Suicide and Suicide Attempts: National and Regional Data
Santé publique France has published the latest epidemiological data on suicide and suicide attempts in a special issue of the Weekly Epidemiological Bulletin, along with—for the first time—regional reports on suicidal behavior and thoughts.
With approximately 9,000 suicide deaths per year, France has one of the highest suicide rates in Europe. It is therefore a major public health issue with significant human and economic impacts.
The objective of this issue of the BEH is to provide an overview of data on suicidal behavior in France based on surveys and medical-administrative databases that enable the study of mortality, morbidity, and the causes associated with suicidal acts. This knowledge is essential for strengthening suicide prevention strategies. The issue of evaluating remote health prevention and support associations in the field of suicide prevention is also addressed.
Nearly 5% of the adult population reports having thought about suicide during the year
The 2017 Santé publique France Barometer provides insights into suicidal ideation and suicide attempts (SA) among the general population and working-age adults. Nearly 5% of 18- to 75-year-olds in the general population reported having thought about suicide in the past 12 months, and more than 7% reported having made a suicide attempt at some point in their lives. Women were more affected than men. Several factors associated with suicidal behavior were identified: having experienced a depressive episode, facing financial difficulties, being single, divorced, or widowed, being unemployed, exposure to violence, and traumatic childhood experiences.
High-risk occupational sectors
The same survey shows that among the working population, 4.5% of women and 3.1% of men have had suicidal thoughts, and one-third attributed them to work-related reasons. The sectors most affected were accommodation and food services, arts and entertainment, and education.
A concerning situation regarding suicide attempts and suicidal thoughts among young girls
Seventeen-year-olds were surveyed as part of the OFDT’s Escapad survey (Survey on Health and Substance Use during the Defense Readiness Call-up). The results indicate that in 2017, nearly 3% of adolescents reported having made a suicide attempt requiring hospitalization at some point in their lives. The situation among girls is particularly concerning, with an increase in suicide attempts and suicidal thoughts since 2011. Here too, depression is the variable most strongly associated with these behaviors. Other variables are also linked to suicidal behavior, such as dropping out of school and the use of psychoactive substances (alcohol, tobacco, and illicit drugs).
SpFrance’s analysis of hospitalizations for suicide attempts confirms the alarming situation among girls aged 15 to 19. It is within this population that the highest rate is consistently observed, regardless of the year. Furthermore, across the entire population, the number of hospitalizations for suicide attempts decreased between 2008 and 2017, falling from over 100,000 per year to approximately 89,000 in 2017, with this decline being more pronounced among women. In contrast, the annual rate of repeat hospitalizations for suicide attempts remained constant. Certain regions (Brittany, Normandy, and Hauts-de-France) are more affected than others, and this difference observed in 2008 persisted in 2017 (see box). The majority of suicide attempts involve an underlying psychiatric condition, particularly depression.
The Prevalence of Underlying Mental Disorders
Psychiatric disorders, particularly depression and anxiety disorders, were overrepresented in the 156,910 death certificates listing suicide as the cause of death between 2000 and 2014, compared to other death certificates. Suicide, unlike attempted suicide, affects a large majority of men. While some non-mental health conditions were identified on these certificates, it was not possible to determine their link to suicide. The medical-administrative databases of the National Health Data System (SNDS) could provide additional insight.
Identifying at-risk individuals to target prevention efforts
Identifying vulnerable and high-risk individuals to enable intervention before a suicidal crisis occurs is one of the keys to the success of a suicide prevention policy, as is the identification and treatment of depression, and maintaining contact with individuals who have attempted suicide. In the workplace, identifying high-risk sectors will allow for targeted prevention efforts. Among young people, psychoactive substance use, school dropout, and depressive symptoms could be used as indicators for identifying profiles of adolescents at increased risk of suicidal behavior.
Box – Suicidal Behavior at the Regional Level
For the first time, Santé publique France is publishing regional reports on suicidal behavior based on three data sources (deaths, hospitalizations, and emergency room visits for suicide attempts) and on suicidal thoughts based on the 2017 Santé publique France Barometer. When considering all the data, the Hauts-de-France region has the most unfavorable situation. In contrast, the Île-de-France region has the most favorable situation. Inter-departmental differences are even more pronounced.
