Global suicide rates fell 30 per cent since 1990 – but not in the US

Suicide rates have significantly decreased worldwide over the past few decades. Yet some countries, including the United States, have rates rising along the opposite trend lines, putting the world behind track on the World Health Organization’s (WHO) 2030 goal to cut suicides by a third.

Between 1990 and 2021, the global suicide rate fell nearly 30 per cent, from around 10 deaths per 100,000 people to about seven deaths per 100,000 people, according to an analysis by Jiseung Kang at Korea University in South Korea and her colleagues. They collected data on suicide deaths from 102 countries using the WHO’s mortality database.

“Many countries have been recognising more and more that suicide is preventable,” says Paul Nestadt at Johns Hopkins University in Maryland. As such, more of them have enacted policies to reduce suicides, such as restricting access to pesticides, firearms or certain medications – and these policies seem to have been successful.

Suicide rates decreased across every continent except the Americas, where rates grew more than 11 per cent since 2000. There, suicide increased in several countries, including Mexico, Paraguay and the US. Between 2000 and 2020, the suicide rate in the US jumped from about 9.6 deaths to 12.5 deaths per 100,000 people. The researchers believe this is because of an increase in firearm suicides and the mental health effects of the 2008 financial crisis.

Meanwhile, suicide rates steadily declined in Asia and Europe, and those in Oceania and Africa fell before reversing course around 2010 to 2015. However, while rates have been declining in Europe for decades, the region had the highest suicide rate in 2021 at nearly nine deaths per 100,000 people. And Africa had the lowest at three deaths per 100,000.

This is probably due to differences in data collection. Many European countries, for example, have robust systems for capturing and reporting suicide deaths, which helps inform public health policy. “But it also means they are going to show much higher rates than countries in Africa or parts of Asia where not as many resources are dedicated to capturing [suicides],” says Nestadt.

Suicide rates were also significantly greater in high-income countries than in low- and middle-income countries, which could come down to surveillance systems. Cultural differences may play a role as well, given some countries stigmatise suicide more than others. This means some suicides may not be recorded as such, says Nestadt.

Previous studies have found similar declines in global suicide rates, yet this is the first analysis to include data from the early years of the covid-19 pandemic. Many public health experts worried suicides would jump during the pandemic as more people experienced unemployment, isolation and the loss of loved ones. “Basically, it was a perfect storm for suicide,” says Nestadt. “And yet what ended up happening was suicide rates actually went down.” The global suicide rate fell an average of about 1.5 per cent each year between 2010 and 2019. But during the pandemic, it decreased at a rate of nearly 1.7 per cent.

“We do tend to see – not always – a drop in suicide with national tragedies or major world catastrophes,” says Nestadt. “There is a sense of it is okay to not be okay. It is expected to not be okay.” Many governments provide support during crises as well, such as crisis lines, improved access to mental healthcare and financial assistance. “So arguably, from a suicide perspective, it was a success in many ways how we handled the pandemic,” he says.

If current trends continue, the researchers estimate the global suicide rate will fall even further by 2050, to less than 6.5 deaths per 100,000 people.

“These aren’t inevitable deaths. Many, many, many of them are preventable,” says Nestadt. “When we see that there are places that have done something right, resulting in lives saved, that is encouraging.”

Need a listening ear? UK Samaritans: 116123 (samaritans.org); US Suicide & Crisis Lifeline: 988 (988lifeline.org). Visit bit.ly/SuicideHelplines for services in other countries.