Geographic Distribution of Suicide in Kavrepalanchok District, Nepal: A Retrospective Study

Background Suicide remains one of the oldest and most pressing public health challenges, causing profound emotional, psychological, and social trauma for affected families and communities. Common contributing factors include psychological disorders, marital and family disputes, and financial difficulties influenced by geography, gender, and socioeconomic status. While causes may vary, hanging remains the most prevalent method of suicide, followed by poisoning. Objective To examine the geographic and sex-wise distribution of suicide cases and identify high-burden municipalities in Kavrepalanchok District, based on medicolegal autopsies performed at Dhulikhel Hospital from 2nd November 2020 to 13th April 2023. Method A retrospective cross-sectional study was conducted at the Department of Forensic Medicine, Kathmandu University School of Medical Sciences, Dhulikhel. All suicide cases brought for medico-legal autopsy between 2nd November 2020 and 13th April 2023 were included in the study. These individuals were either deceased at the scene or passed away during treatment at the hospital. Cases with an unclear history of suicide or those involving decomposed or skeletonized bodies were excluded. Data were analyzed descriptively using Microsoft Excel and R version 4.4.3. Result A total of 697 autopsies were conducted over a three-year period, of which 468 (67.14%) were identified as suicide cases. Among these, 235 (33.71%) were from outside Kavrepalanchok, and 233 (50.43%) were from within the district. Hanging was the predominant method, accounting for 75.74% of cases overall. Males consistently accounted for a higher proportion of suicides (overall 61.36%) across all three years. An increasing trend in suicide cases was observed over the years, particularly with a rising proportion of suicides due to hanging. The highest number of suicides within the district was reported in Panchkhal municipality (n=32), suggesting a geographic concentration of cases. Conclusion The observed increasing trend in suicide cases over the three-year period, especially among males and through the method of hanging, highlights a significant public health concern. Targeted and coordinated interventions from both government and community stakeholders are essential to mitigate this growing burden.