Commentary: In suicide prevention, data must be timely, transparent and trusted

CNA

5 days ago

SINGAPORE: This week, Singapore reported a provisional suicide count of 314 for 2024. At the same time, the official number for 2023 was revised to 434 suicides, up from the previously reported 322 in July last year.
This sequence in which the data was released highlights the need to treat provisional numbers with care.
The initial figure for 2023 had been widely reported as the lowest in over two decades. Although the figure was clearly marked as provisional, many took it as a hopeful sign that suicide numbers were falling.
The updated number - an increase of more than 100 cases – is a sobering moment for us working in suicide prevention. It affects how we interpret the data and look for patterns, where we direct support and how we speak to grieving families and communities.
There is a need for stakeholders to reflect on how such data is communicated, so we can move forward with honesty and credibility.
EVERY NUMBER IS A LIFE
Suicide statistics aren't like any other metric. They are records of people who struggled, who mattered, and who left behind people who loved them.
Singapore has a suicide reporting system built on careful processes. Each suspected case is referred to the coroner, who considers a full range of information, including police investigations, medical records, forensic evidence and family testimonies.
This approach is rigorous, and rightly so. It ensures that deaths are not classified prematurely or without due care.
But this thoroughness also means that the system takes time.
The numbers released in July each year are marked as provisional. The final figures, as we saw with 2023, may not be confirmed until a full year later. In practice, it can take 18 months or more to know how many people died by suicide in a given year.
In that gap, incomplete numbers can shape outreach, policies and public perceptions.
So when the provisional figure for 2024 was released – 314 suicides, even lower than the previous year – it was shared as the lowest number on record. Based on the data available at the time, that is true.
But given what we now know about the revision of the 2023 numbers, we must ask: What does the number really mean?
This is not a criticism of the coroner's office or the agencies compiling these statistics. Their work is serious and necessary.
Still, any revision of suicide data without clear explanation risks undermining trust, not just in the numbers, but in the larger effort to prevent suicide.
WHAT'S POSSIBLE WITH TIMELY DATA
Countries around the world have found that better data leads to better prevention.
Japan, for example, passed a national suicide prevention law in 2006. Officials collect and share detailed information not just on deaths, but also on risk factors such as age, method and motivation. This data is shared with local municipalities, allowing tailored responses.
Some communities focus on elderly isolation, others on youth stress. Volunteers are mobilised to monitor high-risk locations, and in some areas, blue LED lights - believed to have a calming effect - are installed at train stations to stop people from jumping in front of oncoming trains.
As a result of its efforts, Japan's suicide numbers have fallen from over 30,000 in 2009 to 20,268 in 2024, showing that consistent, localised data can support meaningful change.
Meanwhile in Norway, the National Centre for Suicide Research and Prevention runs a nationwide surveillance system that links cause-of-death data with mental health and addiction records. Using encrypted and anonymised data, the system identifies whether people who died by suicide had recent contact with care services. This information helps the system improve, whether by updating protocols, staff training or outreach.
In Boston in the United States, public schools conduct regular anonymous surveys with students, asking about emotional well-being, self-harm and suicidal thoughts. When data showed rising distress among LGBTQ+ students during the COVID-19 pandemic, the city responded. Peer groups expanded, partnerships grew and resources were redirected to where they were most needed.
These examples offer valuable lessons, but they are not without flaws. Even in well-established systems, challenges remain. Healthcare providers often face unclear reporting duties and worry about how data sharing might affect patient care. Privacy laws are sometimes misunderstood or unevenly applied, and coordinating across agencies is rarely straightforward.
Resources are also a major constraint. Building and sustaining such systems takes years, millions in funding and skilled staff to manage and interpret data.
These aren't reasons to stop trying. But they show that good intentions must be backed by clear design, long-term support and strong safeguards. Singapore can learn from both the progress and the pitfalls.
WHAT SINGAPORE IS MISSING
In Singapore, we lack a robust national system to track suicide attempts. Completed suicides go through the coroner, but most attempts go undocumented unless the person seeks medical care.
Even then, hospitals are not required by law to report them. That leaves the country without a clear picture of who is struggling, or how to intervene early.
International research suggests that for every suicide, there are at least 10 to 20 attempts. Among adolescents, that figure may be even higher. Without clear attempted suicide data, we risk building policies based only on the tip of the iceberg.
Another major gap is the lack of coordinated data on suicidal thoughts and self-harm, particularly among youth. Schools have counsellors. Helplines, like the one manned round the clock by Samaritans of Singapore (SOS), receive calls. But this information is rarely consolidated at the national level. Without a full picture, we end up responding to fragments, often when it is too late.
WHAT NEEDS TO CHANGE
Singapore is not starting from zero. There are helplines, hospital services, school counselling teams, and dedicated professionals are all working hard to prevent suicide. But we do need better coordination.
One practical step would be to establish a small central team whose job is to bring suicide-related data together. This team would analyse trends across hospitals, schools and helplines, not to identify individuals, but to flag areas where support is most urgently needed.
Anonymous surveys, like those used in Boston, would also help us understand what young people are experiencing, whether they know where to seek help, and what barriers stand in their way. This is sensitive work, but other countries show it can be done.
Helpline data is another valuable source. Every call and text message to SOS or the 1771 national mental health hotline is a cry for help. For example, if we see more calls in a certain month from a particular age group, that can guide early intervention. But this only works if the data is reviewed regularly and shared responsibly.
Finally, clear communication is essential. When figures are released as provisional, that status should be consistently noted in reporting and public discussion. If the numbers are later revised, explaining why helps people understand the process. Clear communication builds trust, and trust is essential in suicide prevention.
We owe it to those we've lost, and to those still struggling in silence, to do better.
Because behind every number is a person. Someone who mattered. Someone who might still be here if we had seen the signs in time.
Dr Jared Ng is a psychiatrist in private practice in Singapore. He was previously chief of the department of emergency and crisis care at the Institute of Mental Health.
Where to get help:
National mental health helpline: 1771
Samaritans of Singapore Hotline: 1767