Changing pattern of suicide in Sri Lanka

The incidence and nature of suicide in Sri Lanka have varied over time. The cause, frequency and method of suicide have changed with changing conditions.   
In the last three years (i.e.: 2020,2021 and 2022) 15.6 out of every 100,000 of the population in Sri Lanka had died by suicide. And for every successful suicide, there were 15 unsuccessful attempts, according to Dr. Rohan Ratnayake of the Sri Lankan National Institute of Mental Health. Globally, Sri Lanka occupied the 30th place in suicides.   
The suicide rate had come down marginally but steadily from 2015 to 2019. But it saw a spurt in 2020, 2021 and 2022 due to the pandemic and the economic crisis that created joblessness, a decline in businesses, and an increase in family burden and anxiety. The decline of the garment industry due to the pandemic resulted in an increase in suicides in Gampaha District.   
In 2019, according to the World Bank, Sri Lanka had the highest rate of suicide in South Asia at 14.0 per 100,000 population. The suicide rate for the eight SAARC countries in 2019 were as follows: Afghanistan 4.1; Bangladesh 3.7; Bhutan 4.6; India 12.7; Maldives 2.7; Nepal 9.0; Pakistan 8.9; Sri Lanka 14.0.
The World Health Organization (WHO) said in 2019 that over 700,000 people were dying by suicide every year at the global level. And for every person who succeeded in committing suicide, twenty had attempted it. Suicide was the second leading cause of death in the 15 to 29 age group. And 79% of suicides occurred in low-and middle-income countries such as Sri Lanka.   
The website EconomyNext quoted Consultant Psychiatrist at the National Hospital in Sri Lanka, Dr. Chathurie Suraweera, as saying that around 3,000 cases of suicide are reported annually in Sri Lanka, with eight to nine cases reported every day. Ceylon Today quoted Dr. Rohan Ratnayake Director of the National Institute of Mental Health (NIMH) as saying that suicide was happening once every four hours with the majority of those who took their own lives being males. In 2022, for example, 2,833 males and 574 females committed suicide.   

History of Suicide in  Sri Lanka

In his paper, S.T. Kathriarachchi of the University of Sri Jayewardenepura has brought out some interesting facts about the history of suicide in Ceylon/Sri Lanka. Records show that hanging was the most frequently used method between 1880 and 1950. It accounted for more than 70% of all suicides between 1880 and 1889. Hanging was also a predominantly male method. It was the preferred method in 55% of the cases between 1940-1949.
The second most popular method in the early period of Colonial Ceylon was drowning, which was preferred by females. 13% used poison to kill themselves.   
In the early period, drowning was the preferred method of both males and females in the Northern Province. However, it yielded place to poisoning in the 1940-1950 decade. When the Green Revolution came at the end of the 1960s, pesticides came to be used widely. These were effective in the early years because the State medical sector at the time was not geared to treating cases in time.   
The first proven case of insecticide poisoning was in 1954. Even in 1959, poisoning accounted for only 37% of the total suicides, while hanging accounted for 40%. But by 1969, poisoning had risen to 72% and hanging had come down to 15%. Between 1987 and 1991 taking an overdose of drugs accounted for more than 80% of suicide attempts. Ingestion of organophosphorus chemicals was the single most important method, accounting for 60% of suicide attempts.   
Looking at suicide as a socio-economic phenomenon, Kathriarachchi points out that the Gal Oya and Mahaweli resettlement schemes resulted in the destabilization of the social structure. Not all migrants could cope with migration and resettlement. The sex ratio in the population in areas of the new settlement was different. Female preponderance found in their native villages was not there in the setter colonies. The norms and regulations of settled society were also not observed under the new conditions. There was a lack of emotional and social support. Unable to cope, suicide was contemplated and attempted. In Mahaweli resettlement areas nearly 70% of reported deaths were suicidal, Kathriarachchi said quoting K. T. de Silva, W. D. N. R. Pushpakumara ( Love, hate and the upsurge in youth suicide in Sri Lanka: Suicide trends in a Mahaweli new settlement. Sri Lanka Journal of Social Sciences, 19 (1&2) 1996).
The suicide rate kept mounting in Sri Lanka. It was 6.5 per 100,000 population in 1950. But by 1995 it had increased to a peak of 47 per 100,000. It took another decade to halve it. 

 
Reduction of  Suicide Rate

The reduction in the suicide rate was brought about by the government, which took two steps: (1) It restricted the import and sale of WHO Class I toxicity pesticides in 1995 and endosulfan in 1998 (2) It decriminalized suicide in 1996.   
De-criminalization made people with suicidal thoughts come into the open and seek treatment. Criminalization, on the other hand, encouraged people to resort to extreme steps to avoid criminal action in case of a failure to die.   
Youth suicide was a noticeable phenomenon in the 1980s. 45% of all suicides were accounted for by youths is the 15 - 25 age group. However, currently, it is down to 18.5%.   
Research done by Emma Poynton-Smith of the University of Nottingham gives an idea as to why men more than women commit suicide. While women recognise depression as a condition which can be treated and seek the help of companions, peers and even experts, men think that depression should not be admitted, displayed and treated. Male ego prevents them from doing this.   
Compared to women, men choose more lethal methods, are more impulsive, and are less likely to seek help for emotional problems. Women use drug overdose and carbon monoxide poisoning, while men tend to use firearms and hanging. This explains higher mortality among men, Poynton-Smith says.   
In the West and increasingly in South Asia, men are expected to be self-reliant, hide vulnerabilities and display emotional control, which militates against seeking help that involves relying on others, admission of powerlessness, and recognition of an emotional problem.   
Levels of family cohesion are another factor which determines suicidal tendencies. Family cohesion is a protective factor against suicidal thoughts. However, sometimes, family cohesion may take the form of family oppression.   
In his study of the family and demographic change in Sri Lanka, B. Caldwell says that since the nuclear family of husband, wife and children is the norm in the island, the burden of running a family rests on the shoulders of the man. The luxury of getting the help of a joint family or an extended kinship circle is not there. In times of economic stress, the man might feel the burden. Secondly, young men have to find their own brides, unlike in the rest of South Asia. Though caste barriers have broken down, finding a bride who has confidence in the man is not easy.   
Family problems can be difficult to cope with. Personality clashes and communication breakdowns hurt the most when they happen at home. One could face abuse, trauma, and tension. Pressure from parents and addictions also pose problems.   
There are organizations like Sri Lanka Sumithrayo that could help. Sri Lanka Sumithrayo is a government-approved charity founded in 1974. It provides emotional support to develop coping skills and deal with everyday stress and strains of life. It conducts programmes for the farming community too. Most importantly, it conducts awareness programmes to prevent suicidal tendencies.