From an excellent blog, Neuroskeptic, here is a survey of some data on mental illness incidence and suicide rates across countries. The correlation is surprisingly low:
So what’s the story? Take a look –
In short, there’s no correlation. The Pearson correlation (unweighted) r = 0.102, which is extremely low. As you can see, both mental illness and suicide rates vary greatly around the world, but there’s no relationship. Japan has the second highest suicide rate, but one of the lowest rates of mental illnesses. The USA has the highest rate of mental illness, but a fairly low suicide rate. Brazil has the second highest level of mental illness but the second lowest occurrence of suicide.
Perhaps I am reacting too much to the examples in the excerpt, but one possible explanation comes from noting that there is a difference between incidence of mental illness and detection. In countries where mental illness is readily diagnosed you will see more reports of it and also (assuming it does any good) less suicide. The US must be the prime example. And as I understand it, mental illness is highly stigmatized in Japan so the effect there is exactly what the data would suggest. I don’t know about Brazil.
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November 30, 2009 at 12:27 pm
Matt
Maybe we over-diagnose. 25% of Americans are mentally ill? Pretty soon there is going to be an apocalypse movie about the pill-factory burning down.
December 1, 2009 at 10:14 pm
Pooka
Over the last ten years a lot of progress has been made in overcoming the traditional stigma against admitting to either having a mental illness or admitting to others outside your family that someone in your family is suffering from and/or dealing with a mental illness in their lives. This is particularly true with regards to greater acceptance of depression and anxiety disorders.
I too wonder if America over-diagnoses it’s citizens. Here in Japan it is definitely the case that depression is massively under-diagnosed and even according to the Ministry of health estimates and studies only 25% of those who suffer with depression are diagnosed at all. Other estimates puts the numbers of people here suffering from depression in the millions. Mental illness in Japan is in fact very high but this does not show in official figures and so does not show up in stastical analysis to the degree it should.
I am a JSCCP clinical psychologist and JFP psychotherapist working in Japan for over 20 years. I would like to put forward a perspective on some of the main reasons behind the unacceptably high suicide numbers Japan and so will limit my comments to what I know about here in Japan but would first like to suggest that western media reports on suicide rates in Japan should try harder to get away from the tendency to ‘orientalize’ the serious and preventable problem of increased suicide rates here over the last 10 years by reverting to stereotypical ideas of Japanese people in general.
Mental health professionals in Japan have long known that the reason for the unnecessarily high suicide rate in Japan is due to unemployment, bankruptcies, and the increasing levels of stress on businessmen and other salaried workers who have suffered enormous hardship in Japan since the bursting of the stock market bubble here that peaked around 1997. Until that year Japan had annual suicide of rate figures between 22,000 and 24,000 each year. Following the bursting of the stock market and the long term economic downturn that has followed here since the suicide rate in 1998 increased by around 35% and since 1998 the number of people killing themselves each year in Japan has consistently remained well over 30,000 each and every year to the present day.
The current worldwide recession is of course impacting Japan too, so unless the new administration initiates very proactive and well funded local and nationwide suicide prevention programs and other mental health care initiatives, including tackling the widespread problem of clinical depression suffered by so many of the general population, it is very difficult to foresee the previous government’s stated target to reduce the suicide rate to around 23,000 by the year 2016 as being achievable. On the contrary the numbers, and the human suffering and the depression and misery that the people who become part of these numbers, have to endure may well stay at the current levels that have persistently been the case here for the last ten years. It could even get worse unless even more is done to prevent this terrible loss of life.
The current numbers licensed psychiatrists (around 13,000), Japan Society of Certified Clinical Psychologists clinical psychologists (19,830 as of 2009), and Psychiatric Social Workers (39,108 as of 2009) must indeed be increased. In order for professional mental health counseling and psychotherapy services to be covered for depression and other mental illnesses by public health insurance it would seem advisable that positive action is taken to resume and complete the negotiations on how to achieve national licensing for clinical psychologists in Japan through the Ministry of Health, Labour and Welfare and not just the Ministry of Education as is the current situation. These discussions were ongoing between all concerned mental health professional authorities that in the ongoing select committee and ministerial levels that were ongoing during the Koizumi administration. With the current economic recession adding even more hardship and stress in the lives its citizens, now would seem to be a prime opportunity for the responsible Japanese to take a pro-active approach to finally providing government approval for national licensing for clinical psychologists who provide mental health care counseling and psychotherapy services to the people of Japan.
During these last ten years of these relentlessly high annual suicide rate numbers the English media seems in the main to have done little more than have someone goes through the files and do a story on the so-called suicide forest or internet suicide clubs and copycat suicides (whether cheap heating fuel like charcoal briquettes or even cheaper household cleaning chemicals) without focusing on the bigger picture and need for effective action and solutions.
Economic hardship, bankruptcies and unemployment have been the main cause of suicide in Japan over the last 10 years, as the well detailed reports behind the suicide rate numbers that have been issued every year until now by the National Police Agency in Japan show only to clearly if any journalist is prepared to learn Japanese or get a bilingual researcher to do the research to get to the real heart of the tragic story of the long term and unnecessarily high suicide rate problem in Japan.
I would also like to suggest that as many Japanese people have very high reading skills in English that any articles dealing with suicide in Japan could usefully provide contact details for hotlines and support services for people who are depressed and feeling suicidal.
Some useful telephone numbers and links for residents of Tokyo and Japan who speak Japanese and/or Engish and are feeling depressed or suicidal and need to get in touch with a mental health professional qualified in Japan:
Inochi no Denwa (Lifeline Telephone Service):
Japan: 0120-738-556
Tokyo: 3264 4343
AMDA International Medical Information Center:
http://amda-imic.com/
http://www.counselingjapan.com
All the best from Tokyo!
Andrew Grimes JCCCP, JCP
Tokyo Counseling Services:
http://tokyocounseling.com/english/
http://tokyocounseling.com/jp/