Modelling Suicide Mortality in Kerala (2018–2022): A Multi-Dimensional Statistical Analysis of Demographic and Spatial Determinants

Kerala, despite its strong health and social development indicators, continues to report one of the highest suicide rates in India, indicating deep-rooted socio-demographic and spatial vulnerabilities that are not captured by aggregate statistics. This study examines suicide mortality in Kerala from 2018 to 2022 using a multi-dimensional statistical framework integrating temporal, demographic, and spatial analyses. Suicide data were obtained from the state vital registration systems, and district-wise population estimates were generated using cubic spline interpolation to compute suicide rates per 100,000 population. Descriptive statistics and inferential methods were employed, including the Mann–Kendall test for temporal and age-stratified trends, Welch’s two-sample t-test for gender-based differences, and Chi-square tests for associations between religion and residence type. Results reveal a statistically stable monotonic trend at the state level, alongside a sharp post-2020 escalation in population-adjusted suicide rates, rising from 14.66 per 100,000 in 2020 to 20.94 in 2022. Suicide mortality is overwhelmingly male-dominated (≈80%, p < 0.001), predominantly rural (≈80%), and spatially concentrated in southern and central districts such as Kollam, Thiruvananthapuram, and Thrissur. Middle-aged and elderly populations account for the largest share of suicides, though age-specific trends remain statistically stable. A strong association between religion and residence type (p < 0.001) highlights the role of socio-spatial context rather than religious affiliation alone. Overall, the findings demonstrate that suicide in Kerala is a persistent, demographically skewed, and geographically heterogeneous public health challenge, calling for district-specific, gender-sensitive, and rural-focused mental health interventions supported by strengthened surveillance and predictive modeling frameworks.