Risk factors for suicide in Karachi, Pakistan
This study sets out to better understand why people living in Karachi commit suicide and what role mental illness has to play. The research will allow an estimate to be made of the incidence rate of suicide in Pakistan’s largest city.
The World Health Organisation proposes that most cases of suicide are preventable and suggests comprehensive national strategies for prevention.
The issue of suicide however, remains largely neglected in developing countries. In Pakistan, an Islamic country, suicide is understudied and under-researched: not even basic epidemiological data on national rates is available. A variety of legal, social and religious reasons make data collection and reporting difficult. The law in Pakistan consider suicide and attempted suicide to be criminal acts, punishable with a prison sentence and financial penalty. Islam condemns suicide as an unforgivable sin, with those who take their own lives denied entry to heaven. The social consequences are enormous with families often stigmatised and ostracised.
To date there have been only a handful of reports about the incidence of suicide: mostly autopsy and newspaper reports. But over the last few years, there is suggestive evidence from various agencies and organisations of an increase of suicide rates in Pakistan: a report by the Human Rights Commission of Pakistan, for example, showed 2000 suicides nationally between January and August 2000.
The absence of reliable data precludes any firm conclusions on the extent of the problem. Preventative measures can only be put in place when the risk factors are known. The few reports that have been made have not explored the role of mental illness in suicide: instead, they have focused on social and situational problems like employment or marital issues.
The findings of this project will help policy-makers better understand a complex problem and can be used to raise public awareness and develop prevention programmes.
The researchers liaised with the Karachi police to access records and address of 100 people aged over 14 who had committed suicide. They then made contact with their families, and identified 100 people of a similar age living in the same neighbourhood as a comparison group in this matched pair case control study.
The project uses the psychological autopsy method, a series of interviews designed to reconstruct the social and psychological features and circumstances around the death of an individual. The researchers used a variety of sources – evidence given at inquests, medical records, information from doctors and interviews with relatives and friends – to clarify the psychological profile of suicide victims and controls.
Karachi has an estimated population of 12.5 million and is the country’s main business and commercial centre.
Professor Murad Khan is a psychiatrist who works in the Department of Psychiatry at the Aga Khan University in Karachi. He is undertaking this research as a PhD, supervised by Professor Martin Prince in the Section of Epidemiology and by Dr Mehtab Karim at Aga Khan University. The research is funded by a research project grant from the University Research Council of the Aga Khan University.
The results of the study are concluded and the report on the findings is entitled, Epidemiology of Suicide in Pakistan: Determining Rates in Six Cities.