Sunday, February 15, 2009

Increasing suicide rates in Egypt

From the blog of Mostafa Hussein: (

Mental health policies and practice are full of problems. An old law, incomplete and disconnected services, insufficient practitioners, lack of awareness, poor training, distortion by religious ideologies and lack of research and statistics.

Discussing all this is difficult because of the amount of it. The new mental health law is a hot topic now with stomach-turning discussions on how some people think that humans living in this country deserve fewer rights.

Suicide is one aspect of mental health policy that is looked upon with a very strange perspective. Because of the religious prohibition on killing oneself, it became a given that all Islamic nations report an unrealistically low rate of suicide. Claims that Islam protects from suicide prompts silent laughs from anyone who can think.

I am not saying that Islam (or religiosity) doesn't protect from mental illness. This is not the issue here. The problem is that the source of this is interpretations of the holy text. Not any scientific method.

These claims feed the vicious stigmatizing circle of mental illness being a result of lack of faith. With people associating mental illness with an unavoidable internal guilt that they can't deal with.

Arabic media propagates the same myth. For more than a year now, I read everything on Google news written in Arabic and mentions the word Psychiatry. A disturbing number of articles written on how the mentally ill should resolve to faith to convalesce. Or the criminal statement that mental disorders are caused by lack of faith. These statements are from psychiatrists. To be fair, most of these statements are from Saudi and Jordanian press.

Religion aside, It seems that suicide rates are looked upon as failure rates. You can blame anything you don't like for increasing the number of suicide.

Per Bjorklund linked to and translated an article in El-Badeel linking Suicide with unemployment.

El Badeel reports: According to a report presented to the people's assembly by independent MP Gamal Zahraan, 12.000 young men in Egypt committed suicide in the last 4 years. The main cause, according to Zahraan, is high levels of unemployment. Zahraan also accuse the government of denying the true extent of the unemployment problem. While the government talk about unemployment levels of 9 percent, the IMF and the World Bank put the numbers at 18 and 22 percent.

And the numbers of suicide look like that:

  • 2005: 1,100 person commited suicide
  • 2006: 2,300 (more than doubled)
  • 2007: 3,700 (again doubled)
  • 2008: It doesn't say a figure but says it doubled again and the totall for the four years reached 12,000. Lets say 7,400 (even though if we deduct the numbers above from the totall of 12,000 we should have 4,900 only)

Anyone can use suicide rates to blame anything. This MP is using suicide rates to blame the government for economic mismanagement and poor outcome. The following is the comment I left on Per's blog:

This is a mental health problem not primarily an economic one.

Blaming unemployment for suicide without a credible causal link is complete non-sense. A statistically significant positive correlation might exist between unemployment and suicide but the real value or significance of this is questionable. Depression is main cause of suicide in the world.

Suicide rates in Egypt, and most Islamic countries, are never publicized. Probably the reason is because suicide is stigmatized and considered a lack of faith.

Studies were done by independent scholars in the 80s about suicide were very small and measured suicide rates in limited areas. They came up with a very small figure of 0.1 in 100,000. Suicide rate in Sweden is around 13 in 100,000.

Those figures in the El-Badeel if credible might be realistic. The 2007 number cited equals a rate of 5.3 in 100,000. While the 2008 figure is around 10.6 which is almost the same suicide rate in the USA and Chile.

However, if these numbers were true, doubling in the number of suicides every year is alarming. A never heard of phenomenon, I think.


I agree with Per's response:

I agree that simplistic explanations should be avoided and that you can't simply blame unemployment for all suicides in Egypt, but I don't understand why there can't be a link between mental health and economic factors. We heard of many cases of people taking their lives after losing their savings in the financial crash, for example. Surely lacking any prospects of a meaningful occupation and living under constant economic hardships could increase the risk of becoming depressed.

But I would like to add that:

Economics control life events and depression is caused by both vulnerability (genetic or familial) and stress (life events like jobs, divorce, etc..).

Yes, there is a link between economics and health (including mental health primarily). But linking economic hardships with suicide is what I disagree about.

Here is a diagram that might explain my point of view:

This is like linking economy with coughing. Economy affects the number of people who develop TB for example. But TB is the reason people are coughing more.

Surely the economic conditions and living standards in Egypt are very difficult. There are also different reasons for suicide. In the end a man who shot himself or woman overdosing on pills probably didn't do that because of merely losing a job. They lost something more significant.

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