Macro-level mental health system indicators and cross-national suicide rates

Abstract

Background The relationship between macro-level mental health system indicators and population suicide rates is an area of contention in the literature, necessitating an analysis of current cross-national data to document any new trend in the relationship. Objective This study investigated whether mental health system indicators are associated with national suicide rates. Method Using an ecological study design and multivariate non-parametric robust regression models, data on suicide rates and mental health system indicators of 191 countries retrieved from WHOs 2017 Mental Health Atlas were compared. Results Findings revealed that the average suicide mortality rate was significantly higher in high- income countries, relative to low-income countries. High-income countries are significantly more likely to have high number of mental health professionals, mental health policies and legislation, independent mental health authority and suicide prevention programs. These mental health system indicators demonstrated significant and positive association with suicide, suggesting that countries scoring high on these factors have higher odds of being categorized as high suicide risk countries. Conclusion The findings have several implications for policy and practice, including the need to make existing mental health systems very responsive to suicide prevention.

Systematic review of suicide prevention studies with data on youth and young adults living in low-income and middle-income countries

“…[93][94][95][96] Further, legal systems that criminalise suicidal behaviour may deter suicidal individuals from seeking care and obstruct the collection of data that are essential for understanding local drivers of suicide and crafting culturally-guided, evidence-informed prevention strategies. 97 Situation analysis by public health professionals, policymakers and other stakeholders is an essential step for determining the optimal approaches to suicide prevention for a given culture and context. 12 The global proliferation of mental health applications, the internet and internet-connectable devices may offer a way to reach more youth globally than previously possible.…”

“…Limitations on healthcare resources that are more evidenced in LMIC, such as barriers to health information exchange, smaller workforce levels, fewer professionally trained mental health providers and limited mental health system governance, also affect the resources available for the identification, treatment and support of people in crisis 93–96. Further, legal systems that criminalise suicidal behaviour may deter suicidal individuals from seeking care and obstruct the collection of data that are essential for understanding local drivers of suicide and crafting culturally-guided, evidence-informed prevention strategies 97. Situation analysis by public health professionals, policymakers and other stakeholders is an essential step for determining the optimal approaches to suicide prevention for a given culture and context 12…”

Affect in anticipation of the 2020 U.S. presidential election in a sample of Latinx adults living on the U.S.–Mexico border: A daily diary study.

“…Macrolevel factors impact the health, well-being, and development of individuals, as highlighted by the bioecological theory of human development (Bronfenbrenner, 1979;Bronfenbrenner & Morris, 1998) and other studies showing the influence of macrolevel factors on individuals' well-being and mental health (Andoh-Arthur & Adjorlolo, 2021;Elia et al, 2020;Ottova et al, 2012). Biological Systems Theory (Bronfenbrenner, 1977) conceptualizes factors of influence as ranging from the more proximal (microsystem: closest to the individual that the individual has direct contact with) to the more distal (macrosystem: cultural environment including economic, social, and political systems) and emphasizes interactions between levels as essential in understanding individual development.…”

The engaged community action for preventing suicide (ECAPS) model in Latin America: development of the ¡PEDIR! program

“…It is estimated that someone dies by suicide every 40s globally and that 3000 people end their lives daily [ 1 ]. However, it is important to note that even this rate is considered a significant underestimate due to a lack of reporting due to structural stigma resulting from cultural and religious attitudes and beliefs, legal consequences related to suicide, variance in the manner in which deaths are recorded across countries in terms of cause and method (i.e., asphyxia versus hanging), and overall absence of a system for registering deaths by suicide [ 2 ]. In addition to barriers related to accessing mental health care, other community-level challenges in these settings include extreme poverty, food insecurity, inadequate housing and educational and employment opportunities, to name a few.…”