Good mental health is essential for maintaining overall well-being and productivity (European Commission, 2023[1]). Living with mental health issues can have a significant impact on people’s daily lives, contribute to poorer educational outcomes, higher rates of unemployment and poorer physical health (OECD, 2021[2]; OECD, 2021[3]). Without effective treatment and support, mental health problems can have a devastating effect on people’s lives, and significantly increase the risk of dying from suicide.
Suicide is a significant cause of death in many European countries. In 2021, about 47 300 people died by suicide across EU countries, a rate of 10.2 per 100 000 population. Slovenia and Lithuania had the highest rate, followed by Hungary (Figure 3.19). Gender differences in mortality from suicide are significant. In 2021, suicide amongst men was almost four times higher than for women (16.8 deaths per 100 000 men compared to 4.6 deaths per 100 000 women). In Lithuania and Slovenia, the gender gap in deaths by suicide is even larger. However, the gender gap in suicidal intent and behaviour is far smaller, and in some instances even reversed, possibly because men use more lethal means during suicide attempts, a pattern referred to as the “gender paradox of suicide” (OECD, forthcoming[4]).
Between 2004 and 2021, suicide rates decreased by 25% across the EU, with declines of as much as 50% in countries such as Lithuania and Hungary (Figure 3.20). Social, economic and other crises can have an impact on suicide rates. For example, some increases in suicide were observed during the 2008 financial crisis. More recently, the COVID‑19 crisis was accompanied by marked increases in symptoms of depression and anxiety (OECD, 2023[5]), but the data for 2020 and 2021 does not show any marked increases in deaths by suicide during the pandemic.
Effective strategies to reduce death by suicide include good access to mental health care and support, targeted suicide prevention strategies, as well as mental health awareness and anti-stigma campaigns. In the Netherlands, the National Agenda for Suicide Prevention 2018‑21 took a multi-disciplinary approach, including suicide prevention training for health workers and persons in contact with high-risk groups (e.g. agencies working with debt relief, unemployment support workers and the police), as well as improving aftercare following a suicide attempt. In Lithuania, which still has the second-highest suicide rate in the EU, recent reforms aim to tackle formal and informal forms of stigmatisation of adults with mental-ill health, and increase access to mental health services (OECD, 2021[3]). Lithuania also adopted a new suicide prevention plan for 2023‑26 in October 2023.
Mental health conditions can affect people at all ages, including later in life. Depression can come with a range of consequences for people in their mid- and later-life, including increased likelihood of absence from work, early retirement, greater difficulties managing physical health conditions and poorer quality of life. In 2021‑22, on average 26% of adults over 50 had multiple symptoms of depression (4+ symptoms) in the EU (Figure 3.21). In all countries, women are much more likely to report symptoms of depression than men. On average, 32% of women aged over 50 had multiple symptoms of depression compared to 19% of men. Strategies to prevent depression amongst people aged over 50 include promoting exercise and social connection, reducing loneliness, support during life transitions such as retirement, and access to good mental health care when needed (OECD, 2021[3]).
