The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis

Abstract

ObjectivesTo complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece.SettingGreece from 1 January 1983 to 31 December 2012.ParticipantsA total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period.Primary and secondary outcomesNational data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides.ResultsIn 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (−27.1%, p<0.05).ConclusionsThis is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public messaging of these policies and related events.

Characteristics of Attempted Suicide Patients Presenting to a Greek Emergency Department

“…The existence of different clinical profiles and temporal factor may require more tailored models for intervention. In Greece most studies have focused on changes of suicide-related mortality rates [13,14] and the differentiation of suicide attempters on demographic and clinical parameters at hospitalized patients and general population during financial crisis [15,16]. However the characteristics of the methods used to completed suicide may be associated with different characteristics of the methods used to attempted suicide as well as the characteristics of attempters who were hospitalized do not reflect the patterns of attempted suicide seen in emergency departments.…”

Suicidal ideation and suicide attempts in Greece during the economic crisis: an update

“…However, the mechanism underlying this association is one of the most controversial. Some theorists and researchers believe that alliance is therapeutic in itself; others argue that it is a byproduct of effective treatment or of a trait-like patient ability to benefit from treatment 3,4 . For many years, the debate has been confined mainly to the domain of theory.…”

“…Recently, a 30-year interrupted time series analysis on the influence of austerity-and prosperity-related events on suicide rates in the period 1983-2012 found a rise in total suicides by 35.7% after the introduction of new austerity measures in June 2011 4 . In a similar vein, another ecological study reported an increase in suicides by 35% between 2010 and 2012, with unemployment bearing a strong correlation with suicide mortality especially among working age men 5 .…”

The Great Recession and suicide

“…Prior US studies on the Great Recession and suicide have generally not allowed for non-linearity and seasonality, though interrupted time series analyses in Spain [3], Greece [43] and Ireland [13] have shown detrimental impacts of the Great Recession on suicide. The presence of seasonal and long-term trends complicates interrupted time series designs, but accounting for such factors in the pre-intervention period is the crucial assumption for the validity of any interrupted time series analysis [36,37,44,45].…”