10^th September 2012 sees the tenth anniversary of the first World Suicide Prevention Day, with this year's theme: Suicide Prevention across the Globe: Strengthening Protective Factors and Instilling Hope.

Few people are aware of the global extent of suicide. Data from the World Health Organisation (WHO) indicates that each year a million people around the world take their own lives. This equates to one death every forty seconds. Probably three people will have died this way since you started reading this article.

Suicide is one of the leading causes of death in the world and in some countries, in recent years, suicide rates have risen by as much as 60%. In addition a great many people try to commit suicide but are unsuccessful; it is estimated that the number of unsuccessful suicide attempts outnumber successful attempts by about 20 to one.

It is thought that published suicide rates could actually be much higher than reports suggest. Many single car, single driver road accidents, unwitnessed drownings and other undetermined deaths are thought to be the result of suicide, but are not reported as such. Often this is due to religious concerns or social attitudes.

In addition there are often financial issues associated with self-inflicted death or injury. The associated economic costs of this are estimated to be in the billions of US dollars a year.

Suicide is no respecter of age. Starting in childhood, its frequency rises steeply through middle to late adolescence and into adulthood. Among 15 to 19-year-olds, after accidents, suicide is the second cause of death worldwide; at least 100,000 members of this age-group die as a result of suicide each year.

Suicide rates are high among the adult population, with the highest rates among those aged over 75. Elderly people are likely to have a stronger motivation and tend to use more lethal methods than those used by younger people, so their success rates are usually higher.

As a general rule across all age groups in every country of the world there are about three male suicides for every female suicide, although the rates for suicide attempts in women are two to three times higher than in men. One of the reasons for a higher success rate among men is that they tend to use more lethal methods and have a greater desire to die.

It is difficult to be precise as to prevalence rates in different countries of the world, simply due to lack of reliable data. For instance, the best-documented rates come from Eastern European countries, while documentation is lowest in Central and Southern American countries. The United States, Western Europe and Asia fall into the middle range, but for some African and South-East Asian countries, no data is available at all.

One of the best ways of preventing potential suicide is to identify those who are at most risk.

The strongest predictor is a history of previous suicide attempt or self-harm. There is a 30 to 40 times greater chance of suicide among this group than among members of the general population. About half of those who seriously consider suicide have been diagnosed with some kind of mental disorder during their lives.

Depressive disorders and substance-related disorders, schizophrenia and personality disorders are all major contributors. Alcohol and drug abuse are also important risk factors for suicidal thoughts and behaviours.

Stress brought about by events in a person's life such as family conflict and relationship breakdown can diminish capacity to cope. Economic crisis and unemployment, bereavement and serious illness can all be major contributors.

Every suicide is one too many, but it is important not to get things out of proportion. Although the numbers of attempted and successful suicides are high, the numbers of those who never contemplate such action are infinitely greater.

Most people have the ability to cope with the adverse events that life can throw at them. This is known as resilience. A major protection against the development of suicidal tendencies is a sense of personal self-worth and self-confidence. Problem-solving skills and adaptive help-seeking behaviour can add to the personal armour of protection.

Social and cultural factors also provide a level of protection. These might be religious, or simply some form of social connection, bringing good relationships and support from friends, neighbours and colleagues at work. A healthy lifestyle, a good diet, regular physical activity and a good sleep pattern are all associated with a reduced risk of suicidal behaviour.

The best way to minimise suicide is the early identification of high-risk individuals. More than half of the patients who die by suicide will have seen their primary care physician (their GP) within the previous month. It is therefore important for GPs to be able to recognise the signs and symptoms.

It is also important that people who regularly come into contact with distressed families and individuals, such as clergy, first responders, pharmacists, teachers and police are able to recognise the risk of suicide and self-harm and facilitate the referral of these people for appropriate assessment and treatment.

Often the people who take their own lives do not really want to die, but to them all avenues have been explored and everything has become so hopeless that the termination of life appears to be the only answer.

Most of us never feel that way. To us life is precious and is not something that should be squandered away. However, there are many unhappy people in the world who are prepared to take their own lives. The onus is on us to be vigilant and to be ready to provide support as and when it is needed.

Over 3,000 people around the world have indicated that they will be participating in World Suicide Prevention Day, endeavouring to raise awareness of this wasteful loss of life.

To keep the issue in the forefront of people's minds, the organisers have issued a worldwide invitation to put a lighted candle near a window at 8.00 pm local time on 10^th September to commemorate all those who have died and who continue to die as a result of suicide.