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. Key measures in effective public health suicide prevention programmes comprise improved awareness in the population about mental health promotion and suicide preventive measures, the restriction of access to lethal means of suicide, responsible media coverage of suicide issues, school-based awareness programmes, 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 physicians in collaboration with multidisciplinary teams have a central role in provision of mental health services to the population.