The relationship between general population suicide rates and mental health funding, service provision and national policy: a cross-national study.
OBJECTIVE
The main aims were to examine the relationship between general population suicide rates and the presence of national policies on mental health, funding for mental health, and measures of mental health service provision.


METHODS
Data on general population suicide rates for both genders were obtained from the World Health Organization (WHO) databank available on the WHO website. Data on the presence of national policies on mental health, funding for mental health and measures of mental health service provision were obtained from the Mental Health Atlas 2005, also available on the WHO website.


RESULTS
The main findings were: (i) there was no relationship between suicide rates in both genders and different measures of mental health policy, except they were increased in countries with mental health legislation; (ii) there was a significant positive correlation between suicide rates in both genders and the percentage of the total health budget spent on mental health; and (iii) suicide rates in both genders were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists and psychiatric nurses, and the availability of training in mental health for primary care professionals.


CONCLUSIONS
Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on suicide rates requires further examination in longitudinal within-country studies.
Shah
Ajit
A
University of Central Lancashire, Preston, UK. ajit.shah@wlmht.nhs.uk
Bhandarkar
Ritesh
R
Bhatia
Gurleen
G
D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D005380:Financing, Government; D006291:Health Policy / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics*; D011159:Population Surveillance; D013222:State Medicine / Q000191:economics*; D013223:Statistics as Topic; D013405:Suicide / Q000706:statistics & numerical data*; D014944:World Health Organization