Public mental health and suicide

Abstract The full public health impact of mental health is largely unrecognized. The allocation of the burden of disease attributable to mental and behavioural disorders, which is already substantial, will probably increase steadily in the future, due to the transition of the global disease burden towards mental and behavioural disorders. In addition to the demands that mental disorders put on social welfare and health systems, they also cause decreased productivity in the workplace, prolonged disability, and diminished resources within families. Mental disorders are linked to socioeconomic disadvantages and addressing mental health determinants will reduce health inequalities. Stigma of mental disorders is widespread, and it is a barrier for help-seeking behaviours, as well as the development of healthcare services. Modern mental health policies should aim at improving psychosocial health by addressing determinants of mental health in all public policies. Lately, there has been a heightened interest in the promotion of positive mental health and well-being. Effective programmes have been developed for promoting mental health in everyday settings such as families, schools, and workplaces. New evidence indicates that many mental disorders and suicides are preventable by public mental health interventions. Strong empirical evidence shows that suicide prevention is feasible, effective, and highly cost-effective. Available evidence favours the population approach over high-risk approaches to suicide prevention, as it has the potential to prevent a greater a number of deaths. However, one should not neglect the selective prevention strategies focusing on high-risk groups for suicide, as existing evidence on effective interventions is growing. Key measures in effective public health suicide prevention programmes comprise improved awareness in the population about mental health, the restriction of access to lethal means of suicide, responsible media coverage of suicide issues, and improvements in the identification of depression and suicidality by peers, gatekeepers, and health professionals. Modern community-based mental health services, with a diversified service provision, result in better outcomes on a broader scale compared to ‘old school’ hospital-centred mental health service systems. Primary care has a central role in provision of mental health services to the population.