Findings from a new study from Australia suggest that mental disorders and suicide attempts are caused by social factors. There is a need for social and economic responses beyond provision of mental health services.
Currently, responses to mental disorders usually focus on diagnosis and treatment; socio-economic conditions are less likely to be considered.
Published in the December issue of the British Journal of Psychiatry, this study used information from the 1997 Australian Survey of Mental Health and Wellbeing to estimate associations between socio-economic status, mental disorders and attempted suicide.
Mental disorders selected were substance use disorders, affective disorders (including depression) and anxiety disorders. Lifetime history of one or more suicide attempts was also examined.
Socio-economic characteristics assessed were education level, occupational status, income source and employment status.
Significantly increasing rates of mental disorders were found to be associated with decreasing socio-economic status, using educational attainment and occupational status (in the employed), for both men and women.
Similar associations were found for suicide attempts, which decreased after taking mental disorders into account, but remained significant in the working-age employed.
Government benefit as the main income source and unemployment were associated with higher rates of mental disorders and suicide attempts.
There was a higher prevalence of mental disorder and suicide attempts in women than in men. Women showed a stronger association of substance use disorder with suicide attempts than men. Men tended to show stronger associations between suicide attempts and anxiety disorders than women, despite the higher prevalences of substance use disorders in men and anxiety disorders in women.
The results of this study are consistent with other research into psychological disturbance and measures of socio-economic status. Previous studies have also shown a relationship between low socio-economic status and suicide attempts.
The authors of the study conclude that their results are most likely to be due to social causation. The significant socio-economic status relationship with suicide attempts, after taking mental illness into account, suggests a direct (independent) relationship between status and suicide attempts.
The implication of these findings is that mental disorders and suicide attempts are not just individual phenomena to be addressed solely by medical diagnosis and treatment. Mental disorders (particularly depression) and suicide attempts are also a consequence of material life circumstances, which are much more difficult to contend with for people at the lower end of the social spectrum.
Beyond mental health services and drug treatments, social and economic responses are needed to reduce relative disadvantage. Programmes enhancing perceived life prospects through improved employment opportunities and job security could have an effect on suicide attempts and mental illness just as much as - if not more than - improved mental health services.