Macro-level mental health system indicators and cross-national suicide rates

BACKGROUND: The relationship between macro-level mental health system indicators and population suicide rates is an area of contention in the literature, necessitating an analysis of current cross-national data to document any new trend in the relationship. OBJECTIVE: This study investigated whether mental health system indicators are associated with national suicide rates. METHOD: Using an ecological study design and multivariate non-parametric robust regression models, data on suicide rates and mental health system indicators of 191 countries retrieved from WHOs 2017 Mental Health Atlas were compared. RESULTS: Findings revealed that the average suicide mortality rate was significantly higher in high- income countries, relative to low-income countries. High-income countries are significantly more likely to have high number of mental health professionals, mental health policies and legislation, independent mental health authority and suicide prevention programs. These mental health system indicators demonstrated significant and positive association with suicide, suggesting that countries scoring high on these factors have higher odds of being categorized as high suicide risk countries. CONCLUSION: The findings have several implications for policy and practice, including the need to make existing mental health systems very responsive to suicide prevention.