Background on self-directed violence in women & girls

Self-directed violence is a spectrum of self-harming thoughts and behaviours, which may or may not be suicidal in nature or result in death. Not enough has been done to understand what we can do to help women and girls around the world who hurt themselves, or to prevent them from using self-harm at all. Calls persist for targeted research among women to inform gender-sensitive prevention efforts.

Women’s use of self-harm is routinely portrayed as impulsive, manipulative, attention-seeking and unserious. Common perceptions among the public often suggest women’s vulnerability to self-harm is due to inherent feminine flaws of being “delicate” or “hot-tempered”.

Little research explores women’s experiences globally and in South Asia specifically to understand how, why and with what consequences women and girls choose and use self-directed violence. Even less has been done to explore the cultures within which it occurs, or to acknowledge women’s life circumstances and the interpersonal aspects of their lives over their life course.

Gender is an especially important determinant of physical and mental health outcomes, shaping them directly and indirectly by interacting with personal and social characteristics, influencing health behaviours and how health systems respond to people in need. The social construction of gender can affect individual health trajectories, and gender-conscious research has been long overdue to consider the factors and interactions that frequently operate in women’s lives, influencing women’s vulnerability to and use of self-harm and suicide. The research behind the Pain Pathway explores the ways in which gender informs women’s roles, behaviours, responsibilities, expectations, care-seeking and access to resources and support for self-directed violence, and includes experiences along the full spectrum, from thoughts of self-harm through deaths from suicide.

Facts about self-directed violence

Low- and middle-income countries:

account for 79% of global suicides, as well as increasing occurrence of non-fatal self-harm

South(east) Asia:

is seeing a growth in self-harm
has exceptionally high rates of self-harm amongst women
has higher suicide rates amongst adolescent girls (28 per 100,000 population) than adolescent boys (21 per 100,000 population)
recognises that suicide accounts for a high proportion of preventable deaths in pregnant and postpartum women and girls

India:

accounts for 40% of the world’s suicides amongst women
launched their first National Suicide Prevention Strategy in 2022, but gender conscious prevention guidance remains absent

India:

accounts for 40% of the world’s suicides amongst women
launched their first National Suicide Prevention Strategy in 2022, but gender conscious prevention guidance remains absent

South(east) Asia:

is seeing a growth in self-harm
has exceptionally high rates of self-harm amongst women
has higher suicide rates amongst adolescent girls (28 per 100,000 population) than adolescent boys (21 per 100,000 population)
recognises that suicide accounts for a high proportion of preventable deaths in pregnant and postpartum women and girls

Sri Lanka:

1 in 4 women (aged 15-49 years) report they have either thought about or actually done something to hurt themselves in the past
has an estimated 13-18 non-fatal events for every death by suicide
has made important progress in reducing suicides by pesticide poisoning, but less progress addressing other methods and drivers, particularly for women and girls

Following real stories of three women in Sri Lanka, Pain Pathway Stories: A Road to Preventing Self-harm in Women & Girls helps us see the Pain Pathway unfold in everyday ways and spaces in women’s lives. It invites audiences to consider how recognising this pattern and the forms it can take could be helpful in their own social networks.

The film is suitable for audiences 12+ and available in English, Sinhala and Tamil.

Watch the full film now

Learn their stories