Reviewing global suicide rates via X, Y, and Z perspectives

Fundamental concepts and statistics

Suicide as a public health crisis may occur anywhere, regardless of national boundaries. Suicide (in the form of drinking chemicals, hanging, firearms, burning charcoals, jumping from rooftops, etc.) is defined as an act of intentionally or voluntarily taking one’s own life. The suicide rate worldwide in 2019 was 9.2 (WHO, 2022: 34-35). The suicide rate, also known as the suicide mortality rate, is the number of people who die by suicide per 100,000 individuals annually. Suicide rates were computed by dividing the annual number of suicide deaths in a country by the entire population, and then multiplying the result by 100,000. Contrary to popular belief, suicide rates are not expressed as percentages but as numbers.

In the 21st century, certain countries and regions have shown much higher rates than others. Lesotho (72.4), Guyana (40.3), Eswatini (29.4), South Korea (28.6), Kiribati (28.3), Micronesia (28.2), Lithuania (26.1), Suriname (25.4), Russia (25.1), South Africa (23.5), and other nations had the highest suicide rates. The regions with the highest suicide rates are Europe (12.8), South-East Asia (10.1), the Americas (9.6), the Western Pacific (8.7), Africa (6.9), and the East Mediterranean (5.9) (WHO, 2024). The number of people who considered suicide was far higher than the actual number of suicidal deaths.

All disasters—natural and man-made—involve human casualties, monetary losses, and psychological distress. In addition, since suicide is a tragic act that has horrible repercussions for victims, all suicides may be classified as man-made emergencies (or general disasters) for the purposes of this study. In other words, disasters (including natural hazards and manmade emergencies) lead to both physical (e.g., human loss and economic damage) and social impacts (e.g., mental disorders, injustice, etc.). Considering the above facts, the likelihood of suicide has increased by more than 20 times for those with depression than for those without symptoms (IASP, 2024).

Previous research

Research on suicide or its rate has been robust, considering how many researchers across multiple disciplines have recently studied the subject in relation to the occurrence of various disasters (e.g., coronavirus infection, war, tsunamis, and trauma) (Safarpour et al., 2022: 14-18; Reifels et al., 2024: 1-10). These disciplines included emergency management, criminology, medical science, psychology, psychiatry, demography, and sociology. However, there have been several variations in the precise suicide rates found in different studies or cases. Therefore, this study merits further investigation into global suicide rate trends.

While researching the issue of motivation, McGregor (1960) published his book “The Human Side of Enterprise,” in which he proposed theories X and Y (McGregor, 1960). The psychologist claimed that Theory X presupposed that humans would need a certain degree of control and compulsion in the workplace because they inherently detested work and attempted to avoid it. However, Theory Y indicates that individuals do not require extra supervision to execute their jobs because they are willing (or naturally willing) to work for their employers. In summary, Theory X assumes that human nature is good (or positive), whereas Theory Y holds that human nature is bad (or negative).

Ouchi (1981) presented Theory Y for its American counterparts after studying Japanese corporate management techniques and associated cultures in the 1970s and the 1980s (Ouchi, 1981). At that time, Japanese employers offered their employees lifetime employment in private settings. Employees would prefer to remain devoted to their bosses in exchange for loyalty. Thereby, Ouchi did not dictate that human instincts are inherently good or bad. He believed that human instincts are neutral or void. Regarding the token, the researcher stressed that people’s workplace behavior, either positive or negative, is determined by their educational background. Specifically, he upholds the value of education for individuals in an ever-changing environment.

By observing suicide rates globally because of the coronavirus (COVID-19) pandemic in 2019, Martinez-Ales et al. (2023) maintained that tracking suicide patterns would be critical to prevent potential suicides (Martinez-Ales et al., 2023: 283-300). Researchers have cited variations in location, time, and socio-demography to concentrate on shifts in suicide patterns. After the pandemic, suicide rates often declined or remained unchanged, but later rose in several countries. The researchers concluded that variations in socioeconomic vulnerability and coronavirus transmission were the reasons for the ongoing change in suicide rates.

Onie et al. (2024) investigated the challenges associated with obtaining relevant suicide data in Indonesia (Onie et al., 2024: 1-10). They concluded that there were restrictions on the nation’s capacity to access suicide statistics after examining suicide data from five main sources: the WHO, police, sample registration system, province survey, and death registry. These researchers considered the problem of underreporting suicides to be the most crucial threshold. They stated that various provinces had their own views that were culturally sensitive, which disrupted the methods used to gather suicide data.

Although suicide is a major socio-health concern globally, Diez-Gomez et al. (2024) highlighted the lack of universal strategies for school-aged children. The researchers suggested their own universal program, the PositivaMente program, as a means of preventing suicide through educational settings for students aged 14-16 years (Diez-Gomez et al., 2024: 1-19). Although it was premature to assess the program’s efficacy, the researchers insisted on applying the same elements to all students. This program covered topics such as suicide awareness, risk factors, stress management, and logical thinking that have been highlighted in relevant prior research.

Characteristics of this study

Considering that this study aims to provide a large flow (or transition) of suicide rates, the features of large-scale dynamics have been reflected in related theoretical processes. Large-scale dynamics refer to broad perspectives, trends, patterns, shifts, and movements surrounding the issue (Bures et al., 2023: 123-125). In contrast to micro-perspectives, large-scale dynamics deliver a comprehensive framework. Similarly, it offers a thorough understanding of the topic by appreciating the interactions among several variables. Specifically, large-scale dynamics forecast the evolution of suicide rates when disasters affect the public.

This study suggests three unique approaches in this field. The first two approaches are the foundation of today’s suicide rates, whereas future concerns are the focus of the third approach. Disaster exacerbation theory suggests that suicide rates typically increase when different types of disasters strike (Rodriguez-Rodriguez et al., 2023: 17-33). This perspective is reinforced by Theory X, or good human nature. According to disaster resilience perspective, suicide rates have undoubtedly declined during calamities (Han et al., 2022: 1-10). Theory Y, or bad human nature, supports this perspective. The disaster ecology perspective predicts different suicide rates based on how disasters are handled (Lester, 2021: 89-91). This concept, like the role of ecology, is embraced by Theory Z, or untainted human nature.

Systematic literature review

This study partially employed a systematic literature review (see Figure 1), with qualitative text data interpreted flexibly in the relevant subsections. There is a lack of accurate quantitative information regarding suicide rates and associated statistics worldwide. According to the WHO (2023), only 80 of its 194 member states have implemented a sufficiently comprehensive suicide registration system. A systematic literature review is useful because it allows a thorough analysis and synthesis of earlier studies on the relationship between global suicide rates and disasters. This study identified the commonalities, trends, and patterns observed in previous research.

Figure 1. Analytical frame.

If a text had a significant correlation with both suicide rates and disasters, this was the first criterion used to determine whether it should be included in this study. Several databases, including ScienceDirect, ProQuest, Google, and Sage Knowledge, have created a variety of research articles, books, government documents, websites, and other materials on the subject. The second criterion was fair distribution in terms of years, areas, and disasters. Similarly, the most recent research paper was included when many studies addressed suicide rates during the COVID-19 pandemic. As there are many studies on wealthy countries, suicide rates in underdeveloped countries have also been included. In addition, because there are few publications on the subject, older writings on suicide rates during wars have been added.

Comparative analysis

Given the two primary options (X and Y) available to address the issue of suicide rates, a thorough comparative analysis will help (to) present a distinct alternative (Z) by comparing the two (Sherif et al., 2024: 459-463). In other words, a comparative analysis proposes similarities and differences from the Z perspective after examining the similarities and differences between the X and Y perspectives. In summary, the comparative analysis revealed a similarity and three differences. Comparative analysis should be an inevitable way to realize that it is to aid this study; beginning to focus on two relevant patterns and then foster a growth (or an alternative) by upgrading strategies.

The same four comparable analytical units are used while comparing the first two patterns and then presenting a third trend. Comparable analytical units for the three intended comparable analytical categories should be the same to facilitate a systematic comparison (Manjo, 2021: 14-16). The major stakeholders on the subject were also fully included in the four units. While international leaders collaborated with active participants to organize numerous suicide prevention initiatives, government officials worked on national and local policies. Researchers have investigated the relationship between suicides and disasters in their own places and disaster victims face the reality of suicide.

Disaster exacerbation (X) perspective

International leaders

A few United Nations (UN) agencies, such as the WHO, the UN Office for Disaster Risk Reduction (UNDRR), and the UN Development Programme (UNDP), have leaned toward the possibility that suicide rates may rise during disasters, while acknowledging the difficult reality of human life as well as their own empirical data (Cuthbertson et al., 2022: 1-13). Referring firmly to the multifaceted nature of suicide, these agencies have argued that a holistic intervention approach is essential. The International Federation of Red Cross and Red Crescent Societies (IFRC) and the International Association for Suicide Prevention (IASP) are two of the numerous international nongovernmental organizations (INGOs) concerned about rising suicide rates.

Government officials

To lessen the impact of disasters, many national and local governments, including those of Canada, Norway, Finland, Cuba, Guyana, and South Korea, have accepted that suicide rates rise after various disasters. They presumed that individuals tend to commit suicide when faced with hazards such as climate change, man-made threats, and other dangers. In addition, they believe that disaster impacts have lasted far longer than anticipated by most people (Cartier, 2021). Therefore, these governments have changed related policies such as long-term mental health services, post-disaster help, disaster relief initiatives, and the equitable distribution of pre-existing aid programs.

Researchers

Depending on their research methodologies, such as quantitative analysis, systematic review, and meta-analysis, researchers have examined and validated the proportionate relationship between suicide rates and disaster impacts in several places. Many have explored the important outcomes of disasters as their theories have developed. Accordingly, Pathirathna et al. (2022) examined 33,345 suicide deaths that occurred globally owing to the COVID-19 outbreak (Pathirathna et al., 2022: 1-15). They emphasized that unanticipated human behavior changes brought on by the pandemic, including social isolation and lockdowns, were the primary causes of the rise in suicide rates.

Disaster victims

Compared with locals who have not been affected by disasters, those who have experienced the immediate aftermath of catastrophes respond more reactively to various challenges (Kim and Lee, 2023: 910-912). Numerous variables around disaster victims, including negative aspects of human nature, psychological damage and loss, and financial trouble, may contribute to explaining this phenomenon. Similar variations in suicide rates have been observed among disaster victims based on subjective risk perceptions. In conclusion, disaster victims with retroactive risk perceptions commit suicide more often than those with proactive risk perceptions.

Disaster resilience (Y) perspective

International leaders

Through the development of international community cohesion, mental health advocacy, international humanitarian relief, dialogue, and peace promotion, international leadership has decreased suicide rates. With assistance from faith-based organizations, suicide rates have significantly decreased, particularly during times of war (WHO, 2018: 1-4). For instance, while the precise suicide rate in this context has not yet been made public, the suicide rate in Ukraine (involved in the war against Russia) is believed to have declined significantly, similar to what happened during the Sri Lankan civil conflict between 1983 and 2009 (Aida, 2020: 1-20).

Government officials

Several nations have seen a decline in suicide rates because of government emergency responses and associated public policies. Recently, Australia has been severely affected by a series of cascading disasters such as fires, floods, and droughts. A few years ago, Australia had a higher suicide rate than other countries. Nonetheless, the suicide rate has declined as the drought returns over time (Edwards et al., 2024: 4-5). From 1990 to 2006, the average suicide rate in the United States was 0.56 per 100,000 individuals. However, the number of Americans who committed suicide fell by 0.11 per 100,000 individuals shortly after the 9/11 terrorist attacks in New York City (Mezuk et al., 2009: 485-484).

Researchers

The disproportionate relationship between suicide rates and disaster impacts in various locations has been frequently discussed by researchers. To evaluate suicide rates before and after (i.e., 9-15 months) the COVID-19 outbreak, the suicide rates across 33 countries were examined (Pirkis et al., 2022: 1-19). The researchers were unable to locate any evidence of rising suicide rates in most of these countries; according to scientific evidence, suicide rates have decreased during this pandemic. Suicide rates occasionally exceeded expectations, although this was not always the case in the countries that were the focus.

Disaster victims

Suicide rates have decreased among disaster victims who have taken proactive measures to manage the impacts of disasters. For instance, earthquakes have often destroyed parts of Japan, including the Great East Japan region in 2011, Hanshin-Awaji and Kobe city in 1995, and Niigata-Chuetsu in 2004 (Orui et al., 2014: 465-466). For approximately two or three years following the occurrence of earthquakes, male victims in those locations did not exhibit an increase in suicide rates; rather, suicide rates decreased. Numerous male victims relocated as they recovered from the catastrophe. Most importantly, several male victims actively engaged in community networks while building trusting relationships with others. They were also provided access to mental health services.