The cornerstone of unity

57 SUICIDE PREVENTION
Suicide is a global problem. It is estimated that 800,000 people take their own life each year, and up to ten times 
as many suicide attempts are carried out. The effects of suicides and suicide attempts on the victims and their 
families, friends, and communities are overwhelming and far reaching. 
At the beginning of the 1970s, the high suicide rates of men in Finland attracted public attention. The suicide 
rate of Finnish males over the age of 14 was more than 60 suicides per 100,000 inhabitants. The attention led to, 
among other things, the founding of a suicide committee in 1974 and the world’s first national suicide prevention 
programme. Information was collected for the project by examining each of the 1,397 suicides committed in 
1987. These suicides were examined in detail under the direction of Prof. Jouko Lönnqvist by interviewing those 
who were close to the victims and the professionals who had participated in their care as well as by collecting 
information about the victims from healthcare, social service, and police databases. 
A national suicide prevention strategy was published in 1992 after extensive hearings and participatory 
preparation work, and the programme was implemented from 1992 to 2002 through extensive collaboration with all 
government agencies, including the Finnish Defence Forces and the National Agency for Education, and the media. 
The programme stressed the psychological and social factors behind the suicides, nation-wide measures, and 
factors that protect against suicide. It addressed the public services, everyday life, and the cultural aspects of the 
suicides. Special emphasis was placed on follow-up care after suicide attempts, self-treatment of depression, and 
support of loved ones after suicides. Implementation happened multi-professionally and across sector boundaries 
at the local level with the support of a regional contact person. Locally, the programme was implemented through 
collaboration and by e
mpowering the participants. The programme’s funding enabled the hiring of a small national 
coordination team, but the programme was implemented locally by government and municipal employees making 
time for it. Thus the total costs of the programme were moderate, amounting to 1.6 million euros.
During the programme, the suicide prevention work of charitable organisations expanded, and the Finnish 
Association for Mental Health extended its crisis centre network to cover the whole country. Today, 22 crisis 
centres offer low-
threshold support through conversation in life’s crisis situations. Suicide prevention is one of 
the goals of these centres operating outside the medical paradigm.
The programme’s effectiveness and cost-effectiveness were excellent. The suicide rate dropped by 15% 
during the project and has continued to decrease since then. By 2015, it had dropped to one half of what it was 
in 1990, which was the bleakest year in the statistics for the 20th century. Nowadays the suicide rate is at a 
historical low. Finland has moved from one of the highest positions in European suicide statistics to an average 
rate.
Suicide is connected with mental health problems, but also with social problems. Suicides are more common 
in lower socio-economic groups in Finland. Suicides explain about 10% of the life expectancy differences 
between socio-economic groups in Finland. Since the suicide prevention project and by the year 2014, the 
mortality rates due to suicide, accidents, and violence have gone down faster among men with less education 
and less income than among other men, which has slightly decreased the socio-economic mortality rate 
differences. Deaths due to alcohol have also simultaneously decreased in the lowest income brackets.
Socially excluded members of the lowest socio-economic groups are clearly in a group of their own. Social 
exclusion is closely connected with suicide. Young adults that are not working or studying have an almost 
twentyfold suicide rate compared to others their age. So efforts to prevent social exclusion simultaneously 
prevent suicides.
The use of antidepressants has increased while suicides have decreased, but regional analyses show no 
general connection between sales of antidepressants and suicide rates. Alcohol consumption has decreased, 
which has probably contributed to the positive development, for foreign studies have shown a connection 
between alcohol availability and suicide rates.
Suicide prevention continues to be a pressing issue in Finland and includes efforts to reduce access to 

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alcohol and suicide methods, to improve the ability of laypeople and professionals to recognise warning signs 
and to talk about them, and to promote responsible suicide reporting in the media.
In Finland, restricting the availability of alcohol continues to be an essential sociopolitical measure for suicide 
prevention. Restricting the availability of firearms in homes would especially reduce impulsive suicides of young 
men. Prevention of social stratification and social exclusion will also help to reduce suicides.
War and armed conflict make mental health deteriorate, and traumatised asylum seekers and refugees are a 
new target group for suicide prevention efforts. In addition to social policy, immigration policy is also a means to 
prevent suicide. Putting temporary residence permits back into legislation would save the lives of many rejected 
asylum seekers. 
Kristian Wahlbeck 
– development manager of
the Finnish Association for Mental Health