The intentional killing of oneself can be evidence not
only of personal breakdown, but also of a deterioration of the social context in which
an individual lives. Suicide may be the end-point of a number of different
contributing factors. It is more likely to occur during crisis periods associated with
upheavals in personal relationships, alcohol and drug abuse, unemployment, clinical
depression and other forms of mental illness. Because of this, suicide is often used
as a proxy indicator of the mental health status of a population.
The World Health Organisation defines suicide as an
act deliberately initiated and performed by a person in the full knowledge or
expectation of its fatal outcome. Data on suicide rates are based on official
registers of causes of death.
Mortality rates are based on numbers of deaths
registered in a country in a year divided by the size of the corresponding population.
The rates have been age-standardised to the 1980 OECD population to remove variations
arising from differences in age structures across countries and over time. The source
is the WHO Mortality Database.
Comparability of data between countries is affected by
a number of reporting criteria, including how a person's intention of killing
themselves is ascertained, who is responsible for completing the death certificate,
whether a forensic investigation is carried out, and the provisions for
confidentiality of the cause of death. The number of suicides in certain countries may
be under-estimated because of the stigma that is associated with the act, or because
of data issues associated with reporting criteria. Caution is required therefore in
interpreting variations across countries.
Suicide is a significant cause of death in many
OECD countries, with almost 150 000 such deaths in 2009. There were fewest
suicides in southern European countries (Greece, Italy and Spain) and in Mexico
and Israel, at six or less deaths per 100 000 population. Suicides rates were
highest in Korea, the Russian Federation, Hungary, and Japan, at more than
19 deaths per 100 000 population. There is a ten-fold difference between Korea and
Greece, the countries with the lowest and highest suicide rates.
In general, death rates from suicide are three to
four times greater for men than for women across OECD countries, and this gender
gap has been fairly stable over time. The exception is Korea, where women are much
more likely to take their own lives than in other OECD countries. Suicide is also
related to age, with young people aged under 25 and elderly people especially at
risk. While suicide rates among the latter have generally declined over the past
two decades, less progress has been observed among younger people.
Since 1995, suicide rates have decreased in many
OECD countries, with declines of 35% or more in Estonia, Luxembourg and Austria.
On the other hand, suicide rates have increased in Korea, Chile, Mexico, Japan
and Portugal, although in Mexico rates remain at low levels, and in Japan rates
have been static since the late 1990s. In Korea and Japan, suicide rates are well
above the OECD average.
In Korea, male suicide rates more than doubled
from 17 per 100 000 in 1995 to 39 in 2009, and rates among women are the highest
in the OECD, at 20 per 100 000. Between 2006 and 2010, the number of persons
treated for depression and bipolar disease in Korea rose sharply (increases of 17
and 29 per cent respectively), with those in low socioeconomic groups more likely
to be affected. Economic downturn, weakening social integration and the erosion of
the traditional family support base for the elderly have all been implicated
in Korea's recent increase in suicide rates.
Suicide is often linked with depression and the
abuse of alcohol and other substances. Early detection of these psycho-social
problems in high-risk groups by families and health professionals is an important
part of suicide prevention campaigns, together with the provision of effective
support and treatment. Many countries are promoting mental health and developing
national strategies for prevention, focussing on at-risk groups. In Germany, as
well as Finland and Iceland, suicide prevention programmes have been based on
efforts to promote strong multisectoral collaboration and networking.