Treatment of suicidal people around the world

Background Suicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment. Aims To examine the receipt of mental health treatment and barriers to care among suicidal people around the world. Method Twenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization`s World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care. Results Two-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment. Conclusions Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.

Bristol-Myers Squibb

Eli Lilly

GlaxoSmithKline

Johnson & Johnson Pharmaceuticals

Ortho-McNeil Pharmaceuticals

Pfizer

Sanofi-Aventis

US National Institute of Mental Health (NIMH/NIH)[R01-MH070884]

US National Institute of Mental Health (NIMH/NIH)[MH077883]

John D. and Catherine T. MacArthur Foundation

Pfizer Foundation

US Public Health Service[R13-MH066849]

US Public Health Service[R01-MH069864]

US Public Health Service[R01-DA016558]

Fogarty International Center (FIRCA/NIH)[FIRCA R03-TW006481]

Pan American Health Organization (PAHO)

Eli Lilly Co.

Ortho-McNeil Pharmaceutical

Australian National Health and Medical Research Council

State of Sao Paulo Research Foundation (FAPESP)[03/00204-3]

Ministry of Health

National Centre for Public Health Protection

Shenzhen Bureau of Health

Shenzhen Bureau of Science, Technology and Information

Ministry of Social Protection

European Commission[QLG5-1999-01042]

European Commission[2004123]

Piedmont Region (Italy)

Fondo de Investigacion Sanitaria

Instituto de Salud Carlos III, Spain[FIS 00/0028]

Ministerio de Ciencia y Tecnologia, Spain[SAP 2000-158-CE]

Departament de Salut

Generalitat de Catalunya, Spain

Instituto de Salud Carlos III[GIBER CB06/02/0046]

Instituto de Salud Carlos III[RETICS RD06/0011 REM-TAP]

WHO (India)

United Nations Development Group Iraq Trust

Israel National Institute for Health Policy and Health Services Research

National Insurance Institute of Israel

Japan Ministry of Health, Labour and Welfare[H13-SHOGAI-023]

Japan Ministry of Health, Labour and Welfare[H14-TOKUBETSU-026]

Japan Ministry of Health, Labour and Welfare[H16-KOKORO-013]

Lebanese Ministry of Public Health

WHO (Lebanon)

Fogarty International (FIRCA/NIH)

Janssen Cilag

Roche

Novartis

National Institute of Psychiatry Ramon de la Fuente[INPRFMDIES 4280]

National Council on Science and Technology[CONACyT-G30544-H]

New Zealand Ministry of Health

Alcohol Advisory Council

Health Research Council

WHO (Geneva)

WHO (Nigeria)

Federal Ministry of Health

Abuja

Nigeria

Ministry of Public Health (formerly ministry of Health)

US National Institute of Mental Health (NIMH/NIH)[R01-MH059575]

National Institute of Drug Abuse (NIDA/NIH)

South African Department of Health

University of Michigan

US National Institute of Mental Health (NIMH/NIH)[R01-MH61905]

US National Institute of Mental Health (NIMH/NIH)[U01-MH60220]

Robert wood Johnson Foundation (RWJF)[044708]

John W. Alden Trust