Spatiotemporal epidemiology and hierarchical analysis of suicide mortality and associated risk factors in Thailand using national surveillance data during 1997-2021

Abstract

Suicide as a critical but neglected public health concern in Asia. In Thailand, limited research exists on suicide, further complicated by varying rates across regions and sex disparities. In this context, understanding the nuanced spatiotemporal dimensions of suicide not only illuminates its intricate dynamics but can also guide targeted interventions and more effective mental health policies. Addressing this gap, our study conducted an extensive analysis of routine Thai suicide report data spanning 1997 to 2021 from the Department of Mental Health, Thai Ministry of Public Health. Socioeconomic indicators were sourced from the National Statistical Office of Thailand. Bayesian spatiotemporal hierarchical models were employed to investigate suicide trends and associations with risk factors. Suicide cluster detection was conducted to identify high-risk areas. Between 1997 and 2021, Thailand recorded 106,955 suicide deaths, with males accounting for 78% of the total. The national suicide rate peaked in 1999 and subsequently declined by 29.4% through 2006, followed by a moderate increase of 11.5% from 2018 to 2021. The northern region consistently exhibited the highest crude suicide rates across the study period. A persistent sex disparity was observed: male suicide rates were more than three times higher than female rates and showed greater temporal variability. Suicide hotspots were identified primarily in northern and eastern provinces. Significant associations were found between suicide risk and financial distress as well as crime-related indicators, reflecting complex spatial and temporal dynamics. This research marks a significant stride in unraveling the spatiotemporal dynamics of suicide in Thailand. The distinctive regional and sex-specific trends highlight the need for interventions responsive to these nuances while embracing a holistic perspective. By emphasizing the integration of spatiotemporal insights into policy frameworks, this research offers valuable guidance for crafting targeted mental health strategies, ultimately fostering enhanced well-being throughout Thailand.