Current wave of suicide in Uganda: A national call to action

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OPINION

By Prof. Kennedy Amone-P’Olak

Suicide is one of the leading causes of death worldwide. Over 700,000 people die due to suicide annually, with low- and middle-income countries accounting for 77% of all suicide mortality globally. Africa has one of the highest rates of suicide at 11.5 per 100 000 compared to 8.9 per 100,000 people globally. Moreover, more people die due to suicide than malaria globally. 

According to a WHO report (2025), 2524 people, 1999 of them men, died by suicide in Uganda in 2021. The prevalence rate of suicide in Uganda in 2021 was 11.6 per 100,000 people, higher than the global average of 8.9 per 100,000 people. In Uganda, like in other African countries, there is no national suicide database. However, suicide incidents are reported in the media every week, covering the breadth of the country, with considerable gender disparities and a prevalence of 4.3 per 100,000 in females and 20.9 per 100,000 in males. Furthermore, men use more lethal means of suicide than women.

In this article, I will describe suicidal behaviours, list mental health and social risk factors for suicide, and discuss both individual and public health strategies for preventing suicide.

Suicide and suicidal behaviours

Suicide is a continuum that starts with ideation (thoughts and ideas about suicide), planning (how to carry out the ideas one has about suicide), attempts (trying to end one's life), and suicide (death by suicide). Although more men than women die by suicide, women are more likely than men to have suicidal thoughts and attempts.

Risk factors of suicide

Both mental illness and social factors contribute to suicidal behaviours at an individual and societal level. For example, mental illness is a well-established link between mental illness (e.g., depression, alcohol use disorders, and a history of suicide attempts) and suicide. Nevertheless, numerous instances of suicide happen impulsively during times of crisis when a person's capacity to cope with life's stressors (e.g., financial stress, marital disputes, rejection, chronic pain, and terminal illnesses) is severely compromised.

Nonetheless, several contextual factors, including how society is structured and managed, contribute to suicidal behaviours. These societal factors are collectively referred to as "social determinants" of health and well-being. Social determinants of health are the "circumstances in which people grow, live, work, age, and the systems put in place for the health and well-being of the people”. Political, social and economic factors often drive social determinants of health.

At an individual level, the story behind and the pathway to each suicide are unique. Nonetheless, nearly every suicide story is characterised by the sense of being trapped by excruciating mental pain, guilt, the belief that suicide is the only way to escape feelings of defeat, humiliation, shame, rejection, loss, social isolation, and most importantly, desperation. For instance, in many schools in Uganda, students are under immense pressure from the school administration, parents, and society at large to perform well. Those who perform poorly are left feeling nervous, dejected, and worthless, all risk factors for suicidal behaviours.

Signs of suicide

Warning signs of suicidal behaviours include talking about suicide or death, giving away possessions, expressing feelings of helplessness, hopelessness and being trapped, and withdrawing from loved ones. Increased mood swings, hostility, severe anger, or irritability, along with increased substance use or abuse, are additional warning signs that something is wrong.

Such a person should be closely monitored, counselled and supported. Other risk factors include access to the means of suicide (such as buying drugs, access to pesticides, ropes, or firearms). Acting as though saying goodbye to people and displaying signs of anxiety are additional signs that someone may be thinking about taking their own life.

Prevention at societal levels by targeting the social determinants of suicide

Suicide is a preventable cause of death. Prevention should focus on both social factors and mental ill-health as determinants of suicidal behaviours. To prevent suicide, interventions can be implemented at the individual, sub-population and population levels. These interventions may include:

• Build an effective suicide care and treatment while restricting access to means of suicide, such as pesticides, firearms, barricades in high-rise buildings, and specific medications.
• Media coverage of suicide should be done responsibly to reduce the risk of transmissibility (exposure to suicide death or suicide-related information that could increase the possibility of engaging in suicidal behaviour) and to reduce the negative consequences of suicidal behaviour. Rather, encouraging news reports that feature stories about coping, hope, getting treatment, and recovery after a suicide crisis.
• Build life skills, such as critical thinking, stress management, and coping, to prepare people to safely address challenges such as economic stress, divorce, physical illness, negative life events, among others, and instead seek help. Additionally, establish telephone helplines to provide listening and support services for individuals in crisis.
• Train paraprofessionals (e.g., Village Health Teams (VHTs), community leaders) on signs of suicidal behaviours. Paraprofessionals can recognise and identify community members in distress, offer supportive conversation, and act as a referral pathway to specialised or professional treatment.
• Decriminalise acts of suicide. Under Section 210 of the Penal Code, suicide is a misdemeanour punishable by up to two years in jail. This makes it more difficult to identify and support survivors, further traumatising affected persons, families, and communities, and driving suicidal behaviours underground.
• Develop the capacity for trauma therapy, Psychological First Aid, and Critical Incident Stress Debriefing (CISD). For example, CISD is vital in the event of death by suicide or suicidal attempt, particularly in schools, families, and communities. CISD helps to mitigate the adverse consequences of stress and helps to alleviate the adverse effects and remission of trauma exposure.
• Raising awareness—particularly among religious, social, and cultural leaders—that treating suicide and suicidal behaviours with contempt only serves to stigmatise further, traumatise, and worsen mental health problems and bereavement among survivors and those affected by suicide. Implement strategies that reduce isolation, stigma, shame, discrimination, marginalisation, violence, self-blame and anger while promoting a sense of belonging and fostering emotionally supportive relationships and networks.
• Address socioeconomic determinants of health issues like unemployment, poverty, inadequate health literacy, and substandard housing, among others, by implementing a comprehensive government and society strategy. For instance, the Social Assistance Grant for Empowerment (SAGE) cash transfer program has assisted many elderly people in need, restored their hope, and likely reduced several health risks. A paid internship program for young people who have completed tertiary education is another initiative that merits attention. For a year or more, the young people may be employed as interns in various governmental and non-governmental organisations to get the requisite experience and skills. This may reduce the health risks associated with poverty and desperation.
• There is an urgent need for a deliberate investment in human resources and research (epidemiological surveys, intervention studies, etc.) that provides the foundational pillar for situation analysis, multisectoral collaboration, raising awareness, and building capacity to understand the mental health and social determinants of suicidal behaviours.

In conclusion, suicide prevention is a public health priority. Uganda does not have a standalone national suicide prevention program in place. Yet, suicide adversely impacts and devastates individuals, families and communities with long-term adverse transgenerational consequences. Interventions require a holistic, multisectoral, and public health approach that should go beyond mental health to cover upstream social determinants of health. Given the current incidents and rate of suicide behaviours, it would be "wilful negligence" for the country to do nothing. 

Prof Kennedy Amone-P’Olak, PhD, Professor of Psychotraumatology

kpamone@gmail.com