© 2014 Hogrefe Publishing Crisis 2014; Vol. 35(2):90–101 DOI: 10.1027/0227-5910/a000244 Research Trends Taking Stock – What Is Known About Suicide in Sri Lanka A Systematic Review of Diverse Literature Melissa Pearson 1 , Anthony B. Zwi 2 , Amanda K. Rouse 3 , Ravindra Fernando 4 , Nicholas A. Buckley 5 , and Duncan McDuie-Ra 6 1 University of New South Wales & South Asian Clinical Toxicology Research Collaboration, Sydney, Australia, 2 Global Health and Development, School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia, 3 South Asian Clinical Toxicology Research Collaboration, Peradeniya, Sri Lanka, 4 Department of Forensic Medicine, University of Colombo, Sri Lanka, 5 Prince of Wales Hospital Clinical School, University of New South Wales, Sydney, Australia, 6 Department of International Studies, School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia Abstract. Background: Suicide is and has been a major public health problem in Sri Lanka and has generated a wide range of literature. Aims: This review aimed to systematically appraise what is known about suicide in Sri Lanka. The patterns and content of articles were examined and recommendations for further research proposed. Method: The paper describes the systematic search, retrieval, and quality assessment of studies. Thematic analysis techniques were applied to the full text of the articles to explore the range and extent of issues covered. Results: Local authors generated a large body of evidence of the problem in early studies. The importance of the method of suicide, suicidal intention, and the high incidence of suicide were identified as key foci for publications. Neglected areas have been policy and health service research, gender analysis, and contextual issues. Conclusion: The literature reviewed has produced a broad understanding of the clinical factors, size of the problem, and social aspects. However, there remains limited evidence of prevention, risk factors, health services, and policy. A wide range of solutions have been proposed, but only regulation of pesticides and improved medical management proved to be effective to date. Keywords: suicide, self-poisoning, systematic review, suicide prevention Background Suicide is a multifaceted problem reflecting the complex interplay of biological, psychological, and sociocultural factors (Maris, 2002). In 2004 the World Health Orga- nization (WHO) estimated that almost 1 million people each year commit suicide (WHO, 2004) and 60% of these deaths occur in Asia (Beautrais, 2006; Bertolote & Fleisch- mann, 2002; Hendin et al., 2008; Mann et al., 2005). How- ever, over 90% of the literature on suicide has been based on studies undertaken in industrialized country contexts (Phillips, 2004; Saraceno & Saxena, 2004). Of the ev- idence that exists on the problem in lower- and middle- income countries (LMIC), many authors have highlight- ed the different context of suicide in settings especially in Asia (Khan, 2002; Phillips, 2004; Vijayakumar, John, Pirkis, & Whiteford, 2005; Vijayakumar, Nagaraj, Pirkis, & Whiteford, 2005). In Sri Lanka, suicide emerged as a major public health problem in the 1990s as the annual incidence rates in- creased from 19.1 per 100,000 in 1970 to a peak of 46.94 in 1995 (Gunnell et al., 2007; Maris, 2002). Sri Lanka is one of a few LMIC in which there exists a diverse litera- ture on suicide, much of it written in the past 15 years. The issue has been analyzed from a wide range of disciplinary perspectives including medical, sociological, cultural, his- torical, as well as a range of sectoral perspectives compris- ing health, agriculture, and development. Systematic Reviews The systematic review of the literature has become an important tool for locating, appraising, and synthesizing available evidence of “what works” (Waters & Doyle, 2002). The dominance of clinical systematic reviews has This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.