Unemployment linked with around 45 000 deaths by suicide every year

Unemployment might account for nine times as many deaths by suicide every year (about 45 000) as the recent economic crisis (around 5000 excess suicides), a long-term analysis of suicide risk across 63 countries* between 2000 and 2011, published in The Lancet Psychiatry journal has found.

These striking findings suggest that suicide prevention strategies need to target the negative health effects of unemployment in times of economic stability as well as during recession.

Researchers from the University of Zurich in Switzerland used longitudinal modelling to assess the impact of unemployment on suicide between 2000 and 2011—a period that includes economic stability as well as the 2008 global economic recession and its aftermath. Analysing data on suicide and the economy from the WHO mortality database and the International Monetary Fund’s world economic outlook database, they calculated the effect of unemployment rates on suicide rates across 63 countries in four world regions, and in different age and sex groups.

Findings showed that unemployment had a similar effect on suicide in all four world regions. Between 2000 and 2011, the relative risk of suicide associated with unemployment was elevated by 20% to 30% in all regions (see figure 1 page 3). The researchers estimate that about 233 000 suicides took place each year between 2000 and 2011, of which unemployment accounted for around a fifth (about 45 000). Unemployment was linked with 41 148 suicides in 2007 and 46 131 in 2009, indicating that 4983 excess suicides were associated with the economic crisis in 2008 (see table 3 page 5). In contrast to earlier studies, they found that both men and women of all ages were equally vulnerable to the effects of rising unemployment.

According to lead author Dr Carlos Nordt of Zurich University’s Psychiatric Hospital, “Our findings reveal that the suicide rate increases 6 months before a rise in unemployment. What is more, our data suggest that not all job losses necessarily have an equal impact, as the effect on suicide risk appears to be stronger in countries where being out of work is uncommon. It is possible that an unexpected increase in the unemployment rate may trigger greater fears and insecurity than in countries with higher pre-crisis unemployment levels.”

Nordt adds, Besides specific therapeutic interventions, sufficient investment by governments in active labour market policies that enhance the efficiency of labour markets could help generate additional jobs and reduce the unemployment rate, helping to offset the impact on suicide.

Writing in a linked Comment, Roger Webb and Navneet Kapur from the University of Manchester in the UK caution that suicide cases attributable to the global recession are likely to be only “the tip of the iceberg” of a wider range of social and psychological problems, adding that, “many affected individuals who remain in work during these hard times encounter serious psychological stressors due to pernicious economic strains other than un¬ employment, including falling income, ‘zero¬hour’ contracting, job insecurity, bankruptcy, debt, and home repossession. Caution should therefore be exercised…[As well as death by suicide], we also require a better understanding of other psychosocial manifestations of economic adversity, including non-fatal self-harm, stress and anxiety, low mood, hopelessness, alcohol problems, anger, familial conflict and relationship breakdown. We also need to know how and why highly resilient individuals who experience the greatest levels of economic adversity manage to sustain favourable mental health and wellbeing.”