Suicide risk highest on Mondays and New Year’s Day

Suicide risk is highest on Mondays and increased on New Year’s Day, whereas suicide risk on weekends and Christmas varies by country and region, finds an analysis of data from 26 countries published by The BMJ today.

The researchers say their results can help to better understand the short term variations in suicide risks and define suicide prevention action plans and awareness campaigns.

According to the World Health Organization, more than 700,000 people died due to suicide in 2019, accounting for approximately 1.3% of deaths, which was higher than the number of deaths by malaria, HIV/AIDS, and breast cancer.

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 analyse 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 (v women) and people aged 0-64 years (v 65 years and older).

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.

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 programmes related to holidays and the day of the week.”

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