Research indicates a global pattern where suicides peak on Mondays and New Year’s Day, with inconsistent trends on weekends and holidays across different regions. This significant finding stresses the need for targeted suicide prevention strategies tailored to specific times and demographic groups.
A new analysis of data from 26 countries, published today (October 23) in The BMJ, reveals that suicide risk is highest on Mondays and increases on New Year’s Day. However, the risk on weekends and Christmas varies depending on the country and region.
Researchers believe their findings can improve understanding of short-term suicide risk patterns, helping to shape more effective prevention strategies and awareness campaigns.
In 2019, over 700,000 people died by suicide, according to the World Health Organization (WHO), accounting for about 1.3% of global deaths. This number exceeds deaths from malaria, HIV/AIDS, and breast cancer.
Weekly and Holiday Variations in Suicide Incidence
Previous studies have shown that suicide risk differs by day of the week, but results on the association between major holidays and suicide risk are inconsistent and limited in geographical scope.
To address this, researchers used the Multi-city Multi-country Collaborative Research Network database to analyze suicide data for 740 locations in 26 countries and territories from 1971 to 2019. Just over 1.7 million suicides were included in the analysis.
During the study period, the suicide rate was highest in South Korea and Japan, South Africa, and Estonia, and lowest in the Philippines, Brazil, Mexico, and Paraguay. Across all countries, higher suicide counts were shown for men (vs. women) and people aged 0-64 years (vs. 65 years and older).
Regional Differences and Temporal Patterns
Across all countries, risk of suicide was highest on Mondays (approximately 15-18% of total suicides) compared with other weekdays.
The effect of the weekend on suicide was mixed. Suicide risks were lowest on Saturdays or Sundays in many countries in North America, Asia, and Europe. However, the risk increased during weekends in South and Central American countries, Finland, and South Africa.
Suicide risk increased on New Year’s Day in all countries, especially in men, whereas the pattern on Christmas Day varied, with marginal increases for countries in Central and South America, and South Africa, but a generally decreased risk for countries in North America and Europe.
For three East Asian countries and regions where people celebrate Luna New Year (China, South Korea, and Taiwan), only South Korea showed a decreased suicide risk.
Implications for Suicide Prevention
Possible explanations include distress by pressure from work at the beginning of a week and higher rates of alcohol consumption before and on New Year’s Day and weekends. Further research is needed to investigate these factors, say the authors.
On other national holidays, suicide risk was associated with a weak decrease in many countries, except for Central and South American countries, where the risk generally increased one or two days after these holidays.
These are observational findings and the researchers acknowledge several study limitations, such as possible under-reported or misclassified suicide data in some countries, and being unable to assess the impacts of different types of holidays (eg, festivals or memorial days) on suicide risk by country.
However, they say the findings “provide novel scientific evidence at a global scale, which can help to establish more targeted suicide prevention and response programs related to holidays and the day of the week.”
Reference: “Association of holidays and the day of the week with suicide risk: multicountry, two stage, time series study” 23 October 2024, The BMJ.
DOI: 10.1136/bmj-2024-077262