I remember when suicide statistics in Malta were zero. I am not that old.­

In the Catholic tradition suicide is judged as a sin. As a consequence, the Church never used to allow suicide victims to be buried in the main Catholic cemetery. They had to be buried with the foreigners, in unconsecrated land. So it is surprising to learn that recently Malta has started reporting an increase in the number of suicides.

A new study shows that since 2005 some 302 people committed suicide in Malta. This year alone, 18 suicides have already taken place with the highest rate being for middle aged, those aged 40 to 59.

Suicide is an unspoken pandemic and varies by country, income, gender, age and ethnicity. These factors all play a role. With countries that top the suicide rates being so diverse it seems to be an erratic malady. Guyana in South America, followed by countries of Eastern Europe, Japan and South Korea, Europe – with Belgium leading the continent – are all top suicide clusters in the world, with the US ranking 50th and Malta being 109th in a list of 170 countries.

What is perplexing and worrying is that international suicide statistics report that rates have increased by 60 per cent in the past 45 years.

It is not that we are entering a new dystopian world, but that we are erasing the progress we made since the 1980s. The same story repeats itself in Malta. In 2014, Finnish medical researchers Samuli Helama, Jari Holopainen and Timo Partonen wrote an interesting article about suicides in Malta. The authors found that, historically, suicide was considerably low in Malta but it has increased dramatically since the 1980s. So much so that during 2000-2009 Malta was the only country in Europe to show an increase in suicide among men.

Despite these increases, in real terms, suicide in Malta is one of the lowest in Europe. However, in trying to understand this increase, it is difficult to deal with historical data without knowing the sociological changes Malta has undergone.

Only by addressing the complex problems can we diminish the threat of suicide. This is not happening and suicide will continue to rob us of our most vulnerable sensitive humans

The authors forget to factor in that in a Catholic country, suicide is not only a statistical issue but also a moral one. Knowing this, most Maltese are not surprised to learn that there was not one single female suicide in the 1950s and 1970s. It is likely that the distraught parents or spouse would implore the doctor and priest to write a natural cause of death. Doing so will deflect shame on the family and allow the victim to be buried in the family plot at the Catholic cemetery. Malta is a small community where social norms are important.

Such a social interpretation of suicide is not new. Considering that the first real academic study of suicide was by the father of sociology, Emile Durkheim, who wrote Suicide in the late 1897. Durkheim saw suicide as a normal reaction to an abnormal feeling of detachment and rejection from society. More recently, Ben Fincham, a sociologist with the University of Sussex, has argued that the question is not why people commit suicide but to look at social factors that “contribute to people feeling as though they wish to die”.

But there is not one cause of suicide, there is not even a cluster of causes. We do not have enough data in Malta to start understanding these trends. But we have data from the US among other countries. The causes are different for gender, income, age and opportunity. For every successful suicide there are some 25 failed attempts. Men are four times more likely to commit suicide then women, although again, women attempt suicide three times more often than males. Attempted suicide varies considerably by age as well. It seems that becoming older makes you more adept at carrying out an effective suicide.

For younger people, for every suicide there are 25 attempts, while for older adults, four attempted suicides result in one death. These are pleas for help, and with older adults there are fewer muted shouts for help.

There are other subdued actions for help before a suicide attempt. More than half of older adults visit their doctor a month before committing suicide, a third visit just a week before. Knowing that potential suicide victims feel alienated and unwanted does not provide us with a magic wand to make that pain go away. For men it is different than for women, for younger different than for older adults. Men older than 75 have the highest rate of suicide among any other age group. We understand that old adults might see suicide as an end to ongoing mental and physical pain and anguish.

Despite this understanding, we continue to fail to address suicide because our clinical and social services are still treating it as one problem. Instead, we need to start addressing suicide as an untenable solution to series of complex problems. We tend to assess the individual and whether they will benefit from the treatment we have available rather than to diagnose – and therefore understand – their disease. Only by addressing the complex problems can we diminish the threat of suicide. This is not happening and suicide will continue to rob us of our most vulnerable sensitive humans.

For help, call Aġenzija Appoġġ’s 179 supportline, Crisis Resolution Malta on 9933 9966, the online chat service for youths called Kellimni and the Richmond Foundation’s Casual Contact System on 2144 0324.