Methods used :

• – We cannot, of course, have direct ex post access to the reasons why a human being committed suicide. Unfortunately, it is too late to hear his testimony. The «psychological autopsies» which are by definition “a post mortem investigative procedure to establish and assess suicide risk factors present at the time of death, with the aim of determining with the highest degree of certainty the mechanism that led to death.” are still too rare to be used in a quantitativist approach. On the other hand, we can better know, although still imperfectly, the reasons that led women to make a TS, this is what we saw in the previous chapter. It is well known that the reasons for suicide are multifactorial, however, epidemiological studies we
  learn that the strongest predictor of suicide is having a prior HCW. There is therefore a very powerful link between suicide and TS, the same causes producing the same effects in more extreme. Thus, in the absence of another scientifically more assured method, we
  are led to formulate the hypothesis of the same distribution of the causes of TS in the causes of suicides.
  – The testimonies gathered in many cases of proven forced suicide, of which we have provided some examples in the previous deliverable “State of the art of forced suicide in Europe”, support us in this hypothesis that psychological violence within the couple can be the main cause of a passage to the act. The comorbidities generally associated with these acts (depression, anxiety disorders, etc.) can also be interpreted as consequences of such violence.
• – This reason « for lack of better » scientifically, associated with epidemiological studies on the causes of TS and findings made in case observations conducted by experts on violence within the couple, leads us to validate the hypothesis of a percentage of
  suicides attributable to violence within the couple at least around 11%. This figure applies only to countries in the Europe and America regions (as defined by the WHO) because of the few studies on which it is based (United States, United Kingdom, France).
•  
• Estimated number of SFs in Europe :

• We therefore start from the examination of the number of female suicides by age groups for the EU27 MS provided by Eurostat for 2017, which is the most recent year with complete mortality figures published (Causes of death by country of residence and occurrence) for these
  The raw data for female suicides are :

Estimation limits :

If our selections arrive to our estimate of our SF number, we will be successful :

• – Perform the synthesizing of the trop of the numbers études concernant les possible causes of the tentatives of suicides in the women.
• – Determine a percentage of TS attributable mainly to VSC.
• – Hypothesized that we could apply the percentage of cause of TS to the causes of completed suicides themselves.
• – Applied this same percentage to all MS in Europe EU27.
• – We are aware that this pricing mechanism is not scientifically assured, but that it leads to a “reasoned order of magnitude”. It seems to us that we are closer to the truth regarding the scale of the number of deaths of women victims of VSC by including this figure than by excluding it !
•  

Ways to improve it : There are several ways to improve the robustness of our methodology :

• – Proposal 1 : Conduct in-depth and specific studies in France and other MS on the existing link between VSC on the one hand and suicide attempts on the other hand to better illuminate, understand, quantify and prevent forced suicides . This project participates in this.
• – Proposal 2 : Systematically collect data concerning possible VSC in police or gendarmerie post-suicide investigations, while of course “gendering” the data collected. This amounts to systematizing psychological autopsy procedures to better investigate the causes of suicides.
• – Proposal 3 : Raise awareness and train front-line personnel (police, gendarmes, firefighters, emergency personnel) about the existence and detection of suicide attempts linked to violence au sein du couple.

Studies on the link between violence within the couple and suicide or TS :

It is essential to consider violence within couples as a public health problem. Indeed, according to WHO figures, women victims of intimate partner violence lose one to four years of healthy life. In addition, this violence multiplies by
two health care expenses for these women. It is also important to point out that the costs of domestic violence amount to an impressive 16 billion euros in Europe.

Several studies have aimed to analyze the consequences of intimate partner violence on the mental health of women, some of which have highlighted the correlations between this violence and suicide attempts made by female victims. A presentation of these articles is provided in the following lines.
Note: We logically assume that the figures given in the articles relate to life up to that point when no other duration is mentioned.

• – Article n°1: Morvant, C., Lebas, J., & Chauvin, P. (2002). The consequences of domestic violence on women’s health and their treatment in primary care. Retrieved from https://www.researchgate.net/profile/PierreChauvin/publication/10900409_Consequence
  s_of_domestic_violence_on_women%27s_health_and_their_management_in_primary_health_care/links/5c8fc216299bf14e7e844d97/Consequences‐of‐domestic‐violence‐on‐womens‐health‐and‐their‐management‐in‐primary‐health‐care.pdf [France]
•  

A study carried out in 2002 which set out to analyze the consequences of domestic violence on women’s health reached certain conclusions.

First of all, it is important to note that half of the women who are hospitalized in psychiatry suffer from violence from their partner. In addition, the risk of post‐traumatic syndrome and depression appears to be greater in contexts of domestic violence than of sexual violence suffered in childhood. The same is true with regard to the consumption of psychotropic drugs, which is very high among these female victims. It is, in fact, 4 to 5 times higher compared to the general population.

Finally and more fundamentally, as a result of the previous elements, they would make 5 times more suicide attempts compared to the general population.

• – Article n°2 : Cavanaugh, C. E., Messing, J. T., Del‐Colle, M., O’Sullivan, C., & Campbell, J.C. (2011). Prevalence and Correlates of Suicidal Behavior among Adult Female Victims of Intimate Partner Violence. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152586/pdf/nihms282593.pdf [USA]
•  

This study aimed to highlight the prevalence and correlates of suicide threats and suicide attempts among 662 women victims of intimate partner violence. According to the National Institute of Health, women who are victims of intimate partner violence are more likely to have suicidal thoughts and/or behaviors. Indeed, a study reveals that female victims are 7 times more likely to have suicidal thoughts compared to women who are not confronted with this type of violence. Additionally, one in five victims have threatened or attempted suicide in their lifetime.

The article takes an interesting intersectional perspective.

Thus, women suffering from a chronic or disabling illness were 2.4 times more likely to have threatened or attempted suicide than others. These data can be explained by the fact that these people may be more socially isolated and controlled by their spouse and may therefore see suicide as the only possible way out.

Younger women are significantly more affected.

Ethnicity is also an important variable since African American victims are 40% less likely to have threatened or attempted suicide than Latin American victims. Additionally, certain circumstances can make victims of violence more likely to threaten or attempt suicide.

To begin, victims at greater risk of experiencing potentially fatal assaults by their intimate partners face a significantly higher likelihood of having threatened or attempted suicide.

In addition, serious abuse inflicted by the spouse as well as the spouse’s dangerousness also have an impact.

These findings can be explained by the fact that in cases of fear for their lives, victims may consider suicide as the only way to exercise control over a situation that has become untenable. The considerable danger incurred in a violent relationship impacts the mental health of women who are victims, who are more likely to suffer post-traumatic stress disorder, anxiety and depression. These consequences attached to serious violence on women’s mental health, in turn, increase the likelihood that victims will have suicidal thoughts.

Finally, it appeared that female victims whose partner had threatened or attempted suicide were at a higher risk of having threatened or attempted suicide themselves.

• Article n°3 : Devries, K.. M., Mak, J. Y., Bacchus, L. J., Child, J. C., Falder, G., Petzold, M., Astbury, J., & Watts, C. H. (2013). Intimate Partner Violence and Incident Depressive Symptoms and Suicide Attempts: A Systematic Review of Longitudinal Studies. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3646718/pdf/pmed.1001439.pdf [USA, Australie, Inde, Suède, Nicaragua, Afrique du Sud].
•  

This systematic review and meta‐analysis, including longitudinal studies published before February 2013, aims to study the links between intimate partner violence and depression as well as suicide attempts, and vice versa.

Some studies have, on the one hand, revealed that contexts of domestic violence were strongly and systematically associated with depressive disorders and suicide. A survey found that intimate partner violence doubled the risk of suffering depressive symptoms.

There are, on the other hand, associations in the opposite direction. An analysis showed that depressive symptoms doubled women’s risk of being victims of domestic violence.

The present study confirms this bidirectional direction: women with depression are more likely to be in an abusive relationship, but being in an abusive relationship predicts depressive disorder and thereby increases the risk of suicide attempt.

• Article n°4 : Feminist Citizen. (2019). Domestic violence: depression and suicidal desire Retrieved from https://static.mediapart.fr/files/2019/10/02/enquete‐cf‐violences‐ conjugales‐et‐envie‐suicidaire.pdf [France].
•  

The “Feminist Citizen” movement aimed, in this investigation, to highlight the phenomenon of forced suicides. 584 victims responded to an online questionnaire.

It appears from his study that 76% of victims declared having had suicidal thoughts, that 29% of them had attempted suicide and that 13% were hospitalized in a psychiatric unit.

These figures can be explained by several reasons: the feeling that suicide is the only solution to put an end to the pain felt; the desire to find “peace”; the desire to regain control through suicide; the willingness to conform to the attacker’s expectations; the feeling of being unable to live without the perpetrator of the violence or even the multiplication of constraints.

• Article n°5 : Hirigoyen, M.‐F. (2009). From fear to submission. Retrieved from https://www.cairn.info/revue‐empan‐2009‐1‐page‐24.htm [France]
•  

This article aims to highlight the devastating effects of domestic violence on the health of women who experience it.

Violence between intimate partners can, first of all, cause psychological problems such as anxiety, sleep problems, difficulty concentrating, etc. These difficulties lead, for many of these women, to significant consumption of alcohol, toxins or even psychotropic medications.

A number of psychosomatic disorders may also present. Some female victims may thus suffer from chronic pain, headaches, breathing difficulties, etc.

It is important to highlight that depression affects more than half of women who are victims of violence by their partner. They would also make 5 to 8 times more suicide attempts compared to the general population.

• Article n°6 : Chan, K. L., Straus, M. A., Brownridge, D. A., Tiwari, A., & Leung, W. C. (2008). Prevalence of dating partner violence and suicidal ideation among male and female university students worldwide. Retrieved from http://hub.hku.hk/bitstream/10722/60541/1/Content.pdf [21 pays]
•  

This is a survey aimed at measuring the proportion, within a large sample of students, of people who have perpetrated physical and/or sexual violence against their intimate partner. It was also a question of making the link between domestic violence and suicidal thoughts.

The study shows that there is a strong correlation between intimate partner violence and suicidal ideation, both on the part of the perpetrators and the victims. It is depression that explains the relationship between dating violence and suicidal ideation.

The survey also highlighted the fact that women exposed to intimate partner violence are more likely than others to have attempted suicide. Rates of suicide attempts among female victims range from 20 to 26%.

• Article n°7 : Chang, E. C., Yu, E. A., Kahle, E. R., Du, Y., Chang, O. D., Jilani, Z., Yu, T., & Hirsch, J. K. (2018). The Relationship Between Domestic Partner Violence and Suicidal Behaviors in an Adult Community Sample: Examining Hope Agency and Pathways as Protective Factors. Retrieved from
  https://www.researchgate.net/publication/320289498_The_Relationship_Between_Domestic_Partner_Violence_and_Suicidal_Behaviors_in_an_Adult_Community_Sample_Examining_Hope_Agency_and_Pathways_as_Protective_Factors/link/5c34bca8299bf12be3b798d3/download [USA]
•  

98 people aged 18 to 64 participated in this study aimed at determining the links between hope, domestic violence and suicidal ideation.

Domestic violence has a serious impact on the mental health of the women who experience it. They are, in fact, more likely to suffer from, among other things, depression, anxiety, eating disorders and post-traumatic stress.

Studies have shown that 20% of women who experience intimate partner violence have threatened or attempted suicide in their lifetime. Although we know that intimate partner violence can worsen suicidal behaviors, few studies have been conducted to determine the potential protective factors that could reduce the risk of them adopting these behaviors. This is why this article aims to determine to what extent hope could have an influence both on domestic violence and on the risk that it leads to suicidal behavior.

The results of the study that was conducted go in two opposite directions: hope can indeed attenuate the relationship between domestic violence and suicidal behavior but it can also exacerbate it.

One explanation for the second effect is that having a high level of hope can make a person more vulnerable when faced with an accumulation of stressful life events, such as is the case during experiences of domestic violence. However, it is necessary to continue studies to understand to what extent hope can be more or less beneficial for victims of intimate partner violence.

• Article n°8 : Wolford‐Clevenger, C., & Smith, P. N. (2017). The Conditional Indirect Effects of Suicide Attempt History and Psychiatric Symptoms on the Association Between Intimate Partner Violence and Suicide Ideation. Retrieved from http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC5647881&blobtype=pdf [USA]
•  

The present investigation aimed to deepen the understanding of the link between violence between intimate partners and suicidal behavior, more precisely in the situation of women seeking shelter from ad hoc professionals. The study aimed to examine the impact of coercive control on suicidal thoughts. 134 women participated in this cross-sectional study.

The survey highlights the fact that victims seeking shelter are at increased risk of having had suicidal thoughts and making suicide attempts (34%) compared to other victims who do not seek such help (6 .6%) than to women in the general population (4.2%).

These findings may, among other things, be justified due to the fact that these women are subject to coercive control from their spouses.

The concept of coercive control refers to: “repetitive strategies, some being violent and others not, whose cumulative effects must be analyzed in their broader context of domination.”

It is deployed through two mechanisms.

On the one hand, the perpetrator may resort to coercion. The latter targets any strategy adopted by the perpetrator of violence with the aim of having what he immediately desires. The use of force or the threat of force are methods that can be used in this regard.

On the other hand, the aggressor can use the strategy of control. Control takes the form of a series of strategies that can take place at different times during the relationship. They can take the form of deprivations of rights and resources and the imposition of micro-regulations. The latter refer to rules dictated by the executioner which can take multiple forms and which aim to maintain the control and domination of the perpetrator over his victim.

Thus, unlike violence between intimate partners which manifests itself by acts taking place according to a certain gradation and in an episodical manner, the notion of coercive control refers to the cumulative and invisible strategies that the spouse puts in place and some of which can be seen as being of less seriousness.

Numerous studies have, in fact, highlighted that coercive control is strongly associated with suicidal ideation and behavior.

It is the theory of fluid vulnerability that would make it possible to understand the links between coercive control, psychiatric symptoms and suicidal behavior. According to this theory, “stressors activate acute suicide vulnerability through a “suicidal mode,” which involves distinct suicide risk-promoting responses from cognitive, affective, physiological, and behavioral systems. /motivational”.

“Specifically, cognitive responses involve one or more negative core beliefs, such as worthlessness and hopelessness. The affective system is characterized by dysphoria, involving various negative mood states such as sadness, anger and anxiety. The physiological components of this mode involve increased arousal. The behavioral and motivational aspects of suicide involve a clear desire to die or the intention to end one’s life.

It is important to note that previous suicide attempts will give rise to a lasting vulnerability, thus predisposing female victims to the activation of the suicidal mode. The latter will thus be more often activated by victims who have made several suicide attempts than those who have made only one or have not made one due to the existence of this vulnerability to suicide.

Women in controlling relationships may be vulnerable to negative self-directed thoughts. It thus appears that victims who seek help suffer from depressive symptoms, post-traumatic stress syndrome, despair, etc.

According to fluid vulnerability theory, these disorders increase the risk of adopting suicidal behaviors.

• Article n°9 : Coker, A. L., Smith, P. H., Thompson, M. P., McKeown, R. E., & Bethea, L. (2004). Social Support Protects against the Negative Effects of Partner Violence on Mental Health. Retrieved from https://uknowledge.uky.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1114&co
  ntext=crvaw_facpub [USA]
•  

The present survey was conducted among 1,152 women victims of intimate partner violence, whose ages varied between 18 and 65 years in family medicine clinics between 1997 and 1999. The objective pursued was to determine what was the impact of violence on health
mental health of victims and to what extent social support could reduce this impact.

Intimate partner violence has consequences on the mental and physical health of victims. The latter are, in fact, more likely to suffer from drug dependence, symptoms of post-traumatic stress, depression, anxiety and behaviors
suicidal.

It appears, following this survey, that, among the women who had testified to the violence suffered by other people, those who received support from these people had a reduced risk of having thoughts or reactions. adopt suicidal gestures. These victims were, in
Indeed, less likely to present poor mental or physical health.

• Article n°10 : Pico‐Alfonso, M. A., Garcia‐Linares, M. I., Celda‐Navarro, N., Blasco‐Ros, C., Echeburua, E., & Martinez, M. (2006). The Impact of Physical, Psychological, and Sexual Intimate Male Partner Violence on Women’s Mental Health: Depressive Symptoms, Posttraumatic Stress Disorder, State Anxiety, and Suicide. Retrieved from https://www.liebertpub.com/doi/pdf/10.1089/jwh.2006.15.599 [Espagne]
•  

This study aimed to establish the impact of intimate partner violence (physical, psychological and sexual) on the mental health of victims. To do this, a comparison between 75 physically and psychologically abused women; 55 women psychologically
abused; and 52 non‐abused women; was conducted.

It appears that women victims of violence (whether physical and psychological or only psychological) have a higher risk of presenting depressive and anxiety symptoms, post-traumatic stress and suicidal thoughts.

It should be noted that, according to this study, there is no difference in terms of impact on the health of victims between those exposed to physical and psychological violence and those exposed only to psychological violence. These results appear important in the
to the extent that moral violence is still strongly considered to be less serious violence within the collective unconscious.

• Article n°11 : Mason, R., & O’Rinn, S. E. (2014). Co‐occurring intimate partner violence, mental health, and substance use problems: a scoping review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240863/pdf/GHA‐7‐24815.pdf [Canada]
•  

This literature review identified 35 articles examining the link between partner violence and mental health, published between 2004 and 2014. The objective of this work was to indicate to front-line mental health professionals what had to know to provide
care adapted to women victims of intimate partner violence.

Declared an epidemic in 2002 by the WHO69, violence between partners, which mainly affects women, also takes forms and has more severe consequences for women.

Among these consequences is the increased risk of developing a mental health disorder, including for example addiction70, depression, dysthymia, suicidality, phobia, generalized anxiety disorder or post‐traumatic stress disorder.

In particular, emotional or psychological abuse has been associated with low self-esteem, depression and post-traumatic stress disorder.

The risk of femicide has been associated with the presence of both depression and post-traumatic stress disorder. The use of alcohol by the victim, on the other hand, was not associated with the lethal risk. Indeed, in another study, victims who suffered the most severe forms of violence
were more likely to have comorbidities.

One possible explanation for the links between childhood and adult abuse and substance use is that childhood abuse can lead to low self-esteem, depression, anxiety, guilt and other problems. psychological, which in turn
lead to vulnerability to adult victimization and self-medication via the products.

• – There are around 2,000 suicides per year in Belgium. Suicide represents the 7th cause of death for the total Belgian population, all causes combined. When referring to “external” causes of death, this phenomenon represents the leading cause of mortality. It is important to point out that most statistics only concern completed suicides. There is, in fact, no official record of suicide attempts which are estimated to be 10 to 20 times more numerous.
  – It is, however, necessary to be cautious with regard to these figures due to the existence of an underestimate in the number of deaths caused by suicides. The reasons are the absence of precise criteria for declaring suicides and the lack of autopsies which would have allowed identification of the cause of death. The propensity to declare a suicide may vary depending, in particular, on the doctor in charge of certification, cultural or religious criteria of the deceased person or their entourage. The same goes for reports of suicide attempts which are much lower than reality.
•  

Certain groups more affected ?

Gender criterion

The gender criterion has a strong impact on the phenomena of suicide and suicide attempts. The majority of completed suicides concern men. Men commit suicide, approximately three times more than women.

Concerning suicide attempts, the trend is reversed: it is women who are significantly more affected. Indeed, the proportion of suicide attempts rises from 1 to 3 for men and from 1 to 14 for women.

At the same time, according to a survey carried out in 2017, more women reported having had suicidal thoughts during their life compared to men (16% compared to 12%).

Women therefore consider and attempt to end their lives more often, while more men succeed in doing so. The figures support this reality: 1,243 suicides were recorded among men compared to 500 among women.

The reasons explaining these higher suicide rates among men appear to be essentially societal. Men appear to exhibit more impulsive behavior compared to women. They would also resort more to violent means to end their lives such as firearms, hanging or even explosives while women would favor more drug ingestion. In addition, women would be more protected from emotional and social isolation due to the fact that they are, still today, more involved within the family sphere. Finally, it appears that men have more difficulty asking for help when they need it and also use medical and support services less.

Age criterion

The people most affected by suicidal behavior are adolescents and the elderly. There are, in fact, a significant number of suicide attempts in adolescence and completed suicides among the elderly. Thus, among young people under 25, there are 100 to 200 suicide attempts. Concerning people aged over 65, suicides affect 1 in 2 or 3 people.

Diploma level criterion

Suicidal behavior is also linked to the level of education of the people concerned. People with the least education are 1.5 times more likely to think about suicide during their lifetime than people with the highest level of education. According to a survey carried out in 2008, there are more suicide attempts among people with less education. There are 6.7% among the group of people who have received the least training compared to 4.1% of higher education graduates.

Evolution of numbers: The mortality rate linked to suicide is stable among men and tends to decrease among women, at least in Wallonia. We thus note a rate equivalent to 0.33 among men and a rate which fell from 0.14 in 1989 to 0.10 in 2004 among women.

• – With around 8,500 deaths by suicide per year, France has a suicide rate higher than the European average. It is therefore a major public health problem whose impact in human and economic terms is significant. To this figure, we must add approximately 100,000 suicide attempts resulting in contact with the healthcare system per year. France is therefore one of the European countries most affected by this scourge.
  – The figures on suicides are provided in France by the CépiDc of Inserm (Centre for epidemiology on medical causes of death). Mortality data comes from the declaration and coding of causes of death. They have been collected officially and regularly in France since 1968.
  – We present below the tables of the number of deaths by suicide from CépiDc from 2010 to 2016, according to age and sex:

Here is the graph of the evolution of these numbers during this period :

•  
• – Health Barometers are periodic surveys, carried out since 1992, which aim to better understand the knowledge, attitudes, beliefs and behaviors of the French in matters of health. According to the 2017 Health Barometer, 7.2% (n=1,742) of 18-75 year olds declared having attempted suicide during their lifetime (9.9% of women vs. 4.4% of men) and 0.39% (n=75) during the last 12 months (0.29% of men vs. 0.48% of women).
• – The main reasons declared by people to explain their action were: “family” (49.2%; 37.7% of men vs. 54.1% of women), “sentimental” (40.8%; 46.5 % vs 38.5%), “professional” (10.3%; 15.6% vs 8.1%) and linked to their state of “health” (10.3%; no significant difference by gender). These “family” or “sentimental” reasons can of course cover quite frequently, and in a rather modest way, a context of conflict within the couple.
• – Furthermore, this study shows that traumatic life events, intra-family problems and sexual violence are strongly associated with TS over the lifespan. Thus, according to the order of importance, sexual violence suffered during life increases the risk of ST by 3.5 for women, violent family climates by 2.2 for both sexes.
• – If we examine the comorbidities associated with these TS in the PMSI-MCO data, the pathologies most frequently noted are depression (32% of stays – 34% among women, 29% among men), disorders mental health and behavior related to alcohol (23% of stays – 18% among women, 32% among men) and anxiety disorders (10% of stays – 11% in women, 9% in men).
• It should be noted that other psychiatric disorders are more rarely noted: psychotic disorders (3%), bipolar disorders (2%), eating disorders (0.7%). We can therefore note that the disorders that are most frequently found in women who have suffered from ST (anxiety, depression, alcohol-related behaviors) are also those that are found as consequences of the violence suffered by women. within their couple.
•  

Back to the causal link :

• – Catherine Le Magueresse, lawyer, associate researcher at the Institute of Legal and Philosophical Sciences at the Sorbonne and former president of the European Association against Violence Against Women at Work (AVFT), believes in an article in Slate that: “ violence leading to suicide or ST must be recognized as feminicide and punished specifically.”
• – “In this context, suicide is committed not by the victim, but by the aggressor,” says the specialist. We must put the focus back on the person responsible, who is the violent man. It is no longer a suicide, because it is provoked. There is a causal link: if it had not been for this behavior, she would not have died. In his eyes, it is this causal link that it is essential to recognize, in the same way as others already taken into account in the law. “If I push someone into the street, the person falls, hits the edge of the sidewalk and dies, this will be prosecuted and penalized under the offense “violence causing death without intention of causing it”. Why, when a woman kills herself because of the psychological, or even physical and sexual, violence she suffered, is this causal link not taken into account? », she asks.
• – The Slate article specifies that for the lawyer, the solution adopted by the Grenelle of domestic violence would be the most effective in criminalizing the suicide of the spouse: “The advantage of the aggravating circumstance is that the we do not have to prove the intentionality of the spouse to lead the other to suicide, unlike the existing offense of “provocation to suicide” – punishable by 3 years of imprisonment and a fine of 45,000 euros. There, if suicide in a context of harassment is noted, the aggravating circumstance is applied. »
• – “The issue of moral harassment at work is also quite recent. How many suicides did it take for it to be recognized? And then it was almost exclusively men. When a man commits suicide, it is real violence, whereas when it is a woman, we put it down to her fragility,” denounces the lawyer.

• – More than 700,000 suicides were recorded across the world in 2019, according to the latest figures from the World Health Organization (WHO), or one death every forty seconds. Suicide is a global phenomenon, but indeed, 77% of suicides occurred in low- and middle-income countries in 2019. Suicide accounted for 1.3% of all deaths worldwide, making it the 17th leading cause of deaths in 2019. It was the fourth cause of death among 15-29 year olds in the world in 2019. It should also be noted that the number of TS is generally 20 times higher than the number of suicides.
• – The reasons given for these deaths vary, depending on the country, from free access to firearms in the United States to excess alcohol in Russia. But we must not forget, reminds the WHO, that the suicide rate is much higher in low-income countries. We must also mention the specific situation of women who in many countries are locked in a heavy patriarchal system which can prove fatal for them.
• – Thus, suicide affects men almost three times more than women in France, this is far from being the case in countries like Bangladesh, Lesotho (in South Africa) or Myanmar (the former Burma), where women commit suicide more than men. Finally, the country with the highest number of female suicides is India with 72,935 female deaths in 2019, or a rate of 11.1 per 100,000 women. The few countries with a higher age-standardized rate of suicide mortality for women are Lesotho (34.6), Guyana (17.0) and Suriname (11.8).
• – Below we provide the global map published by WHO based on the age-standardized rate of female suicide mortality in 2019 :

•  
• – An article from The Lancet public health published in 2020 established that 37% of women who commit suicide worldwide live in India. There is no shortage of abusive punishments, forced marriages, systemic assaults, rapes, honor killings and all types of violence against women to account for the oppression that Indian women suffer.
• – Closer to us, in Morocco, the inequalities between women and men are glaring when we examine them from the angle of suicides. Of 1,013 suicide cases recorded in 2016, 613 concerned women. A very high percentage, but not so surprising, when certain news items demonstrate the way in which women’s rights are little respected in Morocco: high frequency of domestic violence, sexual harassment in the streets and on the beaches or even bans on abortion which induces forms of self-inflicted repression.
• – The WHO report on global suicides (2019) states that: “While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well Established in high-income countries, many suicides occur impulsively in times of crisis with a loss of ability to cope with life stresses, such as problems, relationship breakdown, or chronic pain and illness. Additionally, experiencing conflict, disaster, violence, abuse or loss and feelings of isolation are strongly associated with suicidal behavior. Suicide rates are also high among vulnerable groups experiencing discrimination, such as refugees and migrants, indigenous populations, gay, lesbian, bisexual, transgender, intersex (LGBTI) people, and prisoners.
• https://forcedsuicidedomesticviolence.eu/en-europe/ is undoubtedly a low rate compared to, for example, the South-East Asia region (as defined by the WHO) based on the mortality data in our possession and the cultural contexts that we perceive even more unfavorable to women’s rights.

Remarks : 

• – Belgium is the EM most affected by the phenomenon of suicides among women with a standardized rate of 9.51 per 100,000. France with a rate of 5.86 is slightly above the average (4. 96).
• – The variability of this rate is significant between the different MS, since Belgium has a rate more than 8 times higher than the rate of Cyprus.