Authors: Lakshmi Vijayakumar, Michael R. Phillips, Morton M Silverman, David Gunnell, Vladamir Carli
An estimated 804,000 deaths by suicide occurred globally in 2012, with 75.5 percent of these in low- and middle-income countries (LMICs), which have limited resources to address the issue. Substantial differences exist in the rates and characteristics of suicide between LMICs and high-income countries (HICs) as well as among LMICs in the six World Health Organization (WHO) regions. The relative importance of certain risk factors differs by country and region, such as age of onset of a psychiatric disorder, religious orientation and practice, geographical location, age ranges, and gender distribution, and risk factors may vary over time. One particularly distressing feature associated with suicide in LMICs shows the frequent occurrence of suicide pacts and family suicides, which constitute an estimated one percent of suicides, and which are frequently driven by debt, poverty, and other social issues. Vulnerable groups in LMICs include women, youth, farmers, refugees and internally displaced persons, sexual minorities, and survivors of suicide loss.