Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesis

Suicide remains a significant public health issue in Pakistan, where social stigma and religious prohibitions create formidable barriers to understanding and intervention. Despite its recent decriminalization, the broader socio-cultural perceptions of suicide remain largely unexplored. Guided by the...

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Main Authors: Ahsan Mashhood, Gul Saeed, Fatima Sami
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:SSM - Mental Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666560325000453
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author Ahsan Mashhood
Gul Saeed
Fatima Sami
author_facet Ahsan Mashhood
Gul Saeed
Fatima Sami
author_sort Ahsan Mashhood
collection DOAJ
description Suicide remains a significant public health issue in Pakistan, where social stigma and religious prohibitions create formidable barriers to understanding and intervention. Despite its recent decriminalization, the broader socio-cultural perceptions of suicide remain largely unexplored. Guided by the socio-ecological framework, this qualitative evidence synthesis examines how non-terrorist suicide is perceived across individual, familial, community, and institutional layers in Pakistan. A systematic review was conducted of over six databases up until July 2024 (PsycINFO, PubMed, EBSCO, Web of Science, ProQuest Premium, SCOPUS) and pearling through grey literature (AKU eCommons, QAU repository, Google Scholar). A total of eight studies (out of 1923) met the inclusion criteria. Thematic analysis of qualitative literature identified five key dimensions shaping these perceptions. At the individual level, suicide is often attributed to supernatural influences, mental illness, or a lack of resilience; familial dynamics prioritize ‘izzat’ over individual well-being enforcing invisibility; gendered perceptions of shame and honour further restrict women's access to help; cultural and religious prohibitions, such as labeling suicide the “ultimate sin,” further amplify ostracism and inhibit discussions about mental health; structural neglect, characterized by inadequate resources and societal dismissal, perpetuates stigma and inhibits systemic change. These findings are contextualized within Pakistan's unique religo-legal and socio-cultural dynamics. Our policy recommendations include incorporating mental health education into school curricula, community-based initiatives to challenge harmful norms, and establishing accessible mental health services for local needs.
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spelling doaj-art-2cd6891c1ded4069a1bb010d01c1d7dc2025-08-20T02:06:08ZengElsevierSSM - Mental Health2666-56032025-06-01710043310.1016/j.ssmmh.2025.100433Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesisAhsan Mashhood0Gul Saeed1Fatima Sami2University of Oxford, Department of Social Policy, Oxford, United Kingdom; Corresponding author.Yale School of Public Health, Yale University, New Haven, CT, USAHabib University, Department of Social Development and Policy, Karachi, Sindh, PakistanSuicide remains a significant public health issue in Pakistan, where social stigma and religious prohibitions create formidable barriers to understanding and intervention. Despite its recent decriminalization, the broader socio-cultural perceptions of suicide remain largely unexplored. Guided by the socio-ecological framework, this qualitative evidence synthesis examines how non-terrorist suicide is perceived across individual, familial, community, and institutional layers in Pakistan. A systematic review was conducted of over six databases up until July 2024 (PsycINFO, PubMed, EBSCO, Web of Science, ProQuest Premium, SCOPUS) and pearling through grey literature (AKU eCommons, QAU repository, Google Scholar). A total of eight studies (out of 1923) met the inclusion criteria. Thematic analysis of qualitative literature identified five key dimensions shaping these perceptions. At the individual level, suicide is often attributed to supernatural influences, mental illness, or a lack of resilience; familial dynamics prioritize ‘izzat’ over individual well-being enforcing invisibility; gendered perceptions of shame and honour further restrict women's access to help; cultural and religious prohibitions, such as labeling suicide the “ultimate sin,” further amplify ostracism and inhibit discussions about mental health; structural neglect, characterized by inadequate resources and societal dismissal, perpetuates stigma and inhibits systemic change. These findings are contextualized within Pakistan's unique religo-legal and socio-cultural dynamics. Our policy recommendations include incorporating mental health education into school curricula, community-based initiatives to challenge harmful norms, and establishing accessible mental health services for local needs.http://www.sciencedirect.com/science/article/pii/S2666560325000453SuicidePakistanSystematic reviewDecriminalizationIslamic contextSocio-ecological theory
spellingShingle Ahsan Mashhood
Gul Saeed
Fatima Sami
Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesis
SSM - Mental Health
Suicide
Pakistan
Systematic review
Decriminalization
Islamic context
Socio-ecological theory
title Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesis
title_full Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesis
title_fullStr Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesis
title_full_unstemmed Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesis
title_short Sociocultural perceptions of suicide in Pakistan: A systematic review & qualitative evidence synthesis
title_sort sociocultural perceptions of suicide in pakistan a systematic review amp qualitative evidence synthesis
topic Suicide
Pakistan
Systematic review
Decriminalization
Islamic context
Socio-ecological theory
url http://www.sciencedirect.com/science/article/pii/S2666560325000453
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AT gulsaeed socioculturalperceptionsofsuicideinpakistanasystematicreviewampqualitativeevidencesynthesis
AT fatimasami socioculturalperceptionsofsuicideinpakistanasystematicreviewampqualitativeevidencesynthesis