Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-23T17:31:36.572Z Has data issue: false hasContentIssue false
  • English
  • Français

The relationship between elderly suicide rates and mental health funding, service provision and national policy: a cross-national study

Published online by Cambridge University Press:  30 November 2007

Ajit Shah  and
Ravi Bhat
Ajit Shah*
Affiliation:
Ethnicity and Mental Health, University of Central Lancashire, Preston, U.K. and West London Mental Health NHS Trust, London, U.K.
Ravi Bhat
Affiliation:
Centre for Older Persons' Health and School of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
*
Correspondence should be addresed to: Professor Ajit Shah, Consultant Psychiatrist, West London Mental Health NHS Trust, Uxbridge Road, Southall, Middlesex, UB1 3EU, U.K. Phone: +44 208 354 8140; Fax: +44 208 354 8898. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Elderly suicide rates may be influenced by mental health funding, service provision and national policy.

Methods: A cross-national study examining the relationship between elderly suicide rates and (i) the presence of national policy on mental health, (ii) funding for mental health, and (iii) measures of mental health service provision was undertaken by utilizing data from the World Health Organization website.

Results: The main findings are: (i) there is no relationship between suicide rates in both sexes in both elderly age-bands and different measures of mental health policy, except they were increased in countries with a substance abuse policy; and (ii) suicide rates in both sexes in both elderly age-bands were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists, 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 elderly 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 elderly suicide rates requires further examination in longitudinal within-country studies.

Keywords

elderly suicidesservice provisionmental health policy and funding
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 3 , June 2008 , pp. 605 - 615
Copyright
Copyright © International Psychogeriatric Association 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abraham, V. J., Abraham, S. and Jacob, K. S. (2005). Suicide in the elderly in Kanyambadi block, Tamil Nadu, South India. International Journal of Geriatric Psychiatry, 20, 953–955.CrossRefGoogle ScholarPubMed
Cattell, H. (1988). Elderly suicides in London: an analysis of coroner's inquests. International Journal of Geriatric Psychiatry, 3, 251–261.CrossRefGoogle Scholar
Cattell, H. and Jolley, D. (1995). One hundred cases of suicide in the elderly. British Journal of Psychiatry, 166, 451–457.CrossRefGoogle Scholar
Chiu, H. F. K., Takahashi, Y. and Suh, G. K. (2003) Elderly suicide prevention in East Asia. International Journal of Geriatric Psychiatry, 18, 973–976.CrossRefGoogle ScholarPubMed
Conwell, Y. and Brent, D. (1995). Suicide and ageing. 1. Patterns od psychiatric diagnosis. International Psychogeriatircs, 7, 149–164.CrossRefGoogle Scholar
Conwell, Y., Rotenberg, M. and Caine, E. D. (1990). Completed suicides at age 50 and over. Journal of the American Geriatric Society, 38, 640–644.CrossRefGoogle ScholarPubMed
Conwell, Y., Olsen, K., Caine, E. D. and Flannery, C. (1991). Suicide in later life: psychological autopsy findings. International Psychogeriatrics, 3, 59–66.CrossRefGoogle ScholarPubMed
De Leo, D. et al. (2001) Attempted and completed suicide in older subjects: results from the WHO/EURO multicentre study of suicidal behaviour. International Journal of Geriatric Psychiatry, 16, 300–310.CrossRefGoogle ScholarPubMed
Diekstra, R. F. W. (1989). Suicide and attempted suicide: an international perspective. Acta Psychiatrica Scandinavica, 80 (Suppl. 354), 1–24.CrossRefGoogle Scholar
Gunnell, D., Middleston, N., Whitley, E., Dorling, D. and Frankel, S. (2003). Why are suicide rates rising in young men but falling in the elderly? A time-series analysis of trends in England and Wales 1950–1998. Social Science and Medicine, 57, 595–611.CrossRefGoogle ScholarPubMed
Hoxey, K. and Shah, A. K. (2000). Recent trends in elderly suicide rates and methods in England and Wales. International Journal of Geriatric Psychiatry, 15, 274–279.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Jianlin, J. (2000). Suicide rates and mental health services in modern China. Crisis, 21, 118–121.CrossRefGoogle ScholarPubMed
Kiemo, K. (2004). Towards a socio-economic and demographic theory of elderly suicides: a comparison of 49 countries at various stages of development. www.soc.ou.se/publications/fulltext/diss2003-3.pdf (last accessed 2 February 2007).Google Scholar
Kua, E. H., Ko, S. M. and Ng, T. P. (2003). Recent trends in elderly suicide rates in a multi-ethnic Asian city. International Journal of Geriatric Psychiatry, 18, 533–536.CrossRefGoogle Scholar
Lodhi, L. and Shah, A. K. (2005). Factors associated with the recent decline in suicide rates in England and Wales, 1985–1998. Medicine, Science and the Law, 45, 115–120.CrossRefGoogle ScholarPubMed
Moscicki, E. K. (1995). North American perspectives: epidemiology of suicide. International Psychogeriatrics, 7, 137–148.CrossRefGoogle Scholar
Rehkopf, D. H. and Buka, S. L. (2006). The association between suicide and the socio-economic characteristics of geographical areas: a systematic review. Psychological Medicine, 36, 145–157.CrossRefGoogle ScholarPubMed
Shah, A. K. (2007a). The relationship between suicide rates and age: an analysis of multinational data from the World Health Organization. International Psychogeriatrics, 19, 1141–1152. DOI:10.1017/S1041610207005285.CrossRefGoogle ScholarPubMed
Shah, A. K. (2007b). Trends in elderly suicide rates in the United Kingdom over 24 years from 1979 to 2002. Medicine, Science and Law, 47, 56–60.CrossRefGoogle ScholarPubMed
Shah, A. K. (2007c). The importance of socioeconomic status of countries for mental disorders in old age: a development of an epidemiological transition model. International Psychogeriatrics. In press.CrossRefGoogle Scholar
Shah, A. K. and De, T. (1998). Suicide and the elderly. International Journal of Psychiatry in Clinical Practice, 2, 3–17.CrossRefGoogle ScholarPubMed
Shah, A. K. and Ganesvaran, T. (1994) Suicide in the elderly. In: Chiu, E. and Ames, D. (eds.), Functional Psychiatric Disorders of the Elderly (pp. 221–244), Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Shah, A. K., Ellanchanny, N. and Collinge, T. (2001) Trends in age band-specific suicide rates in the elderly. Medicne, Science and the Law, 41, 102–106.CrossRefGoogle Scholar
Shah, A. K., Bhat, R., MacKenzie, S. and Koen, C. (2007a). Elderly suicide rates: cross-national comparisons and association with sex and elderly age-bands. Medicine, Science and the Law, 47, 244–252.CrossRefGoogle ScholarPubMed
Shah, A. K., Bhat, R., MacKenzie, S. and Koen, C. (2007b). A cross-national study of the relationship between elderly suicide rates and life expectancy and markers of socioeconomic status and healthcare. International Psychogeriatrics. DOI: 10.1017/S1041610207005352 (e-published ahead of print).CrossRefGoogle Scholar
Vassilas, C. A. and Morgan, H. G. (1993). General practitioner's contact with victims of suicide. BMJ, 307, 300–301.CrossRefGoogle Scholar
Vassilas, C. A. and Morgan, H. G. (1994). Elderly suicides' contact with their general practitioner before death. International Journal of Geriatric Psychiatry, 9, 1008–1009.Google Scholar
Wasserman, D., Cheng, Q. and Jiang, G. X. (2005). Global suicide rates among young people aged 15–19. World Psychiatry, 4, 114–120.Google ScholarPubMed
Yip, P. S. F. (2001). An epidemiological profile of suicides in Beijing, Chine. Suicide and Life-Threatening Behaviour, 31, 62–70.CrossRefGoogle Scholar
Yip, P. S. F. and Tan, R. C. E. (1998). Suicides in Hong Kong and Singapore: a tale of two cities. International Journal of Social Psychiatry, 44, 267–279.CrossRefGoogle Scholar
Yip, P. S. F., Callanan, C. and Yuen, H. P. (2000). Urban/rural and gender differentials in suicide rates: East and West. Journal of Affective Disorders, 57, 99–106.CrossRefGoogle ScholarPubMed
Yip, P. S. F., Liu, K. Y., Hu, J. and Song, X. M. (2005). Suicide rates in China during a decade of rapid social change. Social Psychiatry and Psychiatric Epidemiology, 40, 792–798.CrossRefGoogle Scholar