Variance in Perceptions of Suicide Within and Between Gender in Nepal

Globally, suicide is the second leading cause of death, and accounts for about 800,000 deaths per year worldwide (WHO, 2013). The majority of these deaths occur in low and middle-income countries (LMIC), yet the research and documentation of suicide is heavily skewed to higher income countries where more systematic reporting of suicide occurs, along with a larger existing evidence base. Nepal is one LMIC where the speculated burden of suicide is high, with a predicted suicide rate of 7th highest in the world. Using both public-health and ethnographic approaches, the current study contributes to the discussion about suicide in Nepal. The primary goal of this research study is to understand the similarities and differences in perceived drivers for suicide for men and women in Nepal. Interviews conducted in Kathmandu and Jumla, Nepal were transcribed, and free lists which described drivers for suicide for men and women were extracted from the narratives. Thematic codes were then created to classify narrative responses into a cultural domain. The most salient codes listed by males and females for drivers for male/female suicide were analyzed and further contextualized using interview dialogue. Findings reveal social and relational drivers of suicide as the most salient for both genders, suggesting that suicide is not an individual act, but something that is caused by the broader, social environment. Additionally, perceptions of the reasons for suicide vary between gender. Perceived drivers for suicide for males are more often correlated with financial burden and the responsibilities tied to being the source of income and prosperity in a highly patriarchal society. Violence and inequality are perceived to be among the main drivers for female suicide. Findings contribute to the ethnographic research of suicide and the suicide literature in Nepal, and generate a better understanding of how reasons for suicide differ among males and females.