World Suicide Prevention Day 2013
“Stigma: A Major Barrier for Suicide Prevention”.
The International Association for Suicide Prevention (IASP) and the World Health Organization areco‐sponsoring World Suicide Prevention Day on September 10th. The theme of this 11th anniversary
event is “Stigma: A Major Barrier for Suicide Prevention”.
According to the WHO and the latest Burden of Disease Estimation, suicide is a major public healthproblem in high‐income countries and is an emerging problem in low‐ and middle‐income countries.
Suicide is one of the leading causes of death in the world, especially among young people. Nearly
one million people worldwide die by suicide each year. This corresponds to one death by suicide
every 40 seconds. The number of lives lost each year through suicide exceeds the number of deaths
due to homicide and war combined. These staggering figures do not include nonfatal suicide
attempts which occur much more frequently than deaths by suicide.
A large proportion of people who die by suicide suffer from mental illness. Recent estimatessuggest that the disease burden caused by mental illnesses will account for 25% of the total disease
burden in the world in the next two decades, making it the most important category of ill‐health(more important than cancer or heart diseases). Yet a significant number of those with mental
illnesses who die by suicide do not contact health or social services near the time of their death. In
many instances there are insufficient services available to assist those in need at times of crisis.
This lack of access to appropriate care is one of the many factors that magnify the stigma
associated with mental illness and with suicidal ideation and behaviour. This type of stigma, which
is deeply rooted in most societies, can arise for different reasons. One of the causes of stigma is asimple lack of knowledge – that is, ignorance. This type of stigma can be directly addressed byproviding a range of community‐based educational programs that are targeted to specificsubgroups within the society (that is, by age, educational level, religious affiliation, and so forth).
The goal of such programs is to increase public awareness of the characteristics and treatment ofpeople with mental illnesses and/or suicidal behaviour, and of the available treatment resources tohelp individuals with these problems.
But knowledge is not enough to combat stigma. Negative attitudes about individuals with mental
illnesses and/or suicidal ideation or impulses – prejudice – is common in many communities. These
negative attitudes often do not change with education about mental illnesses and suicidal
behaviour. Indeed, many health professionals who feel uncomfortable dealing with persons
struggling with mental illnesses or suicidal ideation often hold negative, prejudicial attitudes aboutsuch patients. This can result in a failure to provide optimal care and support for persons in crisis.
Changing such prejudicial attitudes requires a long‐term effort to change the underlying culturalvalues of the community and a parallel effort to alter the treatment norms of health care
professionals.

World Suicide Prevention Day – www.iasp.info/wspd

Stigma is also the underlying motive for discrimination – inappropriate or unlawful restrictions on
the freedoms of individuals with mental illnesses or suicidal behaviour. Such restrictions can occur
at a personal, community or institutional level. One extreme example is the criminalization ofsuicidal behaviour, which still occurs in many countries. Discrimination can prevent or discourage
people affected by mental illnesses and/or suicidal ideation or behaviour from seeking professional
help or from returning to their normal social roles after receiving treatment for an episode of illness
or crisis. Clearly, criminalization of suicidal behaviour can be a powerful deterrent on the care‐seeking of individuals in crisis who desperately need to be able to access care and support, without
being judged or penalized.
At a government or administrative level, stigma can have an impact on resource allocation. In bothhigh‐income and low‐ and middle‐income countries stigmatized conditions such as mental illnesses
and suicidal behaviour receive a much smaller proportion of health and welfare budgets than isappropriate, given their huge impact on the overall health of the community. Furthermore, fund‐raising efforts to support public health initiatives in this area often fall flat because of lack ofinterest among communities, governments, and international funding agencies; that is, because ofstigma.
Attempts to fight stigma, by undertaking massive public education programs, have been of limited
effectiveness in reducing the stigma associated with mental illness and suicide. New, innovative
methods that are more target‐group specific or that creatively use the emerging social media need
to be developed and tested. Despite the difficulty and complexity of fighting stigma, persons,organizations and governments committed to the dual goals of improving the quality of life ofindividuals suffering from mental illnesses and suicidal ideation and of reducing the huge burden of
suicide on families and communities don’t have an option. Unless stigma is confronted andchallenged, it will continue to be a major barrier to the treatment of mental illnesses and to theprevention of suicide.
World Suicide Prevention Day provides a special opportunity to refocus our collective energies on
addressing this fundamental problem. Changing cultural attitudes about mental illness and suicidal
behaviour requires a scientific awareness of the many forces that influence community norms andthe concerted effort of a wide range of community stakeholders over a prolonged period of time.
World Suicide Prevention Day is an ideal time to inspire people to work towards the goal ofdeveloping creative new methods for eradicating stigma. Comprehensive local or national plans forthe prevention of suicide will not reach their full potential until the problem of stigma is effectivelyaddressed.
On this year’s World Suicide Prevention Day, IASP is hosting its first core activity, which will be toundertake a collective Cycle Around the World, with the aim to globally raise awareness of suicide
and its prevention, and to reduce the stigma associated with it. Further details of this activity will
be published on the IASP website on a regular basis over the coming months.