a greater focus on such conditions by the Ministry of Health. This resulted in the introduction of mental health policies and interventions to tackle the health burden; nevertheless only 1.6% of the total health budget is invested on mental health¹².

A History of Suicide                                           Read More