Suicide is tragic. But there is something everyone can do to help prevent it. Globally, nearly one million people die by suicide each year, and every incident of completed suicide is accompanied by an estimated 20 attempted acts. Institutions like the World Health Organisation (WHO) urge us all take up a role in combating suicide.

In Nepal, as in many other countries, suicide remains a complex public health problem that is poorly understood. Research by Luitel et al. has found high rates of mental illness in Nepal where, about 28 percent of the population may experience depression and 23 percent anxiety. The WHO estimates the incidence of suicide in Nepal to be among the highest in the world, particularly for women. However, there is no reliable and representative data to confirm these projections. More research is needed to better understand suicidal deaths in Nepal, and many organisations have made commitments to pursue such projects. This information will greatly increase our ability to prevent such deaths. However, until rigorous research is completed, it is important to consider the two important ways to prevent suicides: (1) addressing legal interpretations of suicidal behaviour and (2) utilising media reporting of suicide and its causes.

Legal ambiguity

Addressing legal issues related to suicide in Nepal is crucial to prevention efforts and care for persons and families affected by suicidal behaviour. First, there continues to be confusion among health workers, public officials, and public health organisations about whether or not suicide is illegal in Nepal. People who think suicide is illegal in Nepal are less likely to report and document suicides, and to provide care specific to suicide prevention.

In Nepal, the Muluki Ain does not clearly specify that suicide is illegal in the country. Yet this misconception has been propagated by both Nepali and foreign researchers. Therefore, health workers, legal advocates, policymakers, and law enforcement officers need to work together to provide clear messages to the public about the legal issues related to suicide.

The second legal issue is the debate on a potential law that would punish people who incite suicidal behaviour in others. This law is well-intentioned with regard to reducing domestic violence, alcoholism, harassment, and other behaviours related to abuse and maltreatment. But it is often very difficult to clearly connect a suicide with another person’s behaviour as persons who commit suicide are more likely to have mental health problems. In some cases, suicidal behaviour may be a desperate act against someone else who is subjectively perceived to be doing wrong. The best solution, therefore, is not to punish those persons perceived to be inciting suicide. Instead, both the person with suicidal behaviour and those around them need mental health care.

Role of the media

Another promising avenue for suicide prevention is utilising the media for information dissemination and awareness-raising. While the causes for suicide are complex, there is evidence that the media plays a significant role. Following newspaper and media reports, a research has demonstrated that vulnerable individuals may be influenced to engage in imitative behaviours, particularly if the media coverage is high and/or explicitly describes the method of suicide. Thus, responsible reporting plays a deeply important role in educating the public about suicide, and may encourage those at risk of suicide to seek help.

Furthermore, newspapers and other media outlets have the ability to spread positive messages related to suicide, offering information on care resources, warning signs, and ways to help. However, too often, the media provides damaging messages related to suicide. Past evidence has shown that sharing specific information related to the location and method, using sensational language, and providing misleading explanations can cause suicide contagion—an increase in suicides following the news report. For example, it is misleading to attribute a suicide to an individual event like exam failure or relationship breakdown. Research shows that suicidal deaths are very complex and are often a result of a combination of factors, including existing mental disorders, maladaptive coping mechanisms, and many other social, environmental, and cultural factors. Another study has demonstrated that, following a campaign to encourage safe media reporting—less extensive and dramatic coverage of suicides—suicide deaths and attempts dropped by 80 percent over six months.

To avoid increasing suicides, the WHO provides a brief set of guidelines to help media professionals to safely report suicide-related news: take the opportunity to educate the public about suicide and suicide prevention resources; avoid language which sensationalises or normalises suicide, or presents it as a solution to problems; avoid prominent placement and undue repetition of stories about suicide; avoid explicit description of the method used in a completed or attempted suicide; avoid providing detailed information about the site of a completed or attempted suicide; word headlines carefully, avoiding dramatic language; exercise caution in using photos and videos (use school or family photos that respect those affected); take particular care in reporting celebrity suicides; show due consideration for people bereaved by suicide; provide information about where to seek help.

Perhaps, the most important suggestion is to always provide information on help-seeking resources. Nepal has many organisations that can help and care for someone who is contemplating suicide, or a family member who has lost someone. So we call upon all media professionals to help reduce suicides by using these guidelines. No matter what problems the readers are dealing with, there are professionals who want to help them find reasons to keep living. If you, or someone you know, is in crisis or thinking of suicide, you can access a hotline to speak with trained psychosocial support professionals—TUTH Suicide Hotline: 9840021600; Transcultural Psychosocial Organisation-Nepal Crisis Hotline: 1660 0102005; Mental Health Helpline Nepal: 1660 0133666.

Hagaman is a public health researcher, Rawat is a clinical supervisor at Transcultural Psychosocial Organisation Nepal and Pant holds an MD in psychiatry