The end of the 20th century was a particularly grim period for Finland. Suicide rates were among the highest in the world, peaking in 1990 with over 30 deaths per 100,000 citizens, compared with a European average of ten per 100,000.
Authors
Leah Prencipe
Postdoctoral Research Fellow, Public Health, Leiden University
Marieke Liem
Professor of Violence and Interventions, Leiden University
Sami Pirkola
Professor of Social Psychiatry, Tampere University
Finland responded aggressively, implementing a comprehensive national strategy, and ultimately cutting this rate by more than half, to about 13 deaths per 100,000.
Each suicide is unique, with many precipitating factors and personal characteristics, adverse occurrences and failures to get help. These things add up and finally cluster in a lethal way.
That is why there is no single remedy when it comes to suicide prevention. There are, however, several factors that may have contributed to the decline in the Finnish suicide rate.
The main strategy undertaken by the Finnish government included educating health and other care workers to conduct a comprehensive, nationwide research project that collected data on all suicides that occurred during a one-year period.
§The research project itself was a huge intervention, spanning Finland's 400-plus municipalities, which provided direct feedback on suicide rates and specific preventive actions, simultaneously raising awareness of suicide risks.
The media learned to report on suicides in a neutral way - without glorifying or romanticising language. Policies were implemented to limit access to firearms and poisons. And the arrival of a new generation of antidepressants, with fewer side-effects, in the 90s may also have contributed to bringing down the rate.
Counterintuitively, the fast rise of mobile phones in the 90s may have given a big helping hand, too. While we now look at mobile devices and social media as a source of decreasing physical social contacts, they probably helped people keep in touch with others in this large, sparsely populated country. (Loneliness and a lack of sense of belonging are known risk factors in suicide.)
But to what extent was Finland unique in experiencing a decline in suicide rates?
How other countries fared
Over roughly this same period, suicide rates have fallen across Europe. We can never be certain why this is the case, but a good guess might be that there is now better awareness of suicide and greater willingness to talk about mental health. As in Finland, suicide is also reported in a more neutral way in the media.
And, as mentioned above, the new generation of so-called SSRI antidepressant drugs may have played a large role in the fall in suicides, along with more effective mental health treatments, such as cognitive behavioural therapy.
Unfortunately, the outlook is not universally bright, as death by suicide is increasing in some parts of the world. For example, suicide rates in the US have increased by 35% in the first decades of the 21st century, now amounting to about 14 deaths per 100,000.
Why are some countries seemingly thriving in the modern era and others seemingly seeped in despair? This probably points to inequality in wellbeing distribution that leaves some groups vulnerable and unprotected.
In the US, the risk groups seem to include under-educated, marginalised younger people, many of whom are victims of the opioid epidemic. We know that suicide risk is higher among poorer people, and Finland, with its more extensive Nordic welfare state, may be better equipped when it comes to the difficult task of suicide reduction.
The story continues in Finland, where the current mental health strategy includes a suicide-prevention programme with similar focuses to the previous agenda, with an added emphasis on improving crisis services. And they're conducting a nationwide suicide study on young people's suicides. The synthesis of these findings, coupled with continuing endeavours, has the potential to further decrease the rate.
If you're struggling with suicidal thoughts, the following services can provide you with support:
In the UK and Ireland - call Samaritans UK at 116 123.
In the US - call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or IMAlive at 1-800-784-2433.
In Australia - call Lifeline Australia at 13 11 14.
In other countries - visit IASP or Suicide.org to find a helpline in your country.
Marieke Liem receives funding from the Dutch Research Council.
Leah Prencipe and Sami Pirkola do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
