Dr.Rohan Ratnayake of the Sri Lankan National Institute of Mental Health is quoted in the media as saying that 15.6 out of every 100,000 of population in Sri Lanka had died by suicide in 2020, 2021 and 2022. And, for every successful suicide, there were 15 unsuccessfully attempted ones. Sri Lanka, he added, occupied the 30 the. place in suicides globally.

The suicide rate, which was coming down marginally but steadily from 2015 to 2019, saw a spurt in 2020, 2021 and 2022 apparently due to the economic crisis that created joblessness, decline in businesses, and an increase in family burden and anxiety. For example, the decline of the garment industry due to the pandemic resulted in an increase in suicides among garment factory workers in Gampaha district.

According to the World Bank, in 2019, 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 (others put it 800,000). And for every person who succeeded in committing suicide, twenty 20 had attempted suicide. Suicide was the second leading cause of death in the 15 to 29 age group. 79% of suicides occurred in low-and middle-income countries, including 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, with eight to nine cases reported every day. Ceylon Today quoted Dr.  Rohan Ratnayake Director of 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, Dr.Ratnayake said.

In his paper, S.T. Kathriarachchi of the University of Sri Jayewardenepura has brought out some interesting facts on the history of suicide in 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 of suicide. It was the preferred method in 55% of the cases between 1940 and 1949.

The second most popular method in the early period of Colonial Ceylon was drowning, which was preferred by females. And 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 in the 1960s, pesticides came to be used widely in suicide. This method was effective in the early years because the State medical sector at that time was not geared to treating cases.

The first proven case of insecticide poisoning was in 1954. But even in 1959, poisoning accounted for only 37% of the total suicides, while hanging accounted for 40%. However, 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 organophosphorous chemicals was the single most important method, accounting for 60% of suicide attempts.

Seeing 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 those areas did not accord with the female preponderance found back in their native villages. The norms and regulations of a settled society were not observed in the settler colonies. 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 says quoting a study.

Meanwhile, the suicide rate was mounting in the island as a whole. 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.

The reduction was brought about by the government’s taking 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 intent come into the open and seek treatment. On the contrary, criminalization was encouraging people to resort to extreme steps to avoid criminal action in case of failure of the attempt to die.

Youth suicide was a noticeable phenomenon in the 1980s, Kathriarachchi says. 45% of all suicides were accounted for by youths in the 15 – 25 age group. However, currently, youth suicide is down to 18.5%.

Research done by Emma Polynton-Smith of the University of Nottingham UK explains why men more than women commit suicide. Compared to women, men choose more lethal methods, are more impulsive, and are less likely to seek help for emotional problems, she says.

Women use drug overdose and carbon monoxide poisoning, while men tend to use firearms and hanging. This explains the higher mortality among men, she points out.

Men are more impulsive than women and use extreme methods in a fit of frenzy. However, it has also been found that impulsive persons may not always use the most effective methods of suicide. A man who is thoughtful might choose the most effective method.

While women recognise depression as a condition which can be treated and seek the help of companions and even experts, men think that depression should not be admitted, displayed and treated. Male ego prevents them from doing any of these.

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 is 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 pressure or even oppression which can cause suicide.

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, the burden of running a family rests on the shoulders of the man often an inexperienced young 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 more.

Young Sri Lankan 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 him is not easy.

Family problems can be difficult to cope. Personality clashes and communication breakdowns hurt the most when they happen at home. One could face abuse, trauma, tension, addiction or pressure from parents who demand attention and perfection. Family challenges can be hard to solve because there may be many people involved.

Organizations like Sumithrayo provide valuable services for mitigating suicidal tendencies. The EconomyNext website says that psychological problems increased during the pandemic. It quotes Dr. N Kumaranayake, a psychologist based in Colombo, as saying that it had doubled in 2022. But the number of psychologists and psychiatrists is small. According to WHO, there are 0.6 psychiatrists and 0.03 psychologists per 100,000 population in Sri Lanka.