NYAPRS Note: Efforts to link social determinants of health with critical health outcomes is starkly highlighted by a recorded high rate of avoidable suicides since 2008. Poverty, unemployment, housing instability, food insecurity, shifting geographies of capital, and adverse experiences in families and communities all contribute to risks in suicidality. Making suicide a “never event”, a strategy of advocates and policy makers intent to prevent it, is not just about early intervention and service access but about societal changes that remove shocks and stressors to an individuals’ resilience. A fundamental mental health crisis is at the heart of the rise in suicides, but it is not just about treatment. Our state and national policy makers must take initiative to broadly move health and economic strategies forward in the same direction.
Study Finds Great Recession Linked with more than 10,000 Extra Suicides in the EU and US
NewStatesman; Ajit Niranjan, 6/16/2014
Economic hardship is characterized by loss of jobs and homes, a big influence on mental health. Photo: Getty
New research � from the University of Oxford and the London School of Hygiene and Tropical Medicine � has linked economic instability from the recent recession to an increase in suicide mortality in the Western world. The authors estimate that “the Great Recession is associated with at least 10,000 additional economic suicides between 2008 and 2010.”
Suicide rates had been steadily declining in Europe since the start of the century. The paper studied data from 24 EU member states (in addition to the US and Canada) and observed that the onset of the global financial crisis in 2007 coincided with a reversal of this downward trend. Since economic hardship is characterized by loss of jobs and homes, and is often accompanied by mental health issues such as depression and anxiety, suicide rates appear to be an awful but revealing proxy for a nation’s wellbeing.
By comparing the baseline suicide rate with the post-collapse rates, the authors estimated “a total of 7,958 excess suicides” occurred in Europe over the two year period 2008-2009, in addition to 3,415 in Northern America. Worse, lead researcher and sociologist Aaron Reeves suggested that many of these extra suicides were “potentially avoidable”.
He found that countries plagued by similar economic disruption had “marked” differences in suicide levels. Sweden, Finland and Austria were highlighted for maintaining constant suicide rates in spite of economic instability, for example, which the study authors theorised might be due to high investment in “work-based-learning” programmes.
“This study shows that rising suicides have not been observed everywhere, so while recessions will continue to hurt, they don’t always cause self-harm,” said Reeves. “A range of interventions, from return to work programmes through to antidepressant prescriptions, may reduce the risk of suicide during future economic downturns.”
However, as with any larger trend, smaller, important details may be hidden. For example, the study found that “most suicides occur among people with clinical depression” and the NHS identifies mental health and unemployment as key factors influencing suicide rates. Both of these are known to have soared during the recession, but the precise mechanism linking recessions and suicides is yet to be discerned.
This study in New Zealand that examined whether unemployment caused suicides directly (“by increasing the impact of stressful life events”) or indirectly (“by increasing the risk of factors that precipitate suicide”) was inconclusive. Despite stressing a clear link between unemployment and suicide, the authors stressed “it is unclear whether this association is causal.”
Lead researcher Dr Tony Blakely noted: “Being unemployed was associated with a twofold to threefold increased relative risk of death by suicide, compared with being employed. About half of this association might be attributable to confounding by mental illness.”
This explains the caution with which the Oxford researchers presented their findings. The Great Recession is “linked” to 10,000 suicides, but didn’t necessarily cause them. Further research will be needed to establish causation and examine other factors, such as access to means of self-harm and availability of guns.
Despite these limitations, co-author David Stuckler warned of the implications of the study. “Suicides are just the tip of the iceberg. These data reveal a looming mental health crisis in Europe and North America. In these hard economic times, this research suggests it is critical to look for ways of protecting those who are likely to be hardest hit.”