Before It Is Too Late: Suicide Prevention Begins With Conversation

Every year, September 10 is observed as World Suicide Prevention Day. But perhaps the most important question we should ask ourselves on this day is not simply, “How many people are dying by suicide?” It is: “How many people are suffering silently before they reach that point?” The theme of World Suicide Prevention Day 2024–2026 is “Changing the Narrative on Suicide”, with the call to action in 2026 being “Start the Conversation.” The message is simple but profound: suicide is preventable, and prevention begins with openness, compassion and timely support. According to WHO, globally, more than 720,000 people die by suicide every year, according to the World Health Organization. Suicide is also the third leading cause of death among people aged 15–29 globally. But what about Pakistan?

Here, the first challenge is that we do not have sufficiently reliable national suicide data. WHO’s latest comparable estimates for 2021 indicate approximately 13,506 suicide deaths in Pakistan, with an estimated crude suicide mortality rate of 5.6 per 100,000 population. However, WHO classifies the quality of Pakistan’s suicide data as very low.This is not merely a statistical problem. It is a social problem. Stigma, shame, family honour, religious misunderstanding, fear of judgement and, historically, legal consequences surrounding attempted suicide have all contributed to concealment and under-reporting. Pakistani research has specifically identified the absence of a national suicide registry and social stigma as important reasons why the actual magnitude of the problem remains difficult to establish. Therefore, when we talk about suicide in Pakistan, we must remember that the numbers we see may not represent the entire reality.

Suicide is rarely about one problem. One of the biggest mistakes we make is trying to explain suicide through a single event. Someone loses a job or fails an examination. Someone experiences marital conflict , losses relationship or faces rejection.
Someone suffers financial difficulties. Someone might experiences domestic violence or bullied.
We often say, “This happened, and that is why the person took such a step.”But human psychology is rarely that simple. Suicidal behaviour is multifactorial. WHO describes suicide as being influenced by psychological, social, cultural, biological and environmental factors across the life course.

Another imortant factor to consider is underlying mental-health condition such as depression, severe anxiety, trauma-related difficulties or another psychological disorder that reduces a person’s ability to cope with overwhelming circumstances. But there may also be something else: A society that keeps increasing the burden on an already exhausted mind. And this is where we need to have an honest conversation about the invisible pressure of society in Pakistan.

Everyone else’s life appears perfect while our own life feels broken. Behind the photographs, achievements, weddings, holidays, careers and apparently perfect families may be enormous psychological struggles. We have created a culture where people are often expected to look strong rather than be supported. We ask, “What happened?” But we do not always ask: “How are you coping with what happened?” That difference can save lives.Mental illness can significantly affect judgement, emotional regulation, hopelessness and a person’s ability to see alternatives during a crisis. But psychological distress can also emerge from circumstances that overwhelm a person’s coping capacity.

Therefore, prevention requires us to look at both sides of the equation. We need better mental-health services but we also need healthier families. We need psychologists and psychiatrists but we also need parents and partners who listen. We need crisis intervention but we also need schools where children can speak without fear. We need awareness campaigns. but we also need workplaces where employees are not psychologically crushed by humiliation, harassment or unrealistic expectations. Treatment is the later step, we need prevention first and prevention begins much earlier than the moment of crisis.

This is perhaps the most important message I want to give to every reader: You do not have to wait until you are suicidal to ask for psychological help.  You do not need to prove that your problem is “serious enough” to seek help or consult and professional. If you start feeling alone, unsafe, persistantly sad or emotionally exhausted, its enough to convience your self to priortize your mental wellbeing and saying “I am not OK”.

Help can begin with a trusted friend, a family member, teacher, colleague or mentor. But when distress becomes persistent, overwhelming or begins affecting daily functioning, professional support from a psychologist, psychiatrist or qualified mental-health professional should be considered. Seeking help is not weakness. Seeking help is an act of self-preservation.

Families have perhaps the most important role in suicide prevention. We need to stop immediately responding to emotional distress with lectures, criticism and comparisons.

Instead of:“You have everything. What are you worried about?” try: “I can see that you are struggling. Tell me what is happening.”

Instead of:“Be strong.”          say: “You don’t have to handle everything alone.”

Instead of: “People have bigger problems than you.”           say:“Your pain matters to me.”

And if someone tells you that they are thinking about death or suicide, take it seriously.

Do not leave them alone if you believe there is immediate danger. Sometimes listening for ten minutes is more valuable than giving ten pieces of advice. Sometimes it is a conversation, a phone call. A mother noticing that her child has stopped talking. A husband asking his wife, “Are you really okay?”. A sibling saying, “You seem overwhelmed. Do you want to talk?” when you find something serious help them connect with appropriate professional and emergency support.

We also need responsible media. Pakistan’s media has an important role to play. Research examining Pakistani newspaper reporting found serious gaps in responsible suicide reporting. In one study of 2,295 reported suicides over two years, the method was mentioned in 95.6% of reports, while none of the reports provided educational information or resources for people seeking help.  This is an opportunity for our media to change the narrative. We should not sensationalize, romanticize or publish unnecessary details about methods. We should not reduce a person’s death to a single dramatic reason. Instead, reporting should emphasize prevention, warning signs, mental-health support, hope and available resources.

If you are struggling today, remember your problem may feel permanent today but feelings can change, circumstances can change, treatment can help and a life that feels impossible today may look completely different tomorrow. Do not suffer silently. Do not be ashamed to ask for help just start the conversation. Because sometimes, one conversation can become the beginning of a life saved.

For someone in immediate danger in Pakistan, WHO’s Pakistan mental-health support page lists Rescue 1122/112 for emergency ambulance services, Police 15, and Umang Pakistan at 0311-7786264 among available contacts.