Suicide is a multifaceted and complex social problem, influenced by a web of psychological, social, and cultural factors, with low- and middle-income countries (LMICs) bearing the highest burden, accounting for 77% of global suicides ( World Health Organization, 2021 ). In high-income countries like South Korea and Japan, issues such as isolation, long working hours, and mental health stigma are often linked to sociologist Émile Durkheim’s concept of “egoistic suicide,” where individuals feel disconnected from their social community ( Durkheim, 1951 ). In contrast, LMICs like India and Sri Lanka experience suicides driven by social and economic stressors, such as poverty, gender-based violence, and cultural taboos, often aligning with Durkheim’s “fatalistic” suicides (resulting from excessive oppression) or “anomic” suicides (stemming from disrupted social norms) ( Vijayakumar, 2015 ).

A critical phenomenon in suicide research is social contagion, defined as the process by which exposure to suicidal behavior—through peers, family, community, or media—increases the likelihood of suicidal thoughts or actions in others, particularly among vulnerable groups like adolescents ( Gould et al., 2003 ). Social contagion operates through mechanisms such as imitation, normalization of suicidal behavior, or heightened emotional distress triggered by exposure, often amplified in close-knit communities or through social learning processes ( Joiner, 2005 ; Blumer, 1969 ). In the context of this study, social contagion is operationalized in the link between two adolescent boys in Jhenaidah (Cases 9 and 10). Case 9 involves a 14-year-old boy who died by suicide after his father refused to purchase a motorbike, a symbol of peer status. In Case 10, a 15-year-old friend, aware of this incident, threatened suicide to coerce his parents into buying a motorbike and subsequently died in a reckless motorbike accident. The connection between these cases illustrates social contagion, as the first boy’s suicide likely modeled suicidal behavior as a response to unmet material aspirations, influencing the second boy’s threat and risk-taking behavior, which was shaped by cultural symbols (e.g., the motorbike) and peer dynamics in a collectivist setting ( Gould et al., 2003 ; Jordans et al., 2014 ).

Thomas Joiner’s Interpersonal Theory of Suicide further complements this understanding, suggesting that feelings of thwarted belongingness, perceived burdensomeness, and acquired capability for self-harm drive suicidal behavior ( Joiner, 2005 ). Feminist scholars add that women in patriarchal structures face heightened risks due to social comparisons and gender-based oppression, often aligning with fatalistic suicides ( Canetto & Sakinofsky, 1998 ). These perspectives collectively provide a robust framework for understanding the diverse global forces behind suicide, including the role of social contagion in amplifying risk within specific cultural and social contexts.

While the suicide rate in Bangladesh is between 7 and 10 per 100,000, this statistic is likely an underrepresentation, given the stigma and potential illegal status of suicide ( Arafat, 2019 ). Young adults and women aged 15 - 29 are among the most affected groups, often due to pressures stemming from patriarchal cultures, tensions in families, and intense academic pressures ( Khan et al., 2021 ). Moreover, in pre-dominantly rural areas, such as Jhenaidah, the intertwined, collectivist culture may inflate small disputes over family issues or relationships to more substantial disputes, which, again, can be trigger for suicide ( Urme et al., 2023 ).

Jhenaidah District in southwestern Bangladesh stands out as a suicide hotspot, with rates far exceeding national figures, driven by localized socioeconomic pressures amid broader national vulnerabilities. Between 2010 and 2018, Jhenaidah recorded an average suicide rate of 20.6 per 100,000 population—over three times Bangladesh’s estimated 6 - 7.3 per 100,000 ( World Health Organization, 2016-2021 )—translating to roughly 300 annual deaths locally versus 10,000 - 11,000 nationwide ( Khan et al., 2020 ; Mashreky et al., 2013 ). Attempt rates in Jhenaidah were even more stark at 136.35 per 100,000, compared to a national prevalence of 3.88% (2010-2016), rising to 4.29% by 2017-2023 ( Shuvo et al., 2025 ).

In Jhenaidah, females comprised 60% - 70% of victims (rate: 22.7/100,000 vs. 17.7 for males), linked to marital abuse and economic dependence, mirroring Bangladesh’s female predominance in completions ( Arafat, 2019 ; Khan et al., 2020 ). Age demographics overlap, with most victims aged 11 - 30 (mean ~26.7 years nationally ( Arafat, 2019 ), though Jhenaidah’s youth burden is amplified by academic stress and unemployment.

Methods like poisoning (77% in Jhenaidah) and hanging predominate in both, but Jhenaidah’s rates persist post-2018 due to unique risks—poverty, substance abuse near the Indian border, and interpersonal conflicts—exacerbated by COVID-19, where local cases surged alongside a threefold national rise in student suicides ( Mamun et al., 2022 ; Bhuiyan et al., 2023 ). Nationally, underreporting (2 - 3x due to stigma and criminalization) hampers surveillance, but Jhenaidah’s crisis underscores the need for targeted interventions beyond broad calls for mental health integration ( Arafat & Khan, 2023 ; Faruk et al., 2025 ).

Hence, in culturally entwined worlds, there exist people who believe their act to take their own life would be an emotional distress to those who still have affection for themselves, and this is based on people who come from an entwined type of family life. However, at the same time, an entwined world in which suicides themselves are glorified can now present social contagion ( Mashreky et al., 2013 ). Secondly, less access to mental treatment services and stigmas in Islamic Cultural understandings of mental health can present restraints which engender feelings of isolation ( Arafat & Khan, 2023 ).

Jatava provides a comprehensive understanding on suicide as an act of humanity situated halfway between existential despair, emotional distress, and institutional constraint. Jatava attacks philosophers like Albert Camus who pose suicide as the intellectual question but insists on going one better in saying psychological and sociological explanations do not run to it. Jatava proposes there almost inevitably in suicides is present a conflict between outside (problems in family, expectations of society) and inside (despondency) elements functioning as the colluding force at suicidality’s core. Jatava’s comments have certain purchase in areas such as Jhenaidah in which even minor grievances—such as dowry or poor academic achievement—enhance existential dimensions in cases to points at which lethal situations develop. His seemingly parallel comment drawn from life based in this Indian region points to degree to which collectivisms and patriarchal arrangements can aggregate even minor grievances to causes of dying or suicidality. Jatava points out to better education, understanding, and watchfulness from others in the community will help subjects improve their situation. Such thinking around improving education, understanding, and watchfulness would be a viable explanation for suicides, in tandem with the positive theories offered in this study, and suggest an avenue towards a better future ( Jatava, 1999 ).

The Interpersonal theory of suicide authored by Thomas Joiner (2005) establishes a structure for understanding how and why someone may consider dying by suicide. Joiner proposes that an individual is at a heightened risk of attempting or dying by suicide if, and only if, they experience the presence of three constructs at once: Thwarted Belongingness—the experience of deep psychological pain, feeling disconnected, and not belonging or having important, emotional relationships with others. The deep need for human connection is noted in studies of attachment as well as multidisciplinary studies within the field of social psychology ( Baumeister & Leary, 1995 ). Perceived Burdensomeness—a painful belief as to the degree of shame, failure, and worthlessness of one’s existence and how they may perceive themselves as a burden to others. At this level, an individual may believe that the world will be a better place without them ( Beck, 1979 ).

The model developed by Joiner assists the explanation of how these states of being (especially when equivocated with means to potentially terminate their life) can indeed result in acts of suicide ( Van Orden et al., 2010 ). The model expands the opportunity to think about the emotional and narrative nature of grieving in Jhenaidah, where disconnection and shame are the prevailing narratives. Joiner’s Interpersonal Theory of Suicide also holds utility in terms of cognitive mapping towards understanding how the individual constructs self-perception that support the notion that maladaptive habits contribute to distress with death as its destination ( Beck, 1979 ).

Acquired Capability (overcoming instinctive fear of death): this is an extension of a process that occurs when one is exposed to painful or fear-inducing experiences on repeated occasions, such as suicide attempts, self-harming bodies, and others who died by suicide. This conceptualization of acquired capability is predicated on theories of habituation and desensitization ( Joiner, 2005 ). Joiner argues that suicidal desire must have “frustrated belongingness” and “perceived burdensomeness”, while acquired capability represents a transition from intention to action. Overall, Joiner’s Interpersonal Theory of Suicide was developed in the Western context, particularly in clinical populations but could also stress the individual psychological processes ( Van Orden et al., 2010 ).

Émile Durkheim’s ( Durkheim, 1951 ) sociological theory theorizes four categories of suicide related to levels of social integration (connection to society) and normalization (control to conduct):

Egoistic Suicide: Associated with low social integration, individuals do not feel connected to social groups. It is frequently observed in individualistic societies where social bonds are greatly weakened.

Anomic Suicide: Associated with low social regulation, which occurs when disrupted norms (e.g., during economic crises) create uncertainty and give rise to despair, which leads to suicide.

Altruistic Suicide: Found with high social integration, and arise when individuals sacrifice themselves for the good of the collective. This type of suicide is most often found in tightly knit, collectivist societies.

Fatalistic Suicide: Individuals have odd levels of control and repressive social norms, and there will be an absence of agency behavior and elective freedom. This kind of suicide will have a tendency to involve repressive treatment of fringe elements.

Durkheim’s theory explicates structural and societal factors as more relevant than individual psychology, and thus suicide rates reflect the balance of levels of integration and regulation and risk in their respective sociocultural contexts ( Durkheim, 1951 ; Stack, 2000 ). It has also been used in contexts, and increases our understanding of cultural and structural implications of differences in suicide around the world, including geographic regions ( Stack, 2000 ).

Symbolic Interactionism, developed by George Herbert Mead (1934) and Herbert Blumer (1969) , posits that individuals construct meaning through social interactions, with symbols (e.g., language, cultural norms) shaping self-perception and behavior ( Mead, 1934 ; Blumer, 1969 ). Blumer’s three principles are: 1) Meaning: Individuals act based on the meanings they assign to objects, events, or roles. 2) Interaction: Meanings are constructed and negotiated through social interactions. iii. Interpretation: Individuals interpret and modify meanings through personal experiences. Applied to suicide, symbolic interactionism explores how stigmatizing interactions construct suicidal identities, influencing behavior ( Scourfield et al., 2010 ). The theory emphasizes micro-level processes, focusing on the dynamic interplay of self and society.

Feminist theory, as articulated by Judith Butler (1990) and Kimberlé Crenshaw (1989) , examines how patriarchal power structures shape social phenomena, particularly women’s vulnerabilities ( Butler, 1990 ; Crenshaw, 1989 ). Butler’s concept of gender performativity argues that gender norms are socially constructed through repeated performances, constraining individual agency. Crenshaw’s intersectionality highlights how gender interacts with other marginalizations (e.g., class, ethnicity) to produce unique experiences of oppression. Applied to suicide, feminist theory explores how patriarchal norms increase women’s suicide risk, particularly in contexts of gender-based oppression ( Canetto & Sakinofsky, 1998 ).

Four different frameworks help us to examine the complex causes of suicide in Jhenaidah, Bangladesh, that involves an individual’s experience of pain combined with some form of social pressure.

Joiner’s Interpersonal Theory explains the viability of suicide as a result of feeling like a burden or feeling disconnected from others, in combination with exposure to others who suicide ( Joiner, 2005 )—echoing Jatava’s characterization of suicide as a “cry of despair” ( Jatava, 1999 ).

Durkheim’s Sociological Theory outlines how a person feels pressured to comply with expectations of a closely knitted community, resulting in “altruistic suicide”. In contrast, social or economic dislocation leads to “anomic suicide”—crushing the human spirit, as noted by Jatava ( Jatava, 1999 ; Durkheim, 1951 ).

Symbolic Interactionism helps us to understand how labels of “failure” are created by gossip and maligned family dynamics ( Blumer, 1969 ) to create a “suicidal identity”. This also complements remark regarding suicide as symbolic in kind ( Jatava, 1999 ), and controversies related to suicide contagion in communities in Jhenaidah.

Feminist Theory, or forces acting upon individuals, and in this case, especially upon females, who live in patriarchy provides an especial condition of risk for suicide ( Butler, 1990 ). Feminist Theory also fits Durkheim’s account of “fatalistic suicide,” and symbolic interactionism fits the process of being labeled.

What makes these models strong is they interlock. Joiner’s theory of “acquired capability” fits in between the symbolic interactionist view of tales of community normalizing suicide and also stoked by Durkheim’s text on social isolation and normlessness in high-risk social systems. Feminist theory makes it even more complicated by showing us how women live through these dynamics and oppression and stigma of labelling. Jatava’s philosophical framework brings all these viewpoints in harmony and leads us to think about suicide in Jhenaidah as a horribly tragic consequence of turbulent interplay of personal suffering and social forces encouraging us to think compassionately and practically about support of intervention.

This qualitative study employed a case study design to explore ten incidents in Shailkupa, Jhenaidah—nine suicides and one accidental death connected to suicide—selected to capture the multidimensional nature of suicidal behavior in a rural, high-risk context. The inclusion of the accidental death (Case 10), involving a 15-year-old boy who died in a motorbike accident after threatening suicide, was justified by its theoretical relevance to the study’s frameworks, particularly Joiner’s Interpersonal Theory of Suicide and symbolic interactionism. The case exemplifies suicide contagion, where exposure to a peer’s suicide (Case 9) modeled suicidal behavior as a coercive tool, and reflects Joiner’s concept of acquired capability through risk-taking behavior desensitizing the individual to harm ( Joiner, 2005 ). Additionally, symbolic interactionism highlights how the threat and subsequent accident were shaped by cultural symbols, such as the motorbike representing peer status, aligning with the study’s focus on socially constructed meanings ( Blumer, 1969 ). Each case, including the accidental death, was analyzed by integrating Jatava’s philosophical stance with Joiner’s, Durkheim’s, symbolic interactionist, and feminist theories to propose a comprehensive, multidimensional approach to understanding suicide in Jhenaidah ( Jatava, 1999 ; Joiner, 2005 ; Durkheim, 1951 ; Blumer, 1969 ; Crenshaw, 1989 ).

Data were collected between January and December 2023 in Shailkupa, a rural sub-district with high suicide rates, using the following methods:

Case Studies: Ten incidents were identified through local health records, police reports, and community informants, who were purposively selected based on their knowledge of the cases or roles as village leaders, healthcare providers, or neighbors familiar with the victims’ families. Informants were identified through initial consultations with local health officials and police, ensuring relevance to the study. Informed consent was obtained verbally, with participants provided clear explanations of the study’s objectives, confidentiality measures, and their right to withdraw at any time. Family accounts were gathered through semi-structured interviews with immediate family members (e.g., parents, spouses, or siblings) in private settings to minimize emotional distress, or indirectly via community informants with family permission when direct interviews were not feasible. All data were anonymized to protect privacy, and participants were offered access to local counseling resources to address potential emotional distress, acknowledging the stigma of suicide in Bangladesh.

Document Analysis: Local health reports, academic studies, and regional media were reviewed to contextualize the cases and ensure data triangulation.

Cases were purposively selected to reflect diversity in age (11 - 70 years), gender, and suicide methods (pesticide ingestion, hanging, drowning). Questionnaire participants were recruited via snowball sampling, targeting residents of Shailkupa’s rural and semi-urban areas.

Data were analyzed using a thematic approach:

Case Studies: Each incident was coded for triggers (e.g., rejection, abuse), contextual factors (e.g., patriarchy, economic strain), and theoretical constructs (e.g., thwarted belongingness, fatalistic suicide).

Philosophical Integration: Jatava’s concepts of existential despair and agency were applied to interpret individual motivations, bridging psychological and societal dimensions ( Jatava, 1999 ).

All data were anonymized, and pseudonyms were used for case studies. Participants discussing sensitive topics (e.g., domestic violence) were provided access to local counseling resources. The study adhered to ethical guidelines for research involving vulnerable populations, ensuring confidentiality and voluntary participation.

Case 5 involves a 28-year-old housewife who died by pesticide ingestion following domestic violence triggered by a delayed meal. This incident exemplifies the simultaneous interplay of Durkheim’s fatalistic suicide, Joiner’s perceived burdensomeness, and feminist theory’s gendered oppression, woven together by Jatava’s philosophical lens of existential agency.

This integrated analysis of Case 5 demonstrates how Durkheim’s fatalistic suicide, Joiner’s perceived burdensomeness, and feminist theory’s gendered oppression converge to explain the woman’s tragic outcome. The collectivist, patriarchal culture of Jhenaidah amplified her sense of entrapment and failure, while the availability of lethal means enabled her act, reflecting a lethal interplay of social, psychological, and cultural factors ( Hossain et al., 2022 ; Wu et al., 2012 ).

The remaining cases similarly reflect the interplay of these frameworks, though with varying emphases:

The integration of Jatava’s philosophy and the theoretical frameworks provides a multidimensional understanding of the Jhenaidah incidents: