Impact of social factors on suicide must be recognised

Co-led by Professor Keith Hawton CBE, Emeritus Director of the Centre for Suicide Research at the University of Oxford, the series argues that a change in the narrative is needed to move from presenting suicide as an entirely mental health issue to also recognising social factors, such as poverty, debt, addictions, homelessness, abuse, discrimination and social isolation, can have an effect on a person’s decision to consider suicide.

According to the World Health Organisation, more than 700,000 lives were lost to suicide in 2019, equating to 1,925 per day, or one every 45 seconds.

The Series, which looks at the issue from a global perspective, highlights how clinical treatment services are critical for people in a suicidal crisis, but upstream measures that address social factors must also be included in national suicide prevention strategies in order to prevent people reaching crisis point.

The authors say tackling the social factors which contribute to suicide requires a policy re-set with a whole of government commitment to hold politicians and policy makers from all sectors accountable for decisions that may help or hinder suicide prevention efforts – a 'suicide prevention in all policies' approach.

Examples of potential interventions to address social factors suggested by the Series include:

• Economic policies to reduce poverty such as minimum wage legislation and income protection policies.
• Regulation of commercial products such as policies that limit alcohol consumption and increased regulation of social media platforms.
• Policies, legislation and cultural change that can help reduce domestic violence and abuse.

Professor Hawton says: 'Many suicides are preventable and public health strategies generally have the biggest impacts on reducing population suicide rates. This Series highlights key areas where public health policies are needed and examples of their effective implementation. We hope this will inspire those responsible for suicide prevention across the world to ensure that such approaches are applied in their countries and localities.'

Professor Jane Pirkis, University of Melbourne, Australia, says: 'Suicide is often thought of as stemming from mental illness, but factors like financial hardship, social isolation, discrimination, and domestic violence and abuse wield a major influence. This Series demonstrates that addressing these more upstream factors is likely to lead to sizeable reductions in suicide rates. We are calling on governments from around the world to take a ‘suicide prevention in all policies’ approach that would see consideration given to how actions in a range of sectors might influence suicide and its prevention.'

The authors also highlight the importance of including people with lived experience in policy making and ensuring their input is valued in the same way as those with professional expertise.

Read the full series in Lancet Public Health.