Suicide decline and improved psychiatric treatment status: longitudinal survey of suicides and serious suicide attempters in Tokyo

Abstract

Background Connecting individuals in need of psychiatric treatment with adequate medical services has been a major strategy for suicide prevention in Japan. By investigating serious suicide attempters admitted to our Critical Care Medical Center (CCM), we aimed to examine longitudinal changes in the psychiatric treatment status of high-risk suicidal individuals, and to explore the association between any improvement in psychiatric treatment status and suicide decline. Methods Subjects from two periods, 2006–2011 and 2012–2017, were enrolled. We collected the data of 32,252 suicides in Tokyo from police reports and the data of 942 suicide attempters admitted to CCM from medical records. Data were annually collected by both age and gender for the number of suicide completers, the number of suicide attempters, and the psychiatric treatment rates, respectively. ANOVA and t-test were used to examine whether there were differences in the number of suicides and attempers between the two periods. The difference in psychiatric treatment rate between the two periods was examined by chi-square test. Additionally, we used Pearson’s correlation coefficient to analyze any correlation between annual treatment rate and the number of suicide completers in subgroups with altered psychiatric treatment rates. Results The number of suicide attempters in the 20–39-year age group of decreased together with the number of suicides. Psychiatric treatment rates of male attempters aged 20–59 years improved significantly from 48.7 to 70.6% and this improvement correlated with a decrease in suicides. However, psychiatric treatment rates in the elderly, which have the highest number of suicides in both genders, did not improve and remain low. Conclusions The number of suicide attempters, as well as that of suicides, decreased in Tokyo. Improvement of psychiatric treatment status in high-risk suicidal male adults may have contributed to the reduction of suicides in Tokyo. However, the continuing low rate of psychiatric treatment in the elderly is a pressing issue for future suicide prevention.

Forensic analysis of suicide deaths: Comparing forensic information with public information and investigating factors contributing to psychiatric consultations

“…Access to mental health professionals is crucial for preventing suicides due to mental illnesses. 44 , 45 , 46 Therefore, eliminating the stigma toward mental illnesses can be effective in suicide prevention. The results of this study provide foundational data for promoting consultations in psychiatry.…”

“…The stigma associated with mental illnesses, 32,41–43 such as depression or schizophrenia, could influence their decision to not seek psychiatric help. Access to mental health professionals is crucial for preventing suicides due to mental illnesses 44–46 . Therefore, eliminating the stigma toward mental illnesses can be effective in suicide prevention.…”

Temporal Trends and Characteristics of Adult Patients in Emergency Department Related to Suicide Attempt or Self-Harm in Korea, 2016–2020

“… 3 4 5 6 Individuals who attempt suicide or self-harm owing to suicidal ideation need immediate psychiatric intervention and constant attention from the community, which is one of the major strategies for suicide prevention. 7 Compared to suicidal ideation, which can only be identified through reports by the individual, SA is an indicator of suicide risk that can be detected objectively. Understanding the magnitude of SA in detail is of great relevance in implementing preventive interventions since it can provide important clues for identifying vulnerable subpopulations and intercepting suicidal trajectories.…”