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Home arrow Language & Literature arrow The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health

Recommendation for Future Research

The absence of research from LICs casts serious doubts on the generalisabil- ity of the present evidence relating to suicide. Future research engagements on suicide risk factors should therefore focus on LICs and under-researched regions such as Africa, the Arab region, Caribbean and Latin America in order to expand the evidence base on suicide in LMICs. It will be important to investigate evidence on suicide risk factors across different geographic and socio-economic settings. This would provide a more nuanced body of evidence on suicide risk factors and would be in consonance with the emphasis by the WHO (2014) on developing contextually relevant evidence base on suicide. Further, protective factors for suicide in LMICs merit empirical attention. This would help foster the development of resilient mechanisms in LMICs as evidence shows that building protective factors against suicide is as effective as reducing risk factors (Borowski et al. 1999).


This chapter has reflected on research evidence relating to suicides that occur in the ‘majority’ world (i.e. low- and middle-income countries). There is a dearth of research investigating suicide in LICs. Evidence from MICs suggests that suicide is the consequence of the dynamic interaction of multiple factors. Psychiatric disorders (mainly depression, alcohol and substance abuse), interpersonal distress and systemic challenges such as occupational and financial difficulties are the most commonly reported risk factors of suicide in MICs. The gathered evidence indicates that factors function differently in relation to suicide determination in different settings, thus highlighting the need for consideration of cultural circumstances. Importantly, ethnographic evidence from China and India demonstrates that narratives to make meaning of suicide are situated in sociocultural circumstances and that suicide may possess utility in the pursuit of socially sanctioned goals in some contexts. Methodological complexities of the reviewed studies were noted. The arbitrary selection of proxies to act as informants for suicide cases and controls in majority of the studies reviewed represents a clear example of the methodological complexities highlighted in this chapter. What this chapter adds to the evidence base is a systematised and critical condensation of the published empirical evidence of suicide risk factors in MIC. Overall, the synthesised evidence on suicide risk factors was found to be largely consistent with existing evidence from both HICs and LMICs. Multi-sectoral engagement involving inputs from multiple and diverse areas that reflect the different socio-ecological levels of suicide risk factors is required for effective suicide prevention. Various stakeholders (including international bodies, governments, communities, families and individuals) all have key roles to play in suicide prevention efforts. Identified risk factors and methods of suicide should provide the foci and priorities to guide and inform suicide prevention measures in MICs. Nonetheless, such recommended multifaceted interventions and measures should be designed to reflect the nuances, subtleties and peculiarities of suicide in particular contexts.

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