Suicide is the cause of more than 703,000 deaths per year worldwide, which is equivalent to one person taking their own life every 40 seconds, according to the World Health Organization (WHO). Mental health had not been a topic of discussion for years, but after the COVID-19 pandemic it has regained the importance it deserves, although not at the levels necessary for the implementation of specific policies. In fact, this is the fourth leading cause of death globally and the third in Latin America where in 2019, some 98,000 people between the ages of 15 and 29 took their own lives, according to the WHO.
In 2000, the suicide rate in the Americas was 7.53 suicides per 100,000 inhabitants, in contrast to 21.88 suicides per 100,000 inhabitants in Europe, according to Burden of Suicides data from the Pan American Health Organization (PAHO). By 2019, the suicide rate in the Americas increased to 9.64, while in Europe it dropped to 12.76.
According to the same source, during the period 2000-2019, the highest suicide rate is found in the United States and Canada, compared to the rest of the countries in the region. In Latin America and the Caribbean, Uruguay is the country with the highest suicide rate (15.51), double the average for the region (6.5).
Mental health considers several aspects such as emotional, cognitive and behavioral health, as well as the ability to face and adapt effectively to life’s challenges. These conditions of good mental health require an understanding of health as a common good and imply that the well-being of society depends on the participation and commitment of all its members to achieve it.
However, when this state of well-being is impaired, various disorders can manifest as a result of emotional distress. Excessive pain and distress can lead people to consider suicide.
Although the decision to take one’s own life is an individual one, the social implications of suicide are substantial in terms of the health and well-being of a community and society as a whole. For these reasons, this phenomenon should be considered a mental health and public health problem that requires the joint action of governments, health institutions and society in general in order to be solved.
The WHO considers four key actions to improve this situation: 1) promotion, which seeks to influence favorable determinants (protective factors, i.e., conditions that favor a decrease in a person’s vulnerability to suicide and an increase in their ability to cope with difficulties) for the health of society; 2) prevention, which seeks to detect and treat people with a higher risk of suicide in advance; 3) intervention, which consists of providing support and treatment to the individual who has attempted suicide, as well as to his or her family; and finally, 4) the multisectoral approach, which promotes collaboration and coordination among various sectors of society.
For public policy intervention to be efficient and effective, it is a fundamental requirement for states to ensure fiscal stability, so that interventions are sustainable. The economic perspective is relevant due to compliance with fiscal rules, but also considering that the loss of life due to suicide has repercussions on the labor force and productivity of countries.
State involvement takes on a primary role with the implementation of public policies, which are made possible by government investment. According to data from the Economic Commission for Latin America and the Caribbean (ECLAC), health spending as a percentage of Gross Domestic Product (GDP), on average between 2000 and 2019, represented approximately 7.21% of the total budget of Latin American governments. It showed a gradual increase, with a minimum of 5.84% in 2003 and a maximum of 11.86% in 2019.
The country in the region that allocated more budget to the health sector in the analyzed period is Chile (3.97% of GDP). However, it is a relatively low figure, as it is lower than the lowest percentage allocated to the health sector by a European country, Latvia, which allocated 4.17% of its GDP.
According to World Bank Open Data, mental health spending as a percentage of total health spending in the region is led by Jamaica and Costa Rica with 6.04% and 2.91% respectively. Other countries such as Paraguay and Peru commit a smaller fraction of their resources, with only 0.31% and 0.27%, respectively. This allocation of spending on mental health highlights the spending priorities of governments in this area.
In the short term, it is crucial to focus on training health personnel to deal with cases of self-harm and signs of psychological illness. While in the long term, it will be necessary to evaluate the results of public policies already implemented such as the creation and maintenance of medical infrastructure, and efforts to reduce the stigma associated with certain health conditions such as mental health problems.
The impact of increased public spending on health does not manifest itself immediately. Investment in mental health will show results in the long term, and although the political returns may not be as evident in the expected elections, investment in health in general is crucial for the good of families and countries. Hopefully, the Latin American political class will understand that true statespersons must think about the next generation and not the next election.
*Translated by Janaína Ruviaro da Silva from the original in Spanish.
Autor
Economist. Professor of Economics at the University of the Americas - UDLA (Ecuador). Doctoral candidate at the University of Salamanca, Rule of Law and Global Governance program.
