Each year, more than 1million people take their own lives - more than the combined annual deaths from homicides and wars. Suicide is a leading cause of death among teenagers and adults under 35. Men are three times more likely to attempt suicide than women, but rates among women have risen alarmingly fast in the last decade.
Jose Manoel Bertolote, coordinator of the Management of Mental and Brain Disorders at the WHO, says that when the Soviet Union broke up 15 years ago, the newly independent countries began to track their own suicide rates, which reflected their unique demographics.
Rates Rise, Rates Fall
In the European part of the former communist empire, rates rose dramatically, he said, but they went down in the Central Asian region.
The WHO is looking into another possible correlation: in the last few years it has been running an extensive study on whether HIV-infection rates have an effect on suicide rates.
“The modification of the social regime not only didn’t [produce] the same result, [it gave] disparate results," Bertolote says. "The most likely explanation for this is that the separation from the common Soviet regime revealed much more of the natural [population] trends in these former republics. For instance, in the most western Soviet republics -- Ukraine, Belarus, and the Baltic States, which had a natural tendency to higher suicide rates -- it increased. Whereas in the Central Asian republics -- which are to a large extent Muslim republics, [including] Tajikistan, Uzbekistan, Kazakhstan -- suicide rates dropped.”
According to the latest WHO data (from 2003), the leader of this grim statistic among former Soviet republics is Lithuania, with 75 male and 11 female suicides per 100,000 people. Russia is second (70/12), followed by Belarus (63/10).
Brian Mishara, the president of the International Association for Suicide Prevention (IASP), says that in the countries of the former Soviet Union -- with the exception of the Baltic States -- there is an almost total lack of government-sponsored programs on suicide prevention.
Developing Support Network
Developed European countries have had such policies in place for decades, he said.
But he notes positive developments in places like Russia, Ukraine, and Belarus, where nongovernmental organizations (NGOs) operate crisis hotlines and push governments to fund education programs on the causes of suicide.
Mishara also told RFE/RL that one of the reasons for the recent high reported rates of suicide could be that in Soviet times, incidents of suicide were hidden by the authorities.
“There are help lines available in literally all those countries and there are organizations working on a grassroots level," Mishara said. "One of the phenomena is the strong association between alcoholism and suicide. In fact, some studies have shown that the availability costs of vodka have some relationship to suicide rates, as well. The other thing is that suicide rates might artificially appear to be much higher after the breakup of the former Soviet Union simply because there was more open admission to the fact that there were suicides and they were less hidden.”
An Alcohol Connection?
Bertolote says that during the final stages of the Soviet Union, several studies had begun to reveal the close correlation between alcohol consumption and suicide rates.
“There are quite a few good studies indicating the role of alcohol in suicide rates in the former Soviet republics and Russia, in particular," Bertolote says. "These are very interesting studies showing that throughout the regimes of [Yuri] Andropov and then [Mikhail] Gorbachev and then [Boris] Yeltsin afterward -- who had completely different policies on alcohol control -- suicide rates followed very closely the alcohol consumption. When the policies were more restrictive, less alcohol was available -- suicide rates were much smaller. When the alcohol control was relaxed -- suicide rates increased.”
Illegally produced vodka that was seized in Volgograd, Russia, this month (epa)
Those studies take on an added importance when one considers that the official suicide rates in many Muslim countries are much lower compared to predominantly Christian countries. Muslims do not drink alcohol.
The most recent WHO suicide rate report says Iran has 0.3 male deaths and 0.1 female deaths per 100,000 people. Azerbaijan's rates are 1.2 and 0.4.
But both Bertolote and Mishara caution that the differential may be simply because governments in Muslim countries, like former Soviet authorities, do not want to acknowledge the problem.
Looking At HIV
WHO is looking into another possible correlation: in the last few years it has been running an extensive study on whether HIV-infection rates have an effect on suicide rates.
Bertolote said although the study is not finished, early results have revealed some trends.
“The studies indicated that the suicides occurred at the moment of the testing, when people learned that they were HIV-positive," Bertolote says. "Some people decide to commit suicide rather than going through the painful condition of being HIV-positive. Then the introduction of the treatment, the antiviral therapy, the 'cocktail' treatment, decreased suicide rates. So when people learned that there was hope, they didn’t commit suicide.”
According to WHO data, in some countries people with HIV/AIDS are as much as eight times more likely to attempt suicide.
Russia and Ukraine are both believed to be on the verge of major HIV/AIDS epidemics.
The issue of suicide prevention is not without controversy. Politicians and medical professionals alike have questioned whether governments should interfere with the personal decision to end one's life.
But Bertolote dismisses this, citing studies that show 96 percent of people who attempt suicide have diminished or heavily distorted mental judgment capabilities.