Deconstructing the First WHO Suicide Report

  • Over 800,000 people die by suicide each year, around one person every 40 seconds. 
  • 75% of suicides occur in low and middle income countries, although the actual rate of suicide is greater in high-income countries. 
  • Suicide is now the second leading cause of death in 15-29 year olds. 

In time for World Suicide Prevention Day, the World Health Organisation has released its first international suicide report, calling for large-scale strategic action to address a “global imperative”.

Its central advice is that all countries ought to have a national suicide strategy that focussed on restricting access to the ‘means for suicide’, equipping health services to better identify and respond to suicidal risk, and influencing culture to challenge stigma and increase ‘help-seeking behaviour’.

Perhaps surprisingly, given that the report divided nations by income, there is no substantial analysis around global socio-economic factors, or even why the suicide rate appears to be greater in high-income countries. Nor is there analysis of why so many young people should be suicidal.

The report steers clear of discussing current economic situations, unemployment levels, and global conflicts, despite each of these being strongly linked to suicide. Its recommendations are principally concerned with intervention at the point between suicidal ideation and the act of suicide, and not with prevention of suicidal ideation and related illnesses and conditions.

Necessarily, the report has to limit its focus. But in ignoring global events that may be increasing the risk of mental illness and suicide, the report seems to be in conflict with the whole-systems approach to health that the World Health Organisation has been advocating since the 1980s.

On the selfishness of suicide

“I cannot make you understand. I cannot make anyone understand what is happening inside me. I cannot even explain it to myself.”

Let’s say sweeping leaves is ‘leavish’. And chopping wood is ‘woodish’. In the same way, we might say suicide is selfish. The action necessarily involves the self.

But the word ‘selfish’ has moral connotations. It doesn’t just imply paying attention to the self, it suggests a kind of self-interest and disregard for others that exceeds moral norms, even by the narcissistic standards of the West.

From a logical point of view, it makes no sense to describe suicide as selfish. Suicide extinguishes the self. What could be more at odds with the interests of the self than its annihilation? To the degree that the action achieves nothingness from self, it’s better described as non-selfish.

But those making moral judgments about suicide are not speaking from a logical point of view, just as those suffering from suicidal depression can find themselves caught up in beliefs that defy reason. And those that hear such claims, and feel hurt and angered by them, would do better to consider that such judgments may be coming from a place of deep anxiety and trauma rather than careless ignorance.

Many of those who make moral claims have witnessed the pain that suicide can cause to those left behind, and find it hard to understand why anyone would inflict this upon others. To live is seen as the easiest of things, and to die by one’s own hand, the most destructive to others. In this respect, the biases of those making such a judgment are a mirror image of the biases of the suicidal.

Those making moral judgments may look at the suicidal or clinically depressed and deplore their preoccupation with self, but such self-occupation comes not from volition but compulsion, as if, like the protagonist in Kafka’s Metamorphosis, we have woken up to find ourselves suddenly set apart from others by some hideous and shameful peculiarity. No cause is more desperate than to diminish this uncompromising sense of differentiation. Suicide follows when all other attempts to return things to a sense of natural order fall short.

Speak to someone bereaved by suicide and, in spite of their grief and confusion, more often than not they will describe the deceased as having been someone who was exceptionally concerned for the feelings of others. Clinical depression feeds on the compassionate. It latches onto a concern for others and uses it as a weapon with which to bludgeon the self into submission.

Suicide necessarily concerns the self, but it is the least self-interested of acts. As in other areas, the person left most exposed to criticism by ill-founded moral judgments is the judge.