There are only three countries in the world where female suicide rates are higher than male
The World Health Organisation (WHO) estimates that every 40 seconds, somewhere in the world, a person dies by suicide. In total, over 800,000 people take their own life every year across the globe. Whilst this figure may seem shocking in itself, a combination of cultural factors including social taboo, the illegality of suicide in some countries and a lack of accurate data mean that if anything, it may be considered to be conservative.
One trait that suicide rates throughout the world do have in common is that they are disproportionately carried out by men. Suicide is currently the biggest killer of men under 45 in the UK and Australia, and according to the Campaign Against Living Miserably (CALM) close to three quarters of all suicides in the UK are men, despite the fact that women are more likely to self-harm, display suicidal thoughts and attempt suicide. This disparity has been put down to a reluctance of males to ask for help for fear of embarrassment, and the tendency for men to employ more violent means, which are more likely to be fatal. However, according to the WHO’s 2015 statistics, there are three countries in the world where female suicide rates outweigh male.
In the mid 1990s China had one of the highest suicide rates in the world, partly influenced by the deconstruction of the psychiatric care system under the leadership of Chairman Mao and the subsequent lack of mental health provisions in the country from the 1950s until the early 1990s. Whilst suicide rates have fallen dramatically in the intervening years, it is one of the countries bucking the trend when it comes to the male to female suicide ratio. In 2015, 9.5 for every 100,000 women took their own life in China, compared to 7.7 men, and it is now the leading cause of death for young women in the country. Most at risk are those aged between 15 to 34 and living the countryside; women in rural areas are estimated to be between two and five times more likely to kill themselves than those living in cities. In metropolitan areas, female suicide rates have fallen in recent years, with researchers putting this down to higher wages, better living conditions and increased autonomy.
It is believed that a number of factors contribute to the higher female suicide rates in China. The easy access to poisonous chemicals in the countryside - between 1996 and 2000 it was estimated that 62 per cent of suicides occurred as a result of an individual drinking pesticides - is believed to make impulsive self harm more of an option in stressful familial or shame-prompted situations. That women in rural regions often marry younger and leave education earlier than their city-based counterparts is also a factor - as women become increasingly isolated by the pressures of family life, tending to be assimilated into their husband’s family and in many cases losing contact with their own in the process.
However, all of these factors are commonplace in many countries across the developing world. So what makes China different? Ingrained but archaic cultural attitudes which present suicide as a legitimate solution to a problem seem to play a role, as does the disparity in mental health provisions between men and women. Like in the West, a social stigma towards mental health conditions still exists and it is estimated that only 40 per cent of individuals with mental health issues will ever receive any form of treatment. Whilst the prevalence of antidepressants in China is rising as a whole, a 2014 study by The Economist also highlighted a lack of resources for treatment, with just 1.7 psychiatrists per 100,000 people. Women, who are seen as integral to the day-to-day running of the household, are considerably more likely to finish treatment as soon as they show signs of improvement but not necessarily before treatment is complete. Women therefore spend less time receiving help for the same issues as men, before being discharged into the same situations from which they came, to face the same pressures. Those who do undergo treatment are often subjected to practices that would, by many people’s standards, be considered brutal and dehumanising, including being chained to beds.
A lack of provisions in mental healthcare is also considered to have severe repercussions for women in Bangladesh. In a country with a rapidly rising population that currently stands at just over 165 million people, there exist just 500 mental health beds. Where in-patient beds cannot be found, mental health patients will be consigned to other largely unsuitable facilities including “homes for the destitute”. As in China, many women who do receive inpatient treatment are discharged to return to the home as soon as their symptoms show signs of dissipating. In rural areas, patients will often be taken to a local spiritual healer rather than a doctor and thus many individuals do not receive the treatment they require early enough.
Despite the act of suicide being illegal in Bangladesh, it is estimated that in excess of 10,000 people died in this way in the country in 2015. Socially, mental health issues are still stigmatised and the Lunacy Act of 1912, which was introduced during British colonial rule and permits inequality against the mentally ill, is still in place. Generally, accurate information about female suicide in Bangladesh is harder to come by than that pertaining to China. However, the WHO records that in 2015 there were 6.6 per 100,000 female suicides for every 5.3 male suicides. There are conflicting figures, however, regarding just who these women are and what the causes may be. Depression, stalking, sexual harassment, domestic and physical violence and a feeling of powerlessness owing to inferior social status have all been cited as reasons, according to 2010 figures from Jatiya Mahila Ainjibi Samity, a women’s issues NGO based in the country’s capital Dhaka.
Compounding the issue further is the fact that women are also disproportionately more likely to be killed or seriously affected by natural disasters in Bangladesh, particularly in rural areas. In 2017 alone, over eight million people have been affected by flooding, with the country also experiencing cyclones, earthquakes and landslides. In the aftermath of these events, it is not uncommon for post traumatic stress disorder and depression to manifest, and whilst the focus is on immediate disaster relief, the longterm effects of these events are often left untreated. The fact that women are less likely to seek help owing to household responsibilities and more likely to feel the impact of the socio-economic consequences of widowhood further compounds this problem, according to Nazmun Nahur, who has served as the Survivor Service Coordinator for Plan International Bangladesh. In 2004, following the Indian Ocean Tsunami, the WHO did develop a framework for psychological support after traumatic events but this is yet to be effectively implemented in Bangladesh.
In another country liable to the consequences of natural disasters, Grenada, it is perhaps even harder to analyse female suicide rates as accurate record keeping is so limited. According to the WHO’s figures, 0.4 women for every 0.0 men per 100,000 people took their lives during 2015. The suicide rate for both men and women is still one of the lowest in the entire world though, and the male rate has declined sharply over the last decade, down from 5.7 per 100,000 in 2005. Notably, 2005 was also the year that the island was destroyed by Hurricane Emily, and also saw high female suicide levels compared to previous or subsequent years. However, the country is unique in one particular respect: it is the only country in the world where female suicide rates have actively and recently overtaken male suicide rates.
Given the low number of suicides in the country as a whole, there is little research on what has caused this reversal of trends; Grenada has a population of just 107,000 so it is perhaps more reasonable to understand it on a case-by-case basis. However, speaking on the Facebook page of Mount Gay Hospital, one of Grenada’s mental health facilities, Dr. Narasimhan Prabhakar - who was at one point the only psychiatrist on the island - pointed to a combination of societal, community-based and individual factors for changing suicide rates in the country: “Materialism, lofty and unrealistic goals, failures, interpersonal relationship problems and easy availability of the means of doing harm to self-harm.” In what is perhaps a disturbing indication of one of the societal pressures, he also argues that people attempt to take their own lives because they are “confused about their own identity and sexual preferences” as a result of imported “American ideas”. Male homosexuality remains illegal in Grenada and it is not considered even possible for females to commit such an “offence”.
There is a traditional Chinese saying that surmises that there are three solutions to a woman’s problems: “one - to cry; two - to scream; and three - to hang herself”. The World Health Organisation contends that this attitude is improving, albeit slowly, but it is clear that China still has huge strides to make in its treatment of mental health issues, particularly for women. Bangladesh has similar issues to face, lacking as it does adequate responses to gender bias and natural disasters. As for the case of Grenada, it is fair to say that more research needs to be done.
However, the problem of female suicide is by no means restricted to these three countries. In Canada, the rate of suicide in young women has increased by 38 per cent in the last decade, a figure in sharp contrast to the male suicide rate which has fallen by 34 per cent. In the UK, 2016 witnessed the highest number of female suicides for a decade.
Male or female, suicide is always horrendous, but it is quite clear from the progress which has been made that while mental health conditions will continue to exist - after all, the human brain is complex beyond our comprehension - the sooner facilities are improved and social stigmas quashed, the sooner this problem will be tackled, and that goes for our own countries too.
If you have been affected by any of the issues in this article, contact Your Life Your Voice on 1 800 448 3000, Samaritans on 116 123 or the National Suicide Prevention Hotline on 1 800 273 8255. For recorded information, call Mind on 0300 123 3393