Despite decades of scientific progress and increasing resource allocation, suicide remains an obstinate global health crisis that challenges conventional prevention paradigms. Current suicide prevention strategies have predominantly been developed and validated in high-income countries, informed by individual-centered clinical models and risk factor analyses that often overlook broader sociocultural and economic contexts. This narrow framing poses critical limitations, as these conventional models frequently fail to resonate with or adequately address the complex realities shaping mental health outcomes across the world’s vast and diverse populations, particularly in the global south. Emerging discourse now urges a fundamental re-examination of suicide prevention frameworks, emphasizing the indispensable role of structural determinants, cultural practices, and community resilience in understanding and mitigating suicide risk in these overlooked regions.
The persistent global disparity in suicide prevention research and intervention underscores a foundational issue: much of the existing evidence base is geographically and culturally constrained. High-income nations have historically monopolized the generation of suicide-related data, resulting in prevention models finely attuned to clinical symptomatology, individual psychopathology, and biomedical treatment modalities. However, these models often inadequately grasp the pervasive socioeconomic inequalities, entrenched cultural norms, and varying conceptualizations of mental health that critically shape suicidality outside these contexts. The global south, encompassing many low- and middle-income countries, offers invaluable insights that disrupt and enrich the prevailing paradigms, demanding a broader and more contextually responsive approach.
Socioeconomic conditions uniquely influence mental health trajectories and suicide risk in the global south. Persistent poverty, social marginalization, unemployment, and systemic inequities forge an environment where despair and hopelessness may be deeply embedded in everyday lived experiences. Unlike the individual pathology frameworks dominant in high-income settings, here, structural violence and deprivation exert pervasive effects, often rendering traditional clinical interventions insufficient. Recognizing poverty and inequality as core drivers of suicidality calls for prevention strategies that extend beyond symptom management to tackling fundamental social determinants—poverty alleviation, economic justice, and policy reform become crucial components of comprehensive suicide prevention.
Cultural dimensions also profoundly shape how mental illness and suicide are understood and addressed. Conceptual frameworks prevalent in the global south frequently integrate spiritual beliefs, collective identity, and community interconnectedness, contrasting sharply with Western models emphasizing individualism and clinical diagnosis. In many cultures, mental distress may be expressed through somatic symptoms or through metaphors deeply rooted in local worldviews. Suicide itself may carry varied meanings—sometimes seen as a response to social dishonor, spiritual imbalance, or relational rupture rather than solely a consequence of psychiatric disease. Prevention efforts that fail to engage with these cultural realities risk alienating those most in need of support and missing crucial avenues for intervention.
Further complicating the picture is the role of community connection and resilience. In numerous global south settings, social networks and communal relationships offer vital protective factors against suicide. These social structures, often underpinned by shared cultural practices and mutual aid systems, buffer individuals from isolation and despair. Importantly, this community resilience operates in forms often overlooked by mainstream prevention models, which tend toward clinical isolation and individual treatment. Highlighting the strength and potential of collective action, community participation, and culturally embedded social support challenges the dominant narratives focused narrowly on diagnosis and pharmacological intervention.
To move beyond these established yet insufficient models, suicide prevention must embrace epistemological diversity—that is, valuing and integrating multiple ways of knowing, including indigenous knowledge systems and non-Western frameworks of mental well-being. The global south exemplifies a living repository of alternative paradigms that emphasize holistic well-being, social equity, and relational harmony. By incorporating these perspectives, suicide prevention can transcend reductionist views and cultivate strategies that resonate authentically within diverse cultural contexts, enhancing effectiveness and sustainability.
A critical aspect of this transformation involves re-centering prevention efforts on structural determinants and social justice. The mental health field must acknowledge how political economy, historical injustices, and systemic discrimination contribute fundamentally to suicide risk. Preventative interventions that disregard these dimensions risk pathologizing individuals without addressing the root causes, effectively perpetuating cycles of harm. Advocating for policies that promote equitable resource distribution, legal protections, and social inclusion is therefore an ethical imperative intertwined with effective suicide prevention.
Epidemiological analyses increasingly reveal that suicide patterns in the global south deviate markedly from those in the global north, underscoring the inadequacy of universalized models. Variations exist not only in suicide rates but also in age, gender distributions, methods of suicide, and psychosocial correlates. This heterogeneity challenges one-size-fits-all strategies and mandates localized data collection and analysis to inform culturally and contextually appropriate interventions. Building research capacity in these regions and fostering international collaboration aligned with principles of equity is essential to this endeavor.
Theoretical frameworks underpinning suicide prevention require revision to incorporate these complexities. Instead of privileging individual-level psychopathology, new models must systematically incorporate macro-level factors, such as socioeconomic status, cultural norms, and community dynamics, interacting dynamically with individual vulnerabilities. Such multilevel, interdisciplinary frameworks facilitate a more nuanced understanding of suicide risk and illuminate a wider array of intervention points, from policy reforms to community empowerment to clinical care.
Public policy interventions also need reimagining. Mental health frameworks that reduce suicide prevention to healthcare delivery within clinical settings overlook the broader ecosystems influencing risk and resilience. Policies prioritizing social protection programs, education access, anti-discrimination laws, and cultural preservation can indirectly but powerfully mitigate suicide risk. Integrative approaches bridging health, social welfare, education, and justice sectors exemplify the structural, multi-pronged prevention envisioned.
Importantly, suicide prevention grounded in the realities of the global south is not solely relevant for those regions. Insights derived can catalyze a global paradigm shift, informing more equitable and effective approaches worldwide. A global suicide prevention agenda attentive to sociocultural diversity, structural injustices, and multiple epistemologies enriches the collective capacity to address this complex phenomenon across income levels and geographies, fostering solidarity and knowledge exchange.
Achieving this vision requires concerted efforts to decolonize mental health knowledge production and dissemination. Elevating voices from the global south in research design, policy development, and program implementation ensures authenticity, relevance, and respect for indigenous epistemologies. Equitable partnerships replacing extractive research models are foundational to producing transformative knowledge and practice.
Technological innovations, too, have a role in enabling broader access and culturally sensitive interventions. Digital mental health tools can facilitate community-driven support networks and culturally adapted intervention delivery, provided they are developed with local stakeholder engagement and contextual understanding. Bridging modern technology with traditional knowledge systems offers promising avenues to transcend barriers of geographical isolation and stigma.
In sum, recasting suicide prevention through insights from the global south entails embracing complexity, diversity, and structural accountability. This paradigm shift moves prevention beyond symptom-focused clinical care to a comprehensive framework that places social justice, cultural resonance, and community empowerment at its core. The future of global suicide prevention depends on integrating these perspectives, learned from the lived experiences and rich traditions of the global south, to forge more inclusive, effective, and sustainable approaches worldwide.
Subject of Research: Suicide prevention strategies and mental health outcomes with emphasis on sociocultural and structural determinants in the global south.
Article Title: Rethinking suicide prevention: insights from the global south for a new global agenda.
Article References:
Machado, D.B. Rethinking suicide prevention: insights from the global south for a new global agenda. Nat. Mental Health (2025). https://doi.org/10.1038/s44220-025-00491-7
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