Silent Cries for Help in Mideast Plagued by Female Suicide

By Micah McIntyre

People always say that numbers never lie. That’s only partially true–sometimes numbers just never tell the whole story. In the case of global suicide rates, don’t let the absence of Middle Eastern countries from the top 50 fool you—the mental health crisis among Arab adolescents and young adults is worse than ever. They are in the midst of a perfect storm of cultural oppression, chronic violence and an influx negative media with no psychological or emotional support. Desperation has seized a generation of young people. 

Yemen (8.7 suicides per 100,000) and Sudan (8.1) are the outliers in the Middle East where the regional average is considered to be low at 3.1. Those numbers are only slightly above the global average of 7.1 suicides per 100,000 people and come nowhere close to that of Lithuania (31.9) or  Russia (31.1). However, if you step back and look at the increase in suicide rates over the last 25 years, the global numbers pale in comparison.

Since 1993, the suicide rates in the Middle East have increased by 100 percent to almost 30,000 suicides annually, compared to a global increase of only 19 percent in the same amount of time (the U.S. rate has increased by 25 percent). People in Gaza have seen a 40 percent increase in suicides since last year and in 2018 Lebanon has received reports of up to one attempt every six hours. However, the most troubling numbers are from the demographics.

In Europe, men are four times as likely to commit suicide than women and in the United States, it is 3.5 times as likely. The peak age group in both regions is the 45-54 range. However, in the Mideast, the demographics are reversed. The majority of countries have at least a 2:1 ratio of female to male suicide rates. Since 2000, the peak age group for suicide among females has been 15-29, whereas the peak age for males has been 60 plus. In certain provinces in Iran, the peak age group has been 20-29 for both males and females, but the rate for females was almost double that of males (22.6 and 42.9 per 100,000).

Not only are young females taking their own lives far more often than males, their methods of suicide are more violent and deadly than those in any other part of the world. Self-immolation (intentional burning of oneself), the use of firearms and hanging are the most common methods of self-harm in the region.

A study in Egypt revealed that three percent of all burn victims had attempted suicide and 91 percent of those patients were female. In Iran, 27 percent of the suicides involved self-immolation—71 percent of those people were women with an average age of 29. In the northwestern region of the country, 99 percent of the 412 victims that were brought to the burn units were illiterate, married women who lived  in a hostile home environment. These cases are indicative of the situation that many women in the Middle East are facing today. 

How Did We Get Here?

Women do not enjoy the same social and political freedom as men in such a traditionally patriarchal society. In recent years, there have been progressive moves made towards gender equality. (Women can now drive in Saudi Arabia and domestic abuse laws are changing.) But there is still much progress to be done. Marriage and life in a masculine, oppressive society are two of the leading factors in female suicide.

In the rest of the world, married men and women are generally less likely to take their own lives than singles. However, in the Middle East marriage actually increases the likelihood of self-harm and suicide for females. Many marriages are still arranged between very young women and older men. This alone increases the possibility for domestic abuse because in any relationship where the woman is significantly younger than her husband, the power is held by the man solely because of his age and level of maturity. In Afghanistan, forced marriage was cited as the main reason for self-immolation among young women. Some 70 percent of burn victims were married and 90 percent were female, most of whom lived in impoverished or low income households and communities. Poverty and illiteracy coupled with domestic abuse and social oppression often pushes many of these young women to the edge.

Cases of self-immolation and hanging can only be labeled as suicide. Often times, people who take their lives in such violent and conspicuous methods are crying out for help. But for young women (and men) in the Middle East, their cries are neither heard nor understood. The social pressures of being a woman in a male dominated society are some of the main reasons for this upward trend of female suicide in the Mideast. However, in looking at the region as a whole, declining mental health is and will always remain the leading cause of suicide for both females and males.

The Unseen Casualties of War

Many people are saying that the adolescents and young adults in the Middle East are becoming a ‘lost generation’. Years of war are beginning to take their toll on the mental health of the children who have known nothing but violence. Repeated traumatic experiences during developmental years play role in the development of PTSD, anxiety and depression, and other behavioral disorders later in life.

In Israel, about 30 percent of children and adolescents suffer from subclinical depression. In neighboring Palestine, doctors estimated as much as 70 percent of children suffer from PTSD and anywhere from 40 to 100 percent suffer from anxiety. Post-war Iraq saw almost 40 percent of its children diagnosed with mental illness. The increase in adolescent and young adult suicide rates in the Middle East are due in large part to inescapable conflict in the region.

In Gaza, suicide rates are now highest among educated young adults in their 20s. Many of them see no escape from the overcrowded, impoverished strip of land and cannot bear the idea of never being able to practice their trade. Not only are people struggling with mental illness trapped geographically, they are also trapped culturally.

Like Christians, Muslims view suicide as a grave sin. However, in many countries in the Middle East, there are also legal and political repercussions for suicide and attempted suicide. In Lebanon, instances of self-harm and attempted suicide are not covered by insurance. Those who have attempted suicide are tried in court and offered no clinical assistance after the conviction. As a result, performing studies and collecting data about suicide in this region of the world is incredibly difficult. Many say that the suicide rate is actually much higher than the numbers indicate. Families will try to cover up suicides to make them look like accidents; governments ignore and dismiss statistics; those who take their own lives try to make it look accidental to save themselves and their families from the shame. But for those brave enough to seek help, it will not be easy to find.

The Need for Change

In European countries, there are anywhere between nine and 40 psychiatrists per 100,000 people. In the Middle East there are only 0.5 per 100,000. Mental health services are almost non-existent in the region of the world that needs it the most, with little assistance coming from the West. Ahmed Abu Tawahina, the director general of the Mental Health Promotion and Capacity Building Centre in Gaza says, It [treatment] is being provided in an episodic way. If any of the NGOs had a project for ten months, one year or so, they would take care of certain phenomena. But at the end of the project they will leave it, they give up. And this is another risk factor for deepening and creating new psychological problems.”

These young people are receiving very little help from outside their country, but the increase in social media use has opened the door for a new wave of foreign social pressures that these young people are not prepared for.

About four years ago, Russia saw an unexpected increase in teen suicide, especially among females. Investigations eventually revealed that the majority of the teens who took their own lives in that period of time were members of various suicide groups online. The common thread among all of those groups was their symbol: a blue whale.

Since its creation in 2013 by 21 year old psychology student, Philipp Budeikin, the Blue Whale Game (or Challenge) has been confirmed as the cause of at least 130 suicides in Russia alone. The game lasts only 50 days and is intended to lead its victims to take their own lives by the end. The game begins when ‘curators’ or ‘administrators’ reach out to their marks via social media. They then upload a virus to the browser or device which, they claim, gives them access to the victim’s personal information, which is held as leverage if the player tries to quit. For the next 50 days, the curators give the victims instructions and tasks that are designed to confuse and disturb in preparation for their final task.

Throughout the 50 days, the victims are told to harm themselves or mark their bodies to show their commitment–the etching of a blue whale into their arm being the ultimate sign of commitment. Some days, the curators instruct them to wake up at 4:20 in the morning and watch disturbing videos of suicide or horror movies. Other times, they are told to stand on the ledges of rooftops or bridges to get accustomed to being in dangerous positions. If at any time the players fail to follow the instructions, the curators will order some form of punishment or threaten them with the release of personal information they claim to have. It all culminates to the last 8 to 10 days, when the victims are forbidden from sleeping past 4:20 in the morning and are told to watch horror videos and harm themselves every day. 

At the end of the 50 days, the victims are sleep deprived, confused and are mentally unstable, making it easy for them to take their own lives and finish the game. 

Recently, this craze has spread to Middle East. Egypt and Dubai have seen dozens of teen and adolescent suicides in the past year that have been linked to the Blue Whale Game.

People struggling with mental illness, especially teens, who have nowhere to turn to for help turn to social media instead. Games or sites like the Blue Whale prey on these individuals–desperate young people who have no hope for the future. It is difficult to find a generation of young people more desperate than the ‘lost generation’ in the Middle East.

Until the political and social climate changes, the suicide rate of young women and adolescents will continue to rise. The patriarchal society and cultural condemnation of suicide coupled with the chronic violence in the region set this trend in motion and will fuel it for years to come. Lebanon has recently opened a suicide prevention hotline, but it is one of the only countries in the region to do so. Nations in the Mideast and around the world need to bring these issues to light and give those struggling with mental health the help they need in order for things to change.

If this continues, the Middle East will certainly make its way towards the top of the list for global suicide rates.