Gender Based Violence and Suicide in Central Asia: Research Findings and Clinical Recommendations

Background and purpose:

Suicide is a major problem facing the world. About 1.5 million people die by suicide each year. Globally, most suicides occur in Asia, yet suicides are almost exclusively studied in the west. In Central Asian countries in particular, suicides are seen in large numbers. In low and middle income countries suicide is largely correlated with gender based violence and oppression of women in general. The present study is based on a systematic review of literature on suicide in Central Asia and its relation to gender based violence. The objectives of the study are to identify 1) risk and protective factors for suicide in the Central Asian countries 2) identify the relationship between suicide and gender based violence in these countries.

Methods:

In a systematic review four electronic databases (PsycINFO, MEDLINE, CINAHL, and SocINDEX) were searched across 30 years between 1987 and 2016 to identify studies that reported quantitative or qualitative data on suicide in Central Asia. The Boolean search strategy matched the following criteria: (1) Central Asia or Kazakhstan or Kyrgyzstan or Tajikistan or Turkmenistan or Uzbekistan; (2) suicid* or self-immolation or aintihar (Arabic for suicide) or samoubiystvo (Russian for suicide); (3) published in the English or Russian languages; and (4) published as peer-reviewed.

The systematic search identified 44 eligible studies, resulting in a final inclusion of 15 articles in the systematic review according to established criteria. From the identified articles, risk and protective factors for suicide were investigated. Studies finding the risk factor of gender based violence for suicide were closely examined.

Results:

A slight majority, eight of 15 studies (53%) report on risk factors for suicide in Central Asia. A total of 31 distinct risk factors are identified. The category of Family and Community System factors and Socio-Economic factors captured gender specific data which were associated with suicidal behavior among women. The most researched risk factor identified for women suicides is marital abuse. A total of four studies (27%) report abuse by husband as a suicide risk factor and another four studies (27%) report abuse by family members as a risk factor. Abuse by mother-in-law is reported as an added risk factor for women. The other risk factors for women in this category are family conflict, forced marriage, and negative rumors with each being reported by one study (7%).

Conclusions and Implications: A series of clinical, policy and research findings and implications are presented to guide the initial step for effective intervention. 11 specific risk factors center on martial and family violence and gender based oppression. Clinical recommendations suggested the development of victim support services, including specific medical care for abused women and training for medical care personnel regarding abused women, specific prevention and treatment methods developed to target females. Education and policy recommendations centered on improving awareness and education about marital violence as a contributor to suicide across healthcare providers, justice officials, and the public.