“Doctor, will I survive?” are words that weigh heavily on Dr Fauzia Poese, a physician at the Academic Hospital in Paramaribo in Suriname. Her vocation is to save lives, but for patients who come to the hospital after self-harming by drinking pesticide, it is often too late. The tragedy, she explained, is that many of her patients act “in an acute moment of distress”. Sadly, when they reach the emergency room, there is no way to reverse the effects of the poison. In Suriname, as in many low and middle income countries, particularly in rural areas, highly toxic pesticides are easy to find and lethal if consumed.
Suicide Rates in the Americas
Like elsewhere in the America’s (including the US) Suriname’s suicide rates have been rising. Suicide remains one of the leading causes of death among young people worldwide and, according to the World Health Organization (WHO), more than 7 out of 10 suicides occur in low-income and middle-income countries.
WHO recognizes that many factors can contribute to a mental health crisis, including depression and alcohol use disorders as well as problems in relationships, economic and social circumstances. As a result, prevention measures need to be coordinated across a range of sectors, from health services to education and media, as well as supportive laws and policy frameworks.
Training in mental healthcare for health workers as part of a broader program of action is also crucial. WHO reports that despite 1 in 8 people in the world experiencing a mental health disorder, only 1 percent of the world’s health workers provide mental healthcare.
WHO launched its LIVELIFE initiative in 2021. The program approaches suicide prevention in a number of ways. This includes limiting access to the means of suicide, interacting with media for responsible reporting of suicide, fostering life-skills among young people, and early identification and follow-up for people affected by suicide.
Dr Rakesh Gajadhar Sukul, Director of Public Health in Suriname, says his country has no time to lose.
“We need to strengthen suicide prevention now, because no one deserves to feel abandoned and without hope. All people should get the chance to feel inspired to stay alive,” he said.
Suriname’s Ministry of Health is harnessing the expertise of the Pan American Health Organization/World Health Organization (PAHO/WHO) to help it reduce suicide attempts and save lives. The country has established psychosocial support services for young people and it will re-establish a national suicide prevention line. A multi-sectoral suicide prevention taskforce for implementation and surveillance of suicide and self-harm is also being established. Measures to limit access to lethal pesticides are also underway.
Success in Japan and Thailand
Identifying suicide prevention as a public health priority backed up by action and, where necessary, legislation, can lead to significant results. In Japan, where the WHO collaborating center Japan Suicide Countermeasures Promotion Center (JSCP) , leads a comprehensive prevention program, suicide rates have fallen by a more than an third ( 35% between 2006 and 2022). Key to the success was changing the perception of suicide from an individual crisis to a public health and social concern.
In Thailand rising rates of suicide, particularly among those aged over 55, prompted the government to form a multi-stakeholder prevention network. Aiming to understand the common reasons for suicide, they identified relationship and family problems as well as economic difficulties as leading causes. The Hope Taskforce uses social media influencers to detect people at risk, who are referred to telephone counseling services, and, if necessary to police services to help lead rescue efforts. In May 2025 the country launched a digital mental platform based on WHO’s Step by Step program to help people improve their emotional well-being.
These stories were originally published by WHO in September 2024.
WHO’s Special Initiative for Mental Health
WHO’s special initiative for mental health will introduce new mental health services, often in districts with little or no mental health service capacity, at an estimated cost of less than US$ 0.50 per person. In the region of the Americas, WHO/PAHO’s regional suicide prevention initiative aims to:
- Introduce or update action plans to prevent suicides
- Better identify people at risk of suicide
- Train healthcare workers using the WHO/Mental Health Gap Intervention Guide (mhGAP-IG) for mental, neurological and substance use (MNS) disorders
- Improve support for families affected by suicide
WHO Foundation