1. A 30-year review of fatal suicides in Greece revealed that the number of completed suicides per month increased significantly after austerity measures were passed in 2011.
2. Other events that also correlated in time to statistically significant increases in the suicide rate included the start of the Greek recession and a public suicide committed in response to austerity measures. A temporary decrease in the suicide rate followed the launch of the Euro in Greece.
Evidence Rating Level: 2 (Good)
Study Rundown: Greece has been in the midst of an economic crisis for the last decade, which has led to the instatement of austerity measures to cut costs (e.g. reduce benefits for unemployment). Many have speculated that economic austerity measures and the resulting stress from financial strain may have led to an increase in the suicide rate. The authors of this study conducted the first systematic longitudinal analysis of the suicide rate in Greece and found that after austerity-related events there was a significant and abrupt increase in the suicide rate. For example, the number of total, male, and female suicides increased around June 2011 when the government passed economic austerity measures. The male suicide rate also increased with the beginning of the Greek recession in October 2008 and around the time of a public suicide in response to austerity measures in April 2012. Interestingly, researchers found an abrupt and temporary decrease in the male suicide rate in January 2002 after the Euro was launched in Greece (a prosperity-related event).
This study benefited from a strong study design and examination of three decades of data and over 11,000 suicides. It further incorporated statistical methods to account for flux in rates of unemployment, psychiatric disorders, status of the Greek healthcare system, and seasonal variability. It should be noted that non-fatal suicide attempts were not able to be factored into the data. Another limitation is that previous studies found suicides to be underreported in Greece, often for religious reasons. However, the authors performed a sensitivity analysis to include commonly misclassified accidental deaths (e.g. drowning) which resulted in the same associations. Overall, these findings contribute to the literature by suggesting that economic austerity measures may lead to an increase in the suicide rate, and that policy makers should more carefully consider the impacts of fiscal policy on population mental health.
In-Depth [retrospective cohort]: There were 9079 male and 2426 female suicides recorded by the Hellenic Statistical Authority in Greece between January 1983 and December 2012. A death by suicide was determined according to ICD-9 codes recorded in death certificates. An interrupted time-series analysis was used to test the impact of 12 highly publicized austerity and prosperity-related events. In June 2011, when the Greek government passed a second set of economic austerity measures, there was a temporary increase of 11 suicides per month (+36%, p<0.01). A sensitivity analysis that also included potentially misclassified accidental deaths from falls, poison, drowning, and suffocation confirmed this finding. Male suicides increased 13% in October 2008 around the beginning of the Greek recession (p<0.01), and briefly again by 30% in April 2012 after a public suicide in response to austerity policies (p<0.05). Female suicides also were found to have significantly increased since a month before economic austerity measures began in June 2011 (+36%, p<0.05). After the Euro was launched in January 2002, there was a 27% temporary decrease in the number of male suicides (p<0.05).
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