Pakistan is an Islamic country where religion is considered an important protective factor against suicide. Recent research and media reports identify that suicide and self harm behaviours are increasing in different parts of Pakistan.

To inform public policy debate and suicide awareness education interventions.

To study socio-cultural, political, interpersonal and religious factors that can influence suicide and suicide awareness.

Systematic search of Medline, Embase, PsychInfo, CINAHL, Pakmedinet, TRIP, and electronic searches of Pakistani Medical Journals, using terms Suicide, Self harm, Deliberate Self Harm, Self Poisoning, Non-Accidental Deaths, Undetermined Deaths. Focus Group Discussion, Aga Khan Medical University, Pakistan Consultation with experts in the field.

1. a. Epidemiological evidence confirms an increase in suicide rates with variable figures reported from different parts of Pakistan. Higher rates of suicide rates are reported for men with an association with unemployment and mental health problems. Marital Discord and domestic violence identified as risk factors in female suicides.

2. b. Religion is continued to be identified as an important protective factor against suicide.

However, Pakistan's legal system that criminalizes suicide and self harm is criticized for exercising negative influence through preventing early identification of high risk individuals. A variable pattern of suicide reported from different parts of Pakistan identifies the need for deep cultural understanding and examination of protective and risk factors that operate with in family structures and sub-cultures in Pakistan.

An increase in suicide rates in Pakistan has raised mental health and public policy awareness.