Suicide is the third leading cause of death in young people. It accounts for more than 150 000 deaths each year worldwide, most of which occur in low and middle income countries (LMICs).1 Concerningly, youth suicide rates seem to be rising in many countries, including in the UK.2 In India and China, which together account for around a third of the world’s youth population, previously downward trends appear to have reversed.34Interpreting these trends is complex. Suicide data can be affected by numerous biases,1 and ecological studies, which examine exposures and outcomes at the group or population level and are fundamental to assessing population level drivers of suicide trends, have methodological limitations.5 Nonetheless, the global pattern of rising youth suicide rates warrants explanation.234Suicide related research has typically prioritised mental illness as a key determinant.26 However, for youth suicide prevention strategies to have the greatest global impact, it is essential to understand…

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