Is the role of mental illness in suicide overestimated?

Abstract

In the scientific literature, it is often said that 90% of all suicides are the consequences of a mental illness. Nevertheless, recent reports and comments cast doubt on this view and point out that such a limitation might hamper effective suicide prevention. In this overview we will outline and discuss important results on how often suicides are the consequence of mental illnesses and whether the association between mental illnesses and suicide might be overestimated. Mental illnesses and especially affective disorders increase the risk of suicide by 30 to 50 times. Nevertheless, they explain only a certain percentage of all suicides. Observational and treatment studies indicate that mental illness is only one factor of several that lead to suicide. Among other factors are relationship problems, drug abuse, severe somatic illnesses, job problems, financial worries or juridical threats. Suicidal behaviour is an indicator of deep unhappiness but not necessarily caused by a mental illness. Many persons with mental illnesses do not show suicidal behaviour. On the other hand, not all people who take their own lives have a mental illness. This has significant consequences for universal and indicated prevention of suicide.