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Estimation of rates of suicidal behaviors (ideation, plan, and attempt) would help to understand the burden and prioritize prevention strategies. However, no attempt to assess suicidal behavior among students was identified in South-East Asia (SEA). We aimed to assess the prevalence of suicidal behavior (ideation, plan, and attempt) among students in SEA. We followed PRISMA 2020 guidelines and registered the protocol in PROSPERO (CRD42022353438). We searched in Medline, Embase, and PsycINFO and performed meta-analyses to pool the lifetime, 1-year, and point prevalence rates for suicidal ideation, plans, and attempts. We considered the duration of a month for point prevalence. The search identified 40 separate populations from which 46 were included in the analyses, as some studies included samples from multiple countries. The pooled prevalence of suicidal ideation was 17.4% (confidence interval [95% CI], 12.4%–23.9%) for lifetime, 9.33% (95% CI, 7.2%–12%) for the past year, and 4.8% (95% CI, 3.6%–6.4%) for the present time. The pooled prevalence of suicide plans was 9% (95% CI, 6.2%–12.9%) for lifetime, 7.3% (95% CI, 5.1%–10.3%) for the past year, and 2.3% (95% CI, 0.8%–6.7%) for the present time. The pooled prevalence of suicide attempts was 5.2% (95% CI, 3.5%–7.8%) for lifetime and 4.5% (95% CI, 3.4%–5.8%) for the past year. Higher rates of suicide attempts in the lifetime were noted in Nepal (10%) and Bangladesh (9%), while lower rates were reported in India (4%) and Indonesia (5%). Suicidal behaviors are a common phenomenon among students in the SEA region. These findings call for integrated, multisectoral efforts to prevent suicidal behaviors in this group. [ABSTRACT FROM AUTHOR]

Background: Suicide is a global preventable public health problem. About a quarter of all suicides in the world occur in South Asia. As means restriction is an important suicide prevention strategy, gaining knowledge of the common suicide methods and their changing trends in each country and region is crucial. Aims: We aimed to assess the suicide methods in South Asian countries over the last two decades. Methods: A search was performed in PubMed, PubMed Central, Scopus, and Google Scholar with the search terms. Original articles of quantitative studies, published in the English language, from 2001 to 2020, with full-accessible text, that rank different methods of suicide in eight South Asian countries, were included. Results: A total of 68 studies were found eligible for review. The Maximum number of studies were found from India (n = 38), followed by Bangladesh (n = 12), Pakistan (n = 9), Sri Lanka (n = 6), and Nepal (n = 3). Hanging (n = 40, 55.8%) and poisoning (n = 24, 35.3%) were the two most common suicide methods reported, in that order. Hanging followed by poisoning were the commonest suicide methods in Bangladesh, India, and Pakistan while in Sri Lanka, poisoning was the preferred method to hanging. There is a decline in suicide by poisoning and an increase in suicide by hanging in Sri Lanka, Bangladesh, and India. Although hanging is still the commonest method in Pakistan, the use of firearms is growing in recent years (2011–2020). Conclusions: There is a steady decline in the incidence of suicides by poisoning following pesticide regulations in South Asian countries. However, there is heterogeneity of study methods, probable under-reporting of suicide, and lack of robust suicide data. [ABSTRACT FROM AUTHOR]

The article discusses challenges and direction in suicide prevention in Southeast Asia as of 2021. Topics covered include the major suicide drivers of social inequities, gender disparities, financial strife and family conflicts, the countries' lack of central suicide databases, prevention plans, and policies, and their several sources of bias in media reporting. Also noted is the possible vital role that media can play in suicide prevention in this region.