Suicidal Behavior in Malaysia

Malaysia is a multi-ethnic and multi-religious country, with about 63.5% of the population professing adherence to Islam. According to the World Health Organization, the age-standardized suicide rate in Malaysia for both sexes ranged between 4.9 and 6.1 per 100,000 population from 2000 to 2019. The three-year average from 2017 to 2019 was 5.6 for both sexes, 8.8 for males, and 2.4 for females. A nationally representative survey of 19,309 participants in 2013 showed that lifetime suicidal ideation, plans, and attempts were at 1.7%, 0.9%, and 0.5% respectively, and past-12-month suicidal ideation was between 6 and 8%. A risk factor for suicide was ethnicity; Indians had the highest suicide rate in Malaysia and were over-represented in hospital admissions due to a suicide attempt. However, Islam has been shown to be protective of suicidal ideation and attempt, and suicide rates among Muslims are the lowest. Another risk factor was gender. Trend analysis indicates that suicide has increased for Malaysian males from 2014 to 2019; however, more females were admitted into the hospital for a suicide attempt. Other psychosocial factors associated with suicidal ideation and attempt were interpersonal relationships, income, marital status, reporting depression symptoms, and negative coping strategies. Suicide attempt is currently criminalized in Malaysia, even though efforts to decriminalize suicide are ongoing. There is a need to strengthen national reporting mechanisms on suicide and related behaviors, address stigma against suicidal individuals, the safe reporting of suicide in the media, public health suicide prevention methods such as means restriction and gatekeeper training, and postvention services. Culturally tailored strategies to prevent suicide which are sensitive to social, economic, and religious beliefs should be taken into consideration when developing and implementing targeted suicide prevention programs for high-risk groups.