Health at a Glance 2011: OECD Indicators
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branch 1. Health Status
  branch 1.6. Suicide

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, through alcohol and drug abuse, unemployment, clinical depression or other forms of mental illness. Because of this, suicide is often used as a proxy indicator of the mental health status of a population. However, the number of suicides in certain countries may be under-reported because of the stigma that is associated with the act, or because of data issues associated with reporting criteria (see "Definition and comparability" ).

Intentional self-harm is a significant cause of death in many OECD countries, and there were almost 150 000 suicide deaths in 2009. Rates were lowest in southern European countries (Greece, Italy and Spain) and in Mexico and Israel, at six or fewer deaths per 100 000 population (Figure 1.6.1). They 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 highest and lowest suicide rates.

Death rates from suicide are three-to-four times greater for men than for women across OECD countries (Figure 1.6.1), a gap that has remained fairly stable over time. The exception is Korea, where women are much more likely to take their own lives, although male rates are still twice those of females. The gender gap is narrower for attempted suicides, reflecting the fact that women tend to use less fatal methods than men. 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 pronounced declines of close to 40% or more in Estonia, Luxembourg and Austria (Figure 1.6.2). However, death rates from suicides have increased in Korea, Chile, Japan, Mexico and Portugal, although in Mexico rates remain at low levels, and in Japan rates have been static since the late 1990s. 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 (Figure 1.6.3). 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 socio-economic groups more likely to be affected (HIRA, 2011). 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 (Kwon et al., 2009).

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 (Hawton and van Heeringen, 2009). In Germany, as well as Finland and Iceland, suicide prevention programmes have been based on efforts to promote strong multisectoral collaboration and networking (NOMESCO, 2007).

Definition and comparability

The World Health Organization defines suicide as an act deliberately initiated and performed by a person in the full knowledge or expectation of its fatal outcome. 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. Caution is required therefore in interpreting variations across countries.

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 directly 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. Deaths from suicide are classified to ICD-10 codes X60-X84. Mathers et al. (2005) have provided a general assessment of the coverage, completeness and reliability of data on causes of death.

Information on data for Israel: http://dx.doi.org/10.1787/888932315602.

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1.6.1 Suicide mortality rates, 2009 (or nearest year) Figure in Excel
Suicide mortality rates, 2009 (or nearest
1.6.2 Change in suicide rates, 1995-2009 (or nearest year) Figure in Excel
Change in suicide rates, 1995-2009 (or nearest
1.6.3 Trends in suicide rates, selected OECD countries, 1995-2009 Figure in Excel
Trends in suicide rates, selected OECD countries,

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